Three year outcomes in infants with a family history of autism and/or attention deficit hyperactivity disorder

JCPP advances Pub Date : 2023-08-02 DOI:10.1002/jcv2.12189
Tony Charman, Greg Pasco, Alexandra Hendry, Tessel Bazelmans, Nisha Narvekar, Amy Goodwin, Hanna Halkola, Mary Agyapong, Rebecca Holman, Jannath Begum Ali, Mutluhan Ersoy, Mark H. Johnson, Andrew Pickles, Emily J. H. Jones, The STAARS Team
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引用次数: 1

Abstract

Background

Most research on early outcomes in infants with a family history (FH) of autism has focussed on categorically defined autism, although some have language and developmental delays. Less is known about outcomes in infants with a FH of attention deficit hyperactivity disorder (ADHD).

Methods

Infants with and without a FH of autism and/or ADHD, due to a first-degree relative with either or both conditions, were recruited at 5 or 10 months. Three year outcomes were characterised using latent profile analysis (LPA) across measures of cognitive ability, adaptive functioning and autism, ADHD and anxiety traits (n = 131). We additionally ran an LPA using only autism and ADHD measures, and the broader LPA in an independent cohort (n = 139) and in both cohorts combined (n = 270).

Results

A Low Developmental Level + High Behavioural Concerns class had elevated autism, ADHD and anxiety scores, low cognitive and adaptive function, and included all but one child with autism. A Low Developmental Level + Typical Behaviour class had average cognitive ability and typical behaviour but low adaptive function. A Typical Developmental Level + Some Behavioural Concerns class had average cognitive and adaptive function but slightly elevated behaviour scores. A High Developmental Level + Typical Behaviour class had above average cognitive ability and typical behaviour. All four LPAs identified classes characterised by combinations of either, or both, Low Development Level and elevated behaviour scores, as well as a typically developing class. No classes had elevated autism or ADHD traits in isolation.

Conclusions

Some infants with a FH of autism or ADHD have atypical developmental and behavioural outcomes, but do not show strong autism or ADHD traits in isolation. The field needs to recalibrate aims and methods to embrace the broader transdiagnostic pattern of outcomes seen in these infants.

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有自闭症和/或注意缺陷多动障碍家族史的婴儿的三年结果
大多数关于有自闭症家族史(FH)的婴儿早期结果的研究都集中在明确定义的自闭症上,尽管有些人有语言和发育迟缓。对于FH婴儿的注意缺陷多动障碍(ADHD)的结果知之甚少。在5个月或10个月时招募患有或不患有自闭症和/或ADHD的婴儿,因为有一级亲属患有其中一种或两种情况。使用潜在轮廓分析(LPA)对认知能力、适应功能、自闭症、多动症和焦虑特征的测量进行三年结果表征(n = 131)。此外,我们仅使用自闭症和ADHD测量方法进行LPA,并在独立队列(n = 139)和两个队列联合(n = 270)中进行更广泛的LPA。低发育水平+高行为关注班的自闭症、多动症和焦虑得分较高,认知和适应功能较低,除了一名自闭症儿童外,其他所有儿童都患有自闭症。低发育水平+典型行为组的认知能力和典型行为一般,但适应功能较低。一个典型的发展水平+一些行为问题班的认知和适应功能一般,但行为得分略高。高发展水平+典型行为班认知能力和典型行为均高于平均水平。所有四个指标都确定了以低发展水平和高行为分数的组合或两者的组合为特征的类别,以及典型的发展类别。在孤立的班级中,没有自闭症或ADHD特征升高的班级。一些患有自闭症或多动症的婴儿有非典型的发育和行为结果,但孤立地不表现出强烈的自闭症或多动症特征。该领域需要重新调整目标和方法,以接受在这些婴儿中看到的更广泛的转诊模式。
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