Predicting ADHD symptoms and diagnosis at age 14 from objective activity levels at age 7 in a large UK cohort

Valerie Brandt,Julia Kerner auch Koerner,Praveetha Patalay

doi:10.1007/s00787-020-01566-9

Abstract

Hyperactivity is one of the three core symptoms in children with attention deficit hyperactivity disorder (ADHD). Diagnosing ADHD typically involves self-report, third party report and observations. Objective activity data can make a valuable contribution to the diagnostic process. Small actigraphy studies in clinical samples have shown that children with ADHD move more than children without ADHD. However, differences in physical activity between children with and without ADHD have not been assessed in large community samples or longitudinally. This study used data from the Millennium Cohort Study to test whether symptoms of ADHD (parent-rating Strengths and Difficulties Questionnaire) and ADHD diagnosis at age 14 (reported by parents) could be predicted from objective activity data (measured with actigraphs) at age 7 in N = 6675 children (final N = 5251). Regressions showed that less sedentary behavior at age 7 predicted more ADHD symptoms at age 14 (β = − 0.002, CI − 0.004 to − 0.001). The result remained significant when controlled for ADHD symptoms at age 7, sex, BMI, month of birth, SES and ethnicity (β = − 0.001, CI − 0.003 to − 0.0003). ADHD diagnosis at age 14 was also significantly predicted by less sedentary behavior at age 7 (β = − 0.008). Our findings show that symptoms of ADHD can be predicted by objective activity data 5 years in advance and suggest that actigraphy could be a useful instrument aiding an ADHD diagnosis. Interestingly, the results indicate that the key difference between children with and without ADHD lies in reduced sedentary activity, i.e., times of rest.

Highlights

Attention deficit hyperactivity disorder (ADHD) is a common childhood-onset, neurodevelopmental disorder that is characterized by three core symptom domains: hyperactivity, inattention and impulsivity [1]
The results show that lower levels of sedentary activity during the day at age 7 can significantly predict symptoms of ADHD at age 14 over and above parent report
15–70% of children with ADHD continue to display ADHD symptoms in adolescence [39, 40]. It was previously shown in 116 patients with an ADHD diagnosis that ADHD symptoms in adolescence can be predicted by parent-rated hyperactivity/impulsivity and inattention in childhood, comorbidities, SES, and mean activity level [41]

Summary

Introduction

Attention deficit hyperactivity disorder (ADHD) is a common childhood-onset, neurodevelopmental disorder that is characterized by three core symptom domains: hyperactivity, inattention and impulsivity [1]. ADHD is characterized by persistent and trans-situational hyperactivity/impulsivity, inattention or both with a childhood onset and an impairment in functioning [1]. One of the main limiting factors in reaching an ADHD diagnosis is limited, corroborating evidence from family and friends [3]. Neuropsychological tests, such as continuous performance tests, can be conducted but are less commonly used than observation [3, 4]. The subjectivity of observations and reports, and the absence of a ‘gold standard’ diagnostic process has been criticized [4, 5]

Objectives

Results

Conclusion