Abstract
BackgroundSeveral longitudinal studies have shown the partial symptomatic persistence of attention-deficit hyperactivity disorder (ADHD) in clinic-based samples. However, little is known about the patterns and trajectories of ADHD symptoms in community-based populations.MethodsTo differentiate developmental trajectories of ADHD symptoms over 1 year, with a four-wave quarterly follow-up in children and adolescents in the community of Taiwan, we conducted this prospective study in 1281 students in grade 3, 5, and 8. All the students in the regular classes rather than special educational classes were eligible and recruited to the study. Inattention, hyperactivity–impulsivity, and opposition-defiance were rated by parent reports on the Chinese version of the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV). Group-based trajectory modeling and multivariable regression analyses were used to explore the individual, family and social factors associated with differential trajectories.ResultsTrajectories were classified as Low (29.9–40.6%), Intermediate (52.5–58.5%) and High (6.9–12.5%) based on the symptom severity of ADHD symptoms assessed by the SNAP-IV. The proportion of children in the high ADHD trajectory might approximately reflect the prevalence of ADHD in Taiwan. The following factors differentiated High from Low trajectories: male gender, more externalizing problems, fewer prosocial behaviors, school dysfunction, more home behavioral problems, and less perceived family support.ConclusionsOur findings that the concurrent conditions of emotional or externalizing problems, as well as impaired school and home function at baseline, might differentiate the high ADHD symptoms trajectory from others could help developing the specific measures for managing high ADHD symptoms over time in a school setting.
Highlights
Several longitudinal studies have shown the partial symptomatic persistence of attention-deficit hyperactivity disorder (ADHD) in clinic-based samples
One-fifth of participants entered the study while they were in grade 3, one-fifth were in grade 5, and 57% of participants were in grade 8
About 6.9–12.5% children were classified in the High trajectories of ADHD symptoms, which might be the approximate prevalence of ADHD in Taiwan
Summary
Several longitudinal studies have shown the partial symptomatic persistence of attention-deficit hyperactivity disorder (ADHD) in clinic-based samples. The understanding of ADHD symptoms trajectories came mainly from clinic-based studies but not from community studies [7, 8]. Identifying the patterns and trajectories of ADHD symptoms in the non-clinical sample has important implications for the guidance and development of effective prevention and management. Characterizing the persistence of ADHD symptoms is methodologically challenging, partly owing to the complexity in acquiring prospective longitudinal data, provided by a limited number of studies [7,8,9,10], several of which relied on clinic-based samples [7, 8]. Research about the different persistence patterns of ADHD symptoms in community samples may complement findings from the clinic-based literature
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