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BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a prevalent, impairing, and highly heritable condition typically diagnosed in middle childhood. However, it is now recognized that symptoms emerge much earlier in development. 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. To this end, we introduce the recently established Early ADHD Consortium, an international network of investigators engaged in prospective, longitudinal studies of risk for ADHD beginning early in life, conducted within a developmental framework, and which incorporate multimethod approaches. This network seeks to harmonize measures and methodological approaches to increase the potential for data sharing and subsequent impact.MethodsThis perspective paper highlights the importance of investigating pre-diagnostic markers of ADHD, and potential models and mechanisms of ADHD risk and development, with the long-term objective of facilitating development of preemptive interventions that will minimize the impact of ADHD symptoms on everyday functioning and maximize health and developmental outcomes.ResultsWe selectively describe key challenges and questions for this field related to theoretical models and developmental mechanisms in ADHD and recommend next steps for the science, including methodological, measurement, and study design considerations. We then describe potential implications for preemptive intervention development. We conclude by considering other issues including ethical concerns and the critical value of incorporating stakeholder input.ConclusionsIt is hoped that this perspective puts forth a research agenda that will enhance collaborative efforts and accelerate progress in understanding developmental mechanisms and the early ADHD phenotype, with implications for early intervention enhancement of healthy development for infants, young children, and their families.

High levels of early emotionality (of either negative or positive valence) are hypothesized to be important precursors to early psychopathology, with attention-deficit/hyperactivity disorder (ADHD) a prime early target. The positive and negative affect domains are prime examples of Research Domain Criteria (RDoC) concepts that may enrich a multilevel mechanistic map of psychopathology risk. Utilizing both variable-centered and person-centered approaches, the current study examined whether levels and trajectories of infant negative and positive emotionality, considered either in isolation or together, predicted children's ADHD symptoms at 4 to 8 years of age. In variable-centered analyses, higher levels of infant negative affect (at as early as 3 months of age) were associated with childhood ADHD symptoms. Findings for positive affect failed to reach statistical threshold. Results from person-centered trajectory analyses suggest that additional information is gained by simultaneously considering the trajectories of positive and negative emotionality. Specifically, only when exhibiting moderate, stable or low levels of positive affect did negative affect and its trajectory relate to child ADHD symptoms. These findings add to a growing literature that suggests that infant negative emotionality is a promising early life marker of future ADHD risk and suggest secondarily that moderation by positive affectivity warrants more consideration.

Understanding of the effects of in utero opioid exposure on neurodevelopment is a priority given the recent dramatic increase in opioid use among pregnant individuals. However, opioid abuse does not occur in isolation-pregnant individuals abusing opioids often have a significant history of adverse experiences in childhood, among other co-occurring factors. Understanding the specific pathways in which these frequently co-occurring factors may interact and cumulatively influence offspring brain development in utero represents a priority for future research in this area. We highlight maternal history of childhood adversity (CA) as one such co-occurring factor that is more prevalent among individuals using opioids during pregnancy and which is increasingly shown to affect offspring neurodevelopment through mechanisms beginning in utero. Despite the high incidence of CA history in pregnant individuals using opioids, we understand very little about the effects of comorbid prenatal opioid exposure and maternal CA history on fetal brain development. Here, we first provide an overview of current knowledge regarding effects of opioid exposure and maternal CA on offspring neurodevelopment that may occur during gestation. We then outline potential mechanistic pathways through which these factors might have interactive and cumulative influences on offspring neurodevelopment as a foundation for future research in this area.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are commonly comorbid, share genetic liability, and often exhibit overlapping cognitive impairments. Clarification of shared and distinct cognitive effects while considering comorbid symptoms across disorders has been lacking. In the current study, children ages 7-15 years assigned to three diagnostic groups:ADHD (n = 509), ASD (n = 97), and controls (n = 301) completed measures spanning the cognitive domains of attention/arousal, working memory, set-shifting, inhibition, and response variability. Specific processes contributing to response variability were examined using a drift diffusion model, which separately quantified drift rate (i.e., efficiency of information processing), boundary separation (i.e., speed-accuracy trade-offs), and non-decision time. Children with ADHD and ASD were impaired on attention/arousal, processing speed, working memory, and response inhibition, but did not differ from controls on measures of delayed reward discounting, set-shifting, or interference control. Overall, impairments in the ASD group were not attributable to ADHD symptoms using either continuous symptom measures or latent categorical grouping approaches. Similarly, impairments in the ADHD group were not attributable to ASD symptoms. When specific RT parameters were considered, children with ADHD and ASD shared impairments in drift rate. However, children with ASD were uniquely characterized by a wider boundary separation. Findings suggest a combination of overlapping and unique patterns of cognitive impairment for children with ASD as compared to those with ADHD, particularly when the processes underlying reaction time measures are considered separately.

Measuring and understanding fetal neurodevelopment provides insight regarding the developing brain. Maternal nutrient intake and psychological stress during pregnancy each impact fetal neurodevelopment and influence childhood outcomes and are thus important factors to consider when studying fetal neurobehavioral development. The authors provide an overview of fetal neurobehavioral development and the unique contribution of nutrition and psychological stress on the fetus during pregnancy.

Despite evidence that individuals living in low-income and rural communities may be at heightened risk for intimate partner violence (IPV), little is known about the prevalence and nature of IPV occurring in these communities. The goal of the current study, therefore, was to characterize IPV occurring in a population-based sample of families living in communities characterized by rural poverty. Specifically, we examined the prevalence, severity, and chronicity of IPV occurring in this high-risk sample, as well as the demographic correlates thereof. Using data from multiple assessments across the first 5 years of their child's life, we also examined changes in the prevalence of IPV across this time. Results indicate that IPV was most prevalent around the birth of the target child and that the population-level prevalence of IPV decreased significantly over the subsequent 5 years. Although previous research suggests that children under the age of five are at heightened risk for IPV relative to older children, this is the first study to our knowledge to demonstrate that there are changes in the prevalence of IPV within this high-risk age period., Author(s): Hanna C. Gustafsson[sup.1] , Martha J. Cox[sup.2] , the Family Life Project Key Investigators Author Affiliations: (1) Department of Psychiatry, Columbia University Medical Center, 10032, New York, NY, USA [...]

The authors examined the relations among intimate partner violence (IPV), maternal depressive symptoms, and maternal harsh intrusive parenting. Using a cross-lagged, autoregressive path model, they sought to clarify the directionality of the relations among these 3 variables over the first 2 years of the child's life. The results indicated that, in this diverse sample of families living in predominantly low-income rural communities (N = 705), higher levels of early IPV were associated with increases in maternal depressive symptoms, which in turn were associated with increases in maternal harsh intrusive parenting behaviors. These findings suggest that interventions aimed at improving the parenting of women exposed to domestic violence may want to simultaneously target IPV and depressive symptomatology. (Contains 2 figures and 1 table.)

Rapid changes in language skills and social competence, both of which are linked to sensitive parenting, characterize early childhood. The present study examines bidirectional associations among mothers' sensitive parenting and children's language skills and social competence from 24 to 36?months in a community sample of 174 families. In addition, this study examines how these developmental pathways vary by child sex. Findings indicate stability across time in sensitive parenting, expressive language skills, and social competence, as well as positive main effects of sensitive parenting on expressive and receptive language skills for girls and boys. We find mixed evidence over time of reciprocal links between social competence and sensitive parenting. Further, boys' receptive language skills at 24?months uniquely contribute to increases in mothers' observed sensitive parenting from 24 to 36?months. These findings highlight the utility of applying transactional frameworks to the study of sex-based differences in early developmental processes.