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

Author:

Charman Tony1ORCID,Pasco Greg1,Hendry Alexandra2,Bazelmans Tessel1,Narvekar Nisha1ORCID,Goodwin Amy1,Halkola Hanna1,Agyapong Mary1,Holman Rebecca3,Ali Jannath Begum3,Ersoy Mutluhan4,Johnson Mark H.35,Pickles Andrew1,Jones Emily J. H.3,

Affiliation:

1. Institute of Psychiatry, Psychology & Neuroscience King's College London London UK

2. Department of Experimental Psychology University of Oxford Oxford UK

3. Centre for Brain and Cognitive Development Birkbeck University of London London UK

4. Department of Psychology Kastamonu University Kastamonu Turkey

5. Department of Psychology University of Cambridge Cambridge UK

Abstract

AbstractBackgroundMost 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).MethodsInfants 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).ResultsA 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.ConclusionsSome 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.

Funder

Innovative Medicines Initiative

Guy's and St Thomas' Charity

Maudsley Charity

Medical Research Council

National Institute for Health and Care Research

Autistica

South London and Maudsley NHS Foundation Trust

King's College London

University of London

Publisher

Wiley

Subject

General Medicine

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