Links between co-occurring social-communication and hyperactive-inattentive 
trait trajectories

St Pourcain, Beate; Mandy, William P.; Heron, Jon; Golding, Jean; Davey Smith, George; Skuse, David H.

doi:10.1016/j.jaac.2011.05.015

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Links between co-occurring social-communication and hyperactive-inattentive trait trajectories

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St Pourcain, B., Mandy, W. P., Heron, J., Golding, J., Davey Smith, G., & Skuse, D. H. (2011). Links between co-occurring social-communication and hyperactive-inattentive trait trajectories. Journal of the American Academy of Child & Adolescent Psychiatry, 50(9), 892-902.e5. doi:10.1016/j.jaac.2011.05.015.

Cite as: https://hdl.handle.net/11858/00-001M-0000-0029-4A68-3

Abstract

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.