Developmental origins and early detection of ADHD and dysregulatory psychopathology

PROJECT SUMMARY: The goal of this proposal is to identify early life predictors of symptoms of ADHD and associated behavioral and

emotional problems. To do so children are followed from before birth to 4.5-years of age—on the cusp of school entry and well into the preschool period. ADHD and related problems with behavioral and emotional dysregulation are often not

clinically identified until school age. By that point they are difficult to reverse. This proposal answers calls in the literature

for earlier identification of risk and for discovery of early life mechanisms that can be targets for low-risk yet effective

early life intervention to prevent the full onset of these problems. To do so we expand the study of an existing maternal-

infant cohort by adding measures, time points, and an older outcome. We extend the cohort from the toddler years into the preschool period when psychopathology has begun to take shape and be able to be relatively reliably characterized. Key mechanisms to be examined are (a) biological signals in early life, focused on maternal inflammation and serotonergic

metabolites during pregnancy and the trajectory of change in those signals in the first three years of life; (b) brain development as indexed by EEG measures from birth to age 3-years (lower cost and more readily clinically applicable than MRI at this stage); and (c) behavioral dynamics in early caregiving, about which little is known regarding ADHD

risk in the first 24 months of life. The inflammation hypothesis builds on striking preliminary data uncovered by the PI's in their prior work. The EEG metrics likewise are supported by preliminary evidence. The behavioral data also have strong preliminary data and build on multiple theorists' proposals about the role of early emotional regulation in

subsequent risk for dysregulatory psychopathology and ADHD. Both baseline (intercept) and change (trajectory) measures will be examined to help evaluate when in development a particular domain or level of analysis is most informative to subsequent outcome. Each of these hypotheses is examined in stand-alone fashion, and then with those

findings in hand, an integrative developmental model will be tested. If successful the study will open new directions for

low-risk yet potentially effective early intervention by identifying specific, measurable, and reversible risk factors or mechanisms as candidates for clinical trial follow up.