Early Childhood Assessments of Community Pediatric Professionals Predict Autism Spectrum and Attention Deficit Hyperactivity Problems

Merlijne Jaspers,Catharina A Hartman,Andrea F De Winter,Frank C Verhulst,Jan K Buitelaar,Sijmen A Reijneveld

doi:10.1007/s10802-012-9653-4

Abstract

For clinically referred children with Autism Spectrum Disorder (ASD) or Attention Deficit/Hyperactivity Disorder (ADHD) several early indicators have been described. However, knowledge is lacking on early markers of less severe variants of ASD and ADHD from the general population. The aim of the present study is to identify early indicators of high risk groups for ASD and ADHD problems based on routine data from community pediatric services between infancy and age four. Data are from 1,816 participants who take part in Tracking Adolescents’ Individual Lives Survey (TRAILS), a longitudinal study. Information on early developmental factors was extracted from charts of routine Preventive Child Healthcare (PCH) visits. To assess ASD and ADHD problems, respectively, we used the Children’s Social Behavior Questionnaire (CSBQ) and the Child Behavior Checklist (CBCL), filled out by parents three times between the ages of 11 and 17. Note that these are parent ratings and not diagnostic instruments performed by trained clinicians. Male gender, low birth weight, low level of education of the mother, social, behavioral, language, psychomotor and eating problems significantly predicted ASD problems (odds ratios (OR) between 1.34 and 2.41). ADHD problems were also predicted by male gender and low level of education of the mother and by maternal smoking during pregnancy, good gross motor skills in first year, early attention and hyperactivity problems, and absence of parent-reported positive behavior (ORs between 1.36 and 1.74). Routine data on early childhood from PCH services are predictive for ASD and ADHD problems in adolescents in the general population. The PCH services are a useful setting to identify high risk groups, and to monitor them subsequently.

Highlights

Autistic spectrum disorders (ASD) and Attention Deficit/ Hyperactivity Disorder (ADHD) are neurodevelopmental disorders with an onset early in life, with a prevalence of around 1 % and 5 %, respectively (St Pourcain et al 2011; Rommelse et al 2011)
The aim of the present study is to identify early indicators of high risk groups for ASD and ADHD problems based on routine data from community pediatric services between infancy and age four
We investigated whether our final multivariate models changed when we brought the presence of ASD problems into the equation for predicting ADHD problems and vice versa; this to determine whether identified indicators were generic or specific to these problems

Summary

Introduction

Autistic spectrum disorders (ASD) and Attention Deficit/ Hyperactivity Disorder (ADHD) are neurodevelopmental disorders with an onset early in life, with a prevalence of around 1 % and 5 %, respectively (St Pourcain et al 2011; Rommelse et al 2011). Less severe variants of ASD and ADHD below the threshold for a diagnosis seem common, as shown by both family studies and studies in the general population (Constantino and Todd, 2005; Levy et al 1997; Losh et al 2009; Thapar et al 2001). We further denote these as ASD and ADHD problems. Even at subthreshold level, problems may be an important burden for the children themselves, their parents, and others in their environment which may be alleviated by treatment

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