The Interaction Between Infant Negative Emotionality and Cognition Predicts ADHD-Related Behaviors in Toddlerhood

Attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent neurodevelopmental disorder. Children with ADHD followed to adulthood have been found to have lifelong impairments in educational, occupational, and interpersonal domains even if symptoms subside. ADHD is commonly identified in childhood, and affective and cognitive characteristics that are identifiable in infancy could be signals of risk for developing the disorder. 

A group of investigators including Pitt scientists Heather Joseph, DO (Assistant Professor of Psychiatry and Pediatrics), Frances Wang, PhD (Assistant Professor of Psychiatry), and Brooke Molina, PhD (Professor of Psychiatry, Psychology, and Pediatrics), examined the independent and interactive effects of infant negative emotionality and cognition on the development of inattention and hyperactivity/impulsivity in toddlerhood among infants at high and low familial likelihood for ADHD. They published the results in Infant Behavior and Development. 

Seventy-three infants at high or low familial likelihood for ADHD participated in the Pittsburgh ADHD Risk in Infancy Study. High familial likelihood infants had at least one parent with ADHD with persistence into adulthood, and low familial likelihood infants had two parents without ADHD. Both male and female infants were enrolled, and high- and low-familial likelihood offspring were group-matched on infant sex, race, and ethnicity. Parents completed questionnaires regarding demographics and their infant’s temperament and toddler’s behavior. Infants completed a neurodevelopmental examination with behavioral specialists blinded to family history of ADHD. 

Findings from the study showed that the combinations of high negative emotionality and cognition or low negative emotionality and cognition in infancy each predicted ADHD-related behaviors in toddlerhood.

“There is a growing interest in identifying infant and toddler predictors of childhood ADHD that could help determine who needs early intervention. Our findings support the theory that ADHD is a heterogeneous disorder and suggest that multiple cognitive and behavioral domains should be examined to create early risk profiles.” said Dr. Joseph, the study’s corresponding author. 

The interaction between infant negative emotionality and cognition predicts ADHD-related behaviors in toddlerhood
Joseph HM, Lorenzo NE, Wang FL, Wilson MA, Molina BSG
Infant Behavior and Development, August, 2022,