Purpose In children with attention-deficit hyperactivity disorder (ADHD), (1) examine risk factors and parent/caregiver (P/G) perceptions of their children from pregnancy through childhood and (2) evaluate the relationship between these risk factors and perceptions and later childhood mental health.
Methods Thirty families whose children had community-diagnosed ADHD were randomly selected from a group of children attending an ADHD camp. The child age range was 6 to 11 years, mean 8.7 ± 1.6. The parental age range was 31 to 65 years, mean 43.0 ± 8.7. In a retrospective interview, the P/G completed an Early Experience Survey (EES) and Brief Infant-Toddler Social and Emotional Assessment (BITSEA) evaluating risk factors associated with ADHD in pregnancy, toddlerhood, and childhood. P/Gs answered questions from the Behavior Assessment System for Children-Parent (BASC-P) regarding childhood depression and poor social skill. Children answered questions from the BASC-Child (BASC-C) regarding social stress and self-esteem.
Results Data were analyzed using linear regression and analysis of variance. Pregnancy risk factors (maternal alcohol, drug, or tobacco use) were not predictors of BITSEA behavior problems (BBPs) but were significant predictors for poor social skills (p = .02). EES predictors for BBPs were delayed walking (p = .001), delayed fine motor skills (p = .01), and infant feeding problems (p = .02). Behavior difficulty in infancy (colic, irritability, easy frustration, and poor cuddling) predicted BBPs (p = .03). Other EES predictors for BBPs were toddlerhood aggression (p = .001) and chronic illness (p < .001). There were no associations with speech delay, task completion, attention, and impulsivity or family history of ADHD. Toddlerhood BBPs were associated with current BASC-P childhood depression (p < .001) but not parent-rated poor social skills. Toddlerhood BBPs were not associated with current child reported social stress or lower self-esteem. BASC-C poor self-esteem was associated with current parent alcohol use (p = .02), tobacco use (p < .01), and mental health disorders (p = .03).
Conclusions Early and current family and child risk factors are associated with significant behavior problems in older children with ADHD. Screening children with these risk factors in infancy and toddlerhood may help detect children at risk of later mental health problems.
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