Shared and Distinct Developmental Pathways to ADHD and Autism Spectrum Disorder

 描述（由申请人提供）：拟议项目的总体目标是确定自闭症谱系障碍（ASD）和注意力缺陷/多动障碍（ADHD）症状的共同和独特的早期行为指标，并更好地了解每种综合征风险儿童的ASD和ADHD的早期发育途径。ASD和ADHD是两种在儿童早期出现的流行疾病，每一种都会造成严重的长期损害。共同发生是常见的，有证据表明，共享遗传性和家族传播，以及重叠的神经和神经认知异常，但我很少知道的独特和共享的功能非常早期的发展，诊断之前。很明显，确定与ASD或ADHD发展唯一相关的早期体征对于加强准确的早期检测工作和确定理想的干预目标和时间点至关重要。还没有得到很好理解的是，通过确定跨诊断因素或跨疾病共享的过程，这些因素是症状发展的基础，预防和早期干预工作的影响也将得到加强。这是一种适用于ASD和ADHD研究的理想方法，因为鉴于共同的生物学和行为异常的证据，一些早期行为指标也可能重叠，作为非典型发展的一般指标，可用于跨诊断治疗开发和预防工作。两个纵向研究提出了检查早期行为指标和发展轨迹在三组儿童：婴儿兄弟姐妹的ASD儿童（高风险ASD），婴儿兄弟姐妹的ADHD儿童（高风险ADHD），婴儿兄弟姐妹的典型发展的儿童（低风险）。K99研究旨在确定在12个月和18个月大的关键认知，语言，社交和行为领域中，24个月大时维度测量的ASD与ADHD症状发展的早期共享和不同预测因素。R 00研究将建立在K99研究的基础上，对36个月的婴儿进行独立样本，并纳入额外的测量策略和分类诊断结果，从而检查ASD儿童与ADHD诊断结果的共同和不同的早期发育轨迹。在每项研究中，多方法、多知情人、多维度评价将包括直接行为评估、眼动追踪、父母完成的评定量表和检查员完成的评定。这些研究对于（a）阐明共同与不同的发育途径;（B）准确的早期筛查、评估和鉴别诊断至关重要;以及（c）确定关键领域和时间点，用于制定有针对性的、以过程为中心的干预和预防方案，所述干预和预防方案可以在生命早期应用于患有各种诊断或处于各种诊断风险中的许多个体群体，符合NIH研究领域标准（RDoC）的目标。

 DESCRIPTION (provided by applicant): The overarching goals of the proposed project are to identify shared and distinct early behavioral indicators for autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) symptoms, and to better understand early developmental pathways to ASD and ADHD in children at risk for each syndrome. ASD and ADHD are two prevalent disorders emerging early in childhood, each conferring significant long-term impairment. Co-occurrence is common, and there is evidence of shared heritability and familial transmission, as well as overlapping neural and neurocognitive abnormalities, but little i known about unique and shared features very early in development, prior to diagnosis. It is clear that determining early signs uniquely associated with the development of ASD or ADHD is critical to enhancing accurate early detection efforts and identifying ideal targets and time point for intervention. What has been less well appreciated is that the impact of prevention and early intervention efforts will also be heightened by identifying transdiagnostic factors, or processes shared across disorders, that underlie symptom development. This is an ideal approach to apply to the study of ASD and ADHD because, given evidence of shared biological and behavioral abnormalities, it is likely that some early behavioral indicators also overlap, serving as general indices of atypical development that could be leveraged for transdiagnostic treatment development and prevention efforts. Two longitudinal studies are proposed to examine early behavioral indicators and developmental trajectories in three groups of children: infant siblings of children with ASD (high-risk ASD), infant siblings of children with ADHD (high-risk ADHD), and infant siblings of typically developing children (low-risk). The K99 study aims to identify early shared and distinct predictors of the development of dimensionally-measured ASD versus ADHD symptoms at 24 months of age across key cognitive, language, social, and behavioral domains at 12 and 18 months of age. The R00 study will build upon the K99 study, following an independent sample of infants through 36 months and incorporating additional measurement strategies and categorical diagnostic outcomes, allowing for the examination of shared and distinct early developmental trajectories of children with ASD versus ADHD diagnostic outcomes. Within each study, multi-method, multi-informant, multidimensional evaluations will include direct behavioral assessments, eye tracking, parent-completed rating scales, and examiner- completed ratings. These studies will be critical for (a) elucidating shared versus distinct developmental pathways; (b) accurate early screening, assessment, and differential diagnosis; and (c) determining key domains and time points for the development of targeted, process-focused intervention and prevention programs that can be applied early in life across many groups of individuals with, or at risk for, various diagnoses, consistent with the NIH Research Domain Criteria (RDoC) goals.