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Links Between Co-occurring Social-Communication and Hyperactive-Inattentive Trait Trajectories

https://doi.org/10.1016/j.jaac.2011.05.015Get rights and content
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Objective

There is overlap between an autistic and hyperactive-inattentive symptomatology when studied cross-sectionally. This study is the first to examine the longitudinal pattern of association between social-communication deficits and hyperactive-inattentive symptoms in the general population, from childhood through adolescence. We explored the interrelationship between trajectories of co-occurring symptoms, and sought evidence for shared prenatal/perinatal risk factors.

Method

Study participants were 5,383 singletons of white ethnicity from the Avon Longitudinal Study of Parents and Children (ALSPAC). Multiple measurements of hyperactive-inattentive traits (Strengths and Difficulties Questionnaire) and autistic social-communication impairment (Social Communication Disorder Checklist) were obtained between 4 and 17 years. Both traits and their trajectories were modeled in parallel using latent class growth analysis (LCGA). Trajectory membership was subsequently investigated with respect to prenatal/perinatal risk factors.

Results

LCGA analysis revealed two distinct social-communication trajectories (persistently impaired versus low-risk) and four hyperactive-inattentive trait trajectories (persistently impaired, intermediate, childhood-limited and low-risk). Autistic symptoms were more stable than those of attention-deficit/hyperactivity disorder (ADHD) behaviors, which showed greater variability. Trajectories for both traits were strongly but not reciprocally interlinked, such that the majority of children with a persistent hyperactive-inattentive symptomatology also showed persistent social-communication deficits but not vice versa. Shared predictors, especially for trajectories of persistent impairment, were maternal smoking during the first trimester, which included familial effects, and a teenage pregnancy.

Conclusions

Our longitudinal study reveals that a complex relationship exists between social-communication and hyperactive-inattentive traits. Patterns of association change over time, with corresponding implications for removing exclusivity criteria for ASD and ADHD, as proposed for DSM-5.

Key Words

social-communication trait
hyperactive-inattentive trait
maternal smoking
teenage pregnancy
ALSPAC

Cited by (0)

This work was supported by UK Medical Research Council grant 74882, Wellcome Trust grant 076467/Z05/z, and the University of Bristol, which provided core support for the Avon Longitudinal Study of Parents and Children (ALSPAC) and this work.

Disclosure: Drs. St. Pourcain, Mandy, Heron, Golding, Davey Smith, and Skuse report no biomedical financial interests or potential conflicts of interest.

This article is discussed in an editorial by Dr. Angela Reiersen on page 857.

Supplemental material cited in this article is available online.