ADHD Establishing an agenda of international scientific research

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Background

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent, impairing, and highly heritable condition typically diagnosed in middle childhood. But, it’s now accepted that symptoms develop earlier in the development process. Research focused on understanding–using multiple units of analysis–the cascade of early-life (i.e., prenatal-infant-toddler) developmental changes that will later emerge as ADHD has the potential to transform early identification, prevention, and intervention. In this regard we present the newly created Early ADHD Consortium, an international group of researchers involved in long-term, prospective research on the risk of ADHD starting at an early age, and conducted in a developmental context, using multi method methods. The network aims to align methods and measures to enhance the possibility of data sharing and the subsequent impact.

Methods

This paper discusses the importance of examining the pre-diagnostic indicators of ADHD as well as possible models and mechanisms for ADHD vulnerability and growth with the ultimate goal of facilitating the development of preventive interventions that minimise the effect of ADHD symptoms on daily functioning and improve health and developmental outcomes.

Results

We highlight the major issues and concerns in this field that relate to theories and the developmental mechanisms involved in ADHD and suggest future steps for the field of science that include measurement, methodological and design issues. Then, we discuss the potential consequences for developing preemptive interventions. We then discuss additional issues, including ethical concerns and the importance of incorporating input from stakeholders.

Important points

ADHD is a widespread and debilitating condition that is typically diagnosed around the age of 7 however it is now becoming increasingly recognized that symptoms are evident earlier.

The research focusing on understanding the development process that occurs in early life changes that happen in ADHD across a variety of levels of analysis could have the potential to change early detection and treatment.

We created The Early ADHD Consortium, a group of researchers who are engaged in longitudinal, prospective research that begins very early in life, carried out in a developmental context, and that employ multimethod strategies We outline the key aspects of the work in the hope of establishing an agenda of research for the field.

We are striving to speedily increase our understanding of early developmental pathways leading to ADHD and improve outcomes for children and infants at risk.

Introduction

Attention-deficit/hyperactivity disorder (ADHD) is an impairing neurodevelopmental disorder with global prevalence estimated at. Though it is typically diagnosed during middle childhood , the core ADHD symptoms typically manifest in the early years of preschool and the underlying temperamental or other causes might be present earlier. Affected individuals follow heterogeneous, multifinal developmental pathways and show dysregulation across multiple domains, including attentional control (e.g., maintaining/shifting attention), arousal (e.g., alerting/initiation), executive functioning (e.g., inhibiting behaviour, working memory, planning, organisation), and emotion regulation (e.g., regulating internal emotional states and behavioural expressions of emotion) . In reality, ADHD is associated with chronic impairment) which often indicates types of psychopathology that are emerging later (Barbaresi and others. ) and often co-occurs with other ailments (e.g. depression, percent], anxiety (nearly 20 percent oppositional defiant conduct disorder  or a specific learning disorder. The majority of kids suffering from ADHD have at minimum one co-occurring mental illness or neurodevelopmental diagnosis . Since ADHD is typically the first one of these disorders to be recognized and is believed to cause a negative impact on later co-occurring disorders and conditions, it plays a significant part in public health. The early detection and mechanistic understanding may allow preventative interventions that decrease the risk of causing impairments of ADHD symptoms as well as various other impairments related conditions, complications and disorders.

Why do we study the early development of ADHD?

There is a growing body of evidence that suggests that the etiological processes that are associated with ADHD are most active prior to the time when symptoms can be measured reliably which is a good reason to study the developmental origins of ADHD and biomarkers that can be that are associated with ADHD. The first reason is that it can help to gain a better comprehension of ADHD. ADHD is a highly genetically inherited disorder (Faraone & Larsson,) and polygenic scores generated from ADHD-related common genetic variations are at a minimum to some degree predictive of the symptoms of ADHD and neurodevelopmental gene pathways involved (Cross-Disorder group within the Psychiatric Genomics Consortium, . Furthermore, well-established environmental risk factors associated with ADHD are primarily concentrated in the beginning of life, which includes the antenatal and postnatal phases but direct causal proof is not yet established. Risk factors for prenatal birth could be linked to stress during pregnancy or poor nutrition and/or the maternal metabolic condition as discussed below. These are thought to impact the development of the brain in combination with genetic influences that could, ultimately, can cause the subsequent development of symptoms related to behaviour.

Additionally, although there are a few of these risk factors that are immediate interventions however, research in this field could help (a) determine those at risk by using more comprehensive early risk indicators as well as (b) find new ways to enhance the health of the brain and to prevent the clinically impaired symptoms of ADHD as well as other disorders. One of the main goals is to understand how these elements influence the human brain’s development and behaviour, specifically during the foetal and toddler stages where experience-expectant, neuroplasticity that is dependent on experience are the highest which means that new strategies are developed to stop the effects of early problems from spreading and enhance health and functioning. Understanding these early processes could be a clue to more sensitive and precise indicators of ADHD danger that can aid in an earlier detection and a subject we will return to in the future.

Conclusions

It is expected that this approach will help to create an agenda for research that will improve collaboration efforts and accelerate the understanding of developmental mechanisms as well as the early ADHD condition, which has consequences for intervention in the early stages of and enhancement of healthy growth for young children, infants and their families.

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