Parent-child neurobehavioral synchrony and early ADHD symptom trajectories - Project Summary/Abstract Attention-Deficit/Hyperactivity Disorder (ADHD) is the most common neurodevelopmental disorder and is associated with significant social, educational, and health impairments. Symptoms of ADHD are often present at preschool age with more than half of children at age 3 (including those with subthreshold symptoms) meeting full diagnostic criteria later in childhood. Current treatments administered after ADHD diagnosis do not ameliorate long-term dysfunction. Early identification and intervention targeting neural networks implicated in attention during the preschool period, a sensitive period of brain development when ADHD symptoms begin to emerge, may improve symptom trajectories and long-term outcomes. The current study builds upon existing research on the aberrant (weakened resting state) neural connectivity of the frontoparietal network (FPN) among children with ADHD and the influential role of parent behavior on children’s development of attentional control and neural network organization that supports higher order executive functioning. Our team has found that alterations in developmental patterns of FPN connectivity during parental engagement are detectable amongst young children with elevated symptoms before ADHD can be reliably clinically diagnosed. Moreover, our research using functional Near Infrared Spectroscopy (fNIRS) suggests that synchronous brain activity between parents and children may strengthen self-regulation skills (such as attentional focusing). Thus, research identifying the potential to target parent-child behavior, and its implications for brain development supporting attentional focusing, may uncover ADHD prevention opportunities. Thus, using fNIRS, this study will examine the associations between parent-child focused attention, parent-child neural synchrony (PCNS), and child resting state FPN connectivity in relation to ADHD symptom trajectories among 210 preschool-aged children (3-4 years). The sample will be enhanced for risk of developing ADHD (2/3 with 4+ ADHD symptoms). Children will be followed longitudinally for 2 years with ADHD symptoms and impairment assessed every 6 months through the transition to school age (5-6 years) to examine neural and behavioral predictors of early ADHD symptom trajectories. Finally, to begin to identify potentially malleable parenting behaviors that would support the development of future preventive interventions, we will microcode parenting behavior during a parent-child interaction task and examine, using time-series analyses, which behaviors are antecedents to PCNS and child focused attention. Teaching parents to interact with their children in a way that enhances neural synchrony may strengthen FPN connectivity and dampen development of ADHD symptoms and impairment. This project has the potential to make transformative gains in the understanding of the neurodevelopment of childhood ADHD and pave the way for early preventive interventions before the onset of full symptoms and associated impairment.
