Project Summary
Attention deficit/hyperactivity disorder (ADHD) is a prevalent and impairing early childhood disorder that
presents notable challenges to normative development and can be reliably identified starting at preschool age,
with risk captured as early as toddler age when employing developmentally based assessments. Identification
of concerning attention dysregulation development, before frank disorder presents, could ameliorate negative
cascades associated with emergent ADHD syndromes and impairment. Further, recent research points to
pervasive, early onsetting mental health inequities, evident in patterns of emergent ADHD, and the need for
equitable assessment to reduce bias in predictive risk modeling (i.e., accounting for protective factors in
addition to risks, modeling specific risk indicators, rather than taking race as a proxy thereof). Thus, the current
project seeks to characterize developmental change and its sociodemographic context in patterns of attention
(dys)regulation across toddlerhood with outcomes at preschool age. This work draws on novel, clinically
translatable research tools capturing the typical:atypical spectrum of neurodevelopmental and behavioral
indicators of attention (dys)regulation: parent survey and standardized clinical observation. The project
engages a community-based sample of children recruited at their first annual well-child visits and oversampled
for psychopathology risk (i.e., irritability). Initial examination of outcomes at later timepoints indicates that the
sample is well characterized for ADHD symptoms with prevalence matching other community samples. Under
this award, I will train in innovative methods of longitudinal modeling (i.e., multilevel and group-based trajectory
modeling) to generate models of data collected densely at toddler age, predicting developmental patterns to
emergent ADHD outcomes at preschool age(3-5 years). In alignment with an equitable assessment approach,
structural equation models examining structural and familial risks and protective factors will more richly
characterize pathways to emergent ADHD symptoms at preschool age. This project seeks to characterize
neurodevelopmental vulnerability to ADHD at the earliest point in the developmental sequence, establishing an
empirically grounded, equitable approach to assessment and conceptualization of early risk.