Mental Disorders in Five-Year-Old Children With or Without Developmental Delay: Focus on ADHD

Abstract

Epidemiological studies of children and adolescents with intellectual disability have found 30 to 50% exhibiting clinically significant behavior problems. Few studies, however, have assessed young children, included a cognitively typical comparison group, assessed for specific disorders, and/or studied family correlates of diagnosis. We assessed 236 5-year-old children—95 with developmental delay (DD) and 141 with typical development—for clinical diagnoses using a structured interview. Every disorder assessed was more prevalent in the DD group. The percent of children meeting criteria for Attention Deficit Hyperactivity Disorder (ADHD) most highly differentiated the two groups (ratio = 3.21:1). There was high stability from externalizing behavior problems at age 3 to ADHD diagnoses at age 5 in both groups. In regression analyses, parenting stress at child age 3 related to later ADHD diagnosis in both groups and maternal scaffolding (sensitive teaching) also predicted ADHD in the DD group.

This article was based on the activities of the Collaborative Family Study, supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Grant number 34879-1459 (Drs. Keith Crnic, Bruce Baker, and Jan Blacher, PIs). We are indebted to our staff and doctoral student colleagues at Arizona State University, UCLA, and UC Riverside.

Notes

Note: n = 236. OR = odds ratio.

^a n = 95.

^b n = 141.

**p < .01. ***p < .001.

Note: N = 236. DD = developmental delay; TD = typical development; OR = odds ratio; ADHD = Attention Deficit Hyperactivity Disorder.

^a n = 95.

^b n = 141.

*p < .05. **p < .01. ***p < .001.

Note: CBCL = Child Behavior Checklist; DISC = Diagnostic Interview Schedule for Children; DBD = disruptive behavior disorder; ADHD = Attention Deficit Hyperactivity Disorder.

^a n = 44.

^b n = 37.

^c n = 99.

^d n = 17.

**p < .01. ***p < .001.

Note: ADHD = Attention Deficit Hyperactivity Disorder; DBD = disruptive behavior disorder; OR = odds ratio; HO = Home Observations; M-C = Mother–Child; SCL = Symptom Checklist; FIQ = Family Impact Questionnaire.

^a n = 44.

^b n = 37.

^c n = 99.

^d Maternal scaffolding composite comprised by summing z-scores of the total scores for three types of scaffolding (technical, motivational, and emotional).

^e Home observation positive parenting composite comprised by summing z scores for maternal positivity, sensitivity, and stimulation of cognition and subtracting the z score for maternal detachment at 36 and 42 months.

^f Home observation negative parenting composite comprised by summing z scores for maternal negativity and intrusiveness at 36 and 42 months.

^g HO M–C Dyadic Pleasure subscale, composite of 36 and 42 months.

^h HO M–C Dyadic Conflict subscale, composite of 36 and 42 months.

ⁱ SCL; FIQ, Negative Impact scale.

*p < .05. **p < .01. ***p < .001.

^a n = 81.

^b n = 116.

*p < .05.