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[Hyperactivity at 18 months of age and attention-deficit hyperactivity disorder before entry to school--follow up
1Mental Health and Welfare Center of Nagano Prefecture.
Insights
Early childhood behavior, like scurrying away from parents at 18 months, is a significant predictor of Attention-Deficit/Hyperactivity Disorder (ADHD) in later years. This early sign may indicate hyperactivity and impulsivity, suggesting a need for early intervention.
Area of Science:
- Developmental Psychology
- Child Psychiatry
- Behavioral Pediatrics
Context:
- Observational study of attachment behaviors in 18-month-old children during developmental checkups.
- Prospective follow-up of 978 children until school entry.
Purpose:
- To investigate the relationship between specific early childhood behaviors and later diagnoses of neurodevelopmental disorders.
- To identify early behavioral markers for Attention-Deficit/Hyperactivity Disorder (ADHD).
Summary:
- A distinct "scurrying away" behavior observed in 18-month-olds, particularly when not looking back at parents, was found to be significantly associated with ADHD diagnoses before school entry.
- This behavior at 18 months correlates with hyperactivity and impulsivity (e.g., throwing blocks), serving as an early indicator.
- ADHD subtypes were identified based on the presence of this "scurrying away" behavior and aggressivity, with a combined subtype requiring continuous early intervention due to associated impulsivity, speech delay, and behavioral issues.
Impact:
- Identifies a specific, observable behavior in infancy that can aid in the early detection of ADHD.
- Suggests that early identification of ADHD subtypes can guide timely and targeted therapeutic interventions.
- Highlights the long-term implications of early behavioral patterns, potentially predicting future Conduct Disorder or Learning Disorder if not addressed.
Abstract:
Forty children with the following behavior characteristic were selected by observing the attachment behavior between them and their parents at the time of developmental exam in a 18 months' health checkup. The behavior in question is; 18 month old children scurry away from their parent without looking back on parent's calls and without confirming parent's positions. Then all the examined 978 children including the children who had shown the above scurrying away behavior were prospectively followed until before the entry to school. At age six, 6 children were diagnosed of Mental Retardation, 4 of Pervasive Developmental Disorder, and 28 of Attention-Deficit Hyperactivity Disorder (ADHD). Now these results (especially the relationships between this scurrying away behavior at 18 months and ADHD before the entry to school) were analyzed statistically and discussed, then the next conclusions were derived. 1. This scurrying away behavior, especially the behavior without confirming parent's positions, is significantly related to ADHD before the entry to school. 2. This scurrying away behavior is one of the characteristic behaviors at 18 months in ADHD and corresponds to hyperactivity at 18 months. 3. The conduct of throwing a toy block is one of the behaviors that indicates impulsivity at 18 months, when children are requested to hand over a toy block in the developmental exam. 4. Through behavioral observation, ADHDs before the entry to school are categorized to 3 subtypes by presence or absence of this scurrying away behavior at 18 months or by presence or absence of aggressivity before the entry to school. 5. Among the 3 subtypes, the type with this scurrying away behavior and aggressivity before the entry is most necessary to be treated continuously from early childhood. Because it has impulsivity and speech delay since 18 months and untreatable behavioral problems in day nurseries or kindergartens, and therefore it might have Conduct Disorder or Learning Disorder in the future.