ADHD Node

ADHD is one of the most common chronic conditions affecting children in the US. Data indicates the incidence and prevalence are increasing, but the reasons for that aren’t well known. The impact of ADHD is often lifelong, and trajectories for people with ADHD seem to be highly influenced by the nature and type of interventions, supports, and scaffolding that parents can provide to optimize their child’s healthy development. It also appears that the recognition of the signs and symptoms and the potential for early intervention and remediation are not well understood, documented, or utilized.

For all these reasons, taking a life course health development (LCHD) approach to understanding the origins and development of ADHD, and impact of various kinds of interventions, is very important. This approach could potentially lead to breakthroughs in how we understand ADHD and how we respond to it. One of the values of an LCHD approach is a deeper understanding of what risk factors and protective factors impact kids’ trajectories, and how they’re arrayed and embedded in the complex developmental ecosystem of a child’s life – including the family, peers, school, community, sports teams, etc. We posit that more holistic, integrated approaches that take a life course perspective have the potential to yield much better results.

Node Projects

PREPARE & INSPIRE

PI: Anne Arnett, Boston Children's Hospital

To prevent substance use disorders (SUDs) in youth with ADHD, adapting an evidence-based intervention for Black and Hispanic youth for whom ADHD is undertreated and supports often less available Intervention. Piloted in the LCIRN, two multigenerational interventions (PREPARE [middle school] and INSPIRE [high school]), each bundle evidence-based intervention components, comprising caregiver and youth peer-group psycho-educational sessions, family therapy sessions, and interactive technologies into a brief 4-week intervention package. The INSPIRE intervention consists of an interactive narrative video game environment designed to promote social problem solving that incorporates game characters that are racially and ethnically diverse. SUDs have major implications for all of development and last throughout adulthood. Middle school and high school are sensitive developmental periods, when interventions that address multiple levels of developmental ecosystems can be most impactful. 

With potential for delivery either in person (INSPIRE was successfully piloted in pediatric provider offices) or online, this intervention can be adapted to a wide variety of settings depending on youth and caregiver preferences, including through the PEDsNET in pediatric offices nationwide.

Previous Work

How can we explore new approaches to ADHD interventions that will yield better outcomes for children, including the potential for community-wide interventions that create a supportive ecosystem that will enhance the effectiveness of clinical interventions? How do we better mobilize resources in a child’s ecosystem and deploy them in a way that builds more supportive pathways to optimize healthy development? How can we apply the principles of life course health development to both the study of the ways in which ADHD develops, and to interventions that might either prevent or ameliorate symptoms?

Life Course Health Development: A potential new Framework to Guide ADHD Research

Researchers and providers working together with children and families impacted by ADHD, who may hold differing views regarding its etiology, neurobiology and management, will need to find new ways to work together on new types of interventions that will better meet the needs of the population. The life course health development approach offers an organizing framework that can be used to draw together all of the strands of evidence from studies in child development, education, epidemiology, genetics and epigenetics, medicine, social sciences, psychology, and others into a cohesive model of health development that allows for a consideration of multiple factors over time that might be influencing a child’s developmental trajectories. This new framework can provide the basis for the creation, design, development and trailing of new interventions for ADHD.

Projects and Progress

In May 2021, the LCIRN and DBPNet held a virtual meeting that brought together researchers, practitioners, educators, and parents of children with ADHD in an interactive format. understanding and managing ADHD and developing new interventions that have the potential to yield better outcomes for children. The intention was to move beyond a narrow clinical focus to one that considered all of the aspects of a child’s life that might be impacting the genesis, manifestation and progress of their ADHD, and also could potentially be the target of future interventions aimed at improving health development trajectories. For example, the group wanted to explore the potential for community-wide interventions that create a supportive ecosystem that might help clinical interventions to work better. Findings from the meeting are being prepared for publication.

Marianne Pugatch is implementing an LCIRN-funded pilot project on The preferences and experiences of adolescents with ADHD for a virtual behavioral health system: a life course intervention pilot study of ChangeGradients. This project is a joint effort with LCIRN, DBPNet, and the Adolescent and Young Adult Health Research Network (AYAH-RN).

Collaborative partners

This node is a collaboration with the Developmental Behavioral Pediatrics Research Network (DBPNet)