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Published on: June 12, 2020
Inattentive/overactive children with histories of profound institutional deprivation compared with standard ADHD
1Developmental Brain-Behaviour Laboratory, School of Psychology, University of Southampton, Southampton, UK. ejb3@soton.ac.uk
Insights
Children with ADHD symptoms and early deprivation (D-I/OA) showed similar ADHD symptoms to clinical ADHD cases, but greater neuropsychological impairment. Girls with D-I/OA experienced symptom remission, unlike boys.
Area of Science:
- Neuroscience
- Child Psychology
- Developmental Psychology
Background:
- Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms, characterized by inattention/overactivity/impulsiveness (I/OA), are linked to early institutional care.
- The English and Romanian Adoptees (ERA) study provides a unique cohort for examining the long-term effects of severe early deprivation.
Purpose of the Study:
- To compare the symptom and neuropsychological profiles of children with a history of I/OA and early severe deprivation (D-I/OA) against standard clinical ADHD cases (S-ADHD) and deprivation-exposed controls (ERA-controls).
- To investigate potential gender differences in ADHD symptom persistence and neuropsychological outcomes in children with a history of institutional care.
Main Methods:
- Comparison of symptom and neuropsychological profiles in three groups: D-I/OA (n=13), S-ADHD (N=20), and ERA-controls (n=22).
- Participants were assessed around age 13, with D-I/OA and ERA-controls drawn from the ERA study cohort.
- Longitudinal data were analyzed to track symptom changes over time.
Main Results:
- Male D-I/OA and S-ADHD cases exhibited similar ADHD symptom patterns.
- Female D-I/OA cases showed symptom profiles more aligned with ERA controls, suggesting remission.
- Neuropsychological assessments revealed greater impairment in both male and female D-I/OA children compared to S-ADHD and ERA controls.
Conclusions:
- Children with D-I/OA demonstrate significant neuropsychological deficits irrespective of persistent ADHD symptoms, which were more evident in boys.
- Gender differences in symptom persistence were observed, with girls showing remission.
- Findings highlight the profound and persistent neuropsychological impact of early severe deprivation, even when overt ADHD symptoms diminish.
Background:
The Inattention/Overactivity/Impulsiveness (I/OA) behavioural cluster diagnostic of ADHD is recognized as a characteristic outcome of early institutional care.
Methods:
We compared the symptom and neuropsychological profiles of children with a history of I/OA and early severe deprivation (D-I/OA: n=13) with standard clinical ADHD cases (S-ADHD; N=20) and children who had experienced deprivation but were not pervasively I/OA (ERA-controls; n=22). The mean age of testing was around 13 years. D-I/OA and ERA-controls were selected from the English and Romanian Adoptees (ERA) study and had spent their early lives in the extremely depriving Romanian institutions of the Ceausescu regime and were later adopted into UK families.
Results:
ADHD symptoms for male D-I/OA and S-ADHD cases showed marked similarities across symptom domains. In contrast, girls with D-I/OA were more similar to ERA controls than to ADHD cases. Longitudinal data suggested that this was due to a remission of symptoms in D-I/OA girls. Neuropsychological profiles of males and females with D-I/OA, however, were similar: both were more impaired than S-ADHD and ERA controls.
Discussion:
Children with D-I/OA were more neuropsychologically impaired than S-ADHD despite the fact that only boys showed a persistent pattern of ADHD symptoms. These results need replication in a larger sample with groups matched for gender.
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