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Preschool Behavior Helps Predict ADHD

Preschool Behavior Helps Predict ADHD Parents can get a heads-up on whether their child may develop attention-deficit hyperactivity disorder by observing the way a child behaves at home during preschool years.

Ideally, information should be garnered from preschool teachers, parent’s observation, and feedback from other adults who have the opportunity to observe the child’s tendency to be inattentive or hyperactive.

This advice comes from Sarah O’Neill, Ph.D., and based on research she conducted in an article published in the Journal of Abnormal Child Psychology.

The study examines how well parent, teacher and clinician ratings of preschoolers’ behavior are able to predict severity and diagnosis of attention deficit hyperactivity disorder (ADHD) at age six.

Characterized by developmentally inappropriate levels of inattention, hyperactivity, and impulsivity, ADHD is one of the most frequently diagnosed childhood psychiatric disorders.

Although many studies focusing on school-aged children have shown that parents and teachers —rather than clinician observations alone — are more likely to assess ADHD accurately, scant evidence exists to support similar conclusions with preschoolers.

To fill this gap in the research, O’Neill and colleagues followed a group of 104 hyperactive and/or inattentive three- and four-year-olds for a period of two years.

Both parents and teachers rated the preschoolers’ behavior. In addition, clinicians, who were blind to parent and teacher reports, completed ratings of preschoolers’ behavior during a psychological testing session.

By the time the children reached age six, more than half (53.8 percent) had been diagnosed with ADHD. The likelihood of such a diagnosis increased when all three informants had rated the child as high on symptoms at age three or four.

Furthermore, after analyzing the reports separately, the research team found that parents’ reports were critical, particularly when combined with either teacher or clinician reports.

Teacher reports alone were not as useful, and the research team ascribed the relative inability of educators’ reports to predict a child’s ADHD status over time to possible situational variables.

Preschoolers may initially have difficulty adjusting to the structured classroom setting, but this disruptive behavior is time-limited to the transition to school. Teachers’ perceptions of “difficult” behavior may also be affected by factors such as classroom setting and size as well as their expectations of children’s behavior.

As a result of the study findings, O’Neill and her team emphasize the importance of using information from multiple informants who have seen the child in different settings.

Parent reports of preschoolers’ behavior appear to be crucial, but these alone are not sufficient. Augmenting the parent report with that of the teacher and/or clinician is necessary.

Also important are clinician observations of preschoolers during psychological testing, which are predictive of an ADHD diagnosis and its severity over time. Being able to identify children at risk for poorer outcomes may help educators and clinicians to plan appropriate interventions.

“Consider a preschool child’s behavior in different contexts,” O’Neill emphasized.

“Although parents’ reports of preschoolers’ inattention, hyperactivity, or impulsivity are very important, ideally we would not rely solely on them. At least for young children, the clinician’s behavioral observations appear to hold prognostic utility.”

Source: Springer

Preschool Behavior Helps Predict ADHD

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Preschool Behavior Helps Predict ADHD. Psych Central. Retrieved on October 21, 2018, from https://psychcentral.com/news/2013/10/02/preschool-behavior-helps-predict-adhd/60203.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.