Later Impairment in Preschoolers at Risk for ADHD: Findings from the Queens College Preschool Project

Jeffrey Halperin 1,2,3 Geneva Hidalgo 4 Cynthia Liu 4 Lorena Villalobos-Maceira 4 Lorna McWilliams 5 Sarah O’Neill 2,4
1Queens College, City University of New York, Flushing
2The Graduate Center, City University of New York
3The Icahn School of Medicine, Mount Sinai
4The City College of New York, City University of New York
5The Christie NHS Foundation Trust, the University of Manchester

Studies indicate both continuity and discontinuity of preschool ADHD symptoms and impairment into later development. ADHD symptom trajectories have been well-characterized as children move from preschool to school-age, with levels of hyperactivity diminishing and inattention becoming more problematic. However, the emergence and trajectories of diverse forms of impairment remain less well characterized and key questions remain regarding the degree to which later impairments are prospectively related to ADHD symptoms per se, as opposed to associated neuropsychological deficits. Using data from the Queens College Preschool Project (QCPP), which prospectively followed a sample of “at-risk” (n = 140) and “typically developing” (n = 76) children with annual re-evaluations spanning preschool through school-age, this presentation will examine the degree to which preschool ADHD symptoms and neuropsychological performance are differentially or in combination associated with later impairment as measured by poor academic achievement and obesity, as reflected by elevated body mass index (BMI). Poorer visuospatial functioning, but not language ability, during preschool was associated with lower math scores at school-age. However, children who had a preschool diagnosis of ADHD, irrespective of neuropsychological functioning, showed less growth in math performance between the ages of 6- 12 years compared to typically developing preschoolers. In contrast, as previously reported in this sample (O’Neill et al. 2016), early language ability was associated with later reading scores. With regard to weight gain, after controlling for preschool BMI, higher levels of inattention and hyperactivity/impulsivity independently predicted increased BMI at age 7 years, but not vice versa – preschool BMI did not predict later ADHD severity. Early neuropsychological measures did not predict later BMI and did not appear to moderate the relation between early ADHD severity and later BMI. These data indicate dissociations between preschool behavioral and neuropsychological functioning with regard to later impairment and may provide clues for the identification of potential targets for early intervention that might improve functional outcomes.

Jeffrey  Halperin
Jeffrey Halperin








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