Solving the jigsaw! Understanding biological and environmental effects on ADHD through discordant mononozygotic twins

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The recent Child and Adolescent component of the National Mental Health Survey identified Attention Deficit Hyperactivity Disorder(ADHD) as the most common behavioural problem among Australian children. Since 1991 our Australian Twin ADHD Project (ATAP) has developed as one of the world's largest programs on the genetics of ADHD, and in 2001 we published the first text on this topic. In this grant we turn the focus onto environmental influences with the question Why can one identical twin have ADHD, while the other twin has no difficulties? Using the unique resources of the Australian Twin Registry and the WA Twin Child Health Study, we shall work across the country to find over 100 identical twin pairs who are very different in ADHD. In this way, each ADHD affected twin has an unaffected 'control twin', offering a powerful means for comparing the two. Such a study is really only possible in Australia, as no other country has such twin resources for research. The questions we want to consider with these children include the following 1- Twins have a more difficult time before and at birth. To what extent do these problems contribute to differences between the twins? 2- Are there differences in specific aspects of brain functioning? 3- Is it that one twin grows out of their ADHD but the other does not? If so, what distinguishes the children? 4- What is it like growing up with a twin who has ADHD, when you have no difficulties yourself? 5- When one twin has ADHD symptoms, is the family more likely to seek help, as they can see how different this child is form the other twin? Obviously identical twins in wehich only one has ADHD are a very unique group. By covering all aspects of development, from brain functioning to service utilisation, the hope is that this study will provide invaluable insights into this common condition which will help all children and families where the diagnosis of ADHD has been made.