Characterizing the Developmental Spectrum and Patterning of Attention via the MAPS Attention Regulation Infant-Toddler Scale

• In Event: MAPping Emotional and Behavioral Dysregulation in Youth

Abstract

Introduction: Attention dysregulation is a promising early indicator of neurodevelopmental risk, in particular attention deficit/hyperactivity disorder (ADHD). While innovative work in the field of early identification has enabled diagnosis as early as preschool age, less has been done to characterize risk prior to frank disorder, across the transition to toddlerhood. The developmental expectability of attention dysregulation at this stage has posed a challenge in distinguishing the normative from the potentially concerning. Thus, explicating the typical:atypical continuum of attention dysregulation is critical for early identification and intervention research. Further, characterizing developmental patterning along the typical:atypical continuum can inform both when early assessment is conducted based on the stability of patterns, and answer questions about whether change in and of itself is uniquely informative in risk prediction. This is particularly relevant during a period characterized by rapid skill consolidation. In this study, we present and model repeated collection of the Multidimensional Assessment Profiles – Attention Regulation Infant-Toddler (MAPS-AR-IT) Scale, a novel parent-report survey of dimensional, developmentally specified of attention (dys)regulation.
Methods: The MAPS-AR-IT is used to characterize the full typical:atypical spectrum via a longitudinal sample of typically developing children (from the larger study, a subsample had complete data on the MAPS-AR-IT, n = 295). This group was well-characterized for ADHD symptoms at 24 months (69% ≥ 2 symptoms, 42% ≥ 6 symptoms). Data were collected starting at 12-18 months of age and captured bimonthly up to 34 months, with ADHD symptom outcomes via parent-report interview (Preschool Age Psychiatric Assessment; PAPA) when children were between 3-5 years old. We propose to establish the typical:atypical continuum using IRT, up to the 34 months, and model trajectories from 12 to 34 months using multilevel modeling. Additionally, we will examine the incremental utility of change of MAPS-AR-IT trajectories in predicting ADHD symptoms.
Results: While preliminary, work investigating the potential value of this approach in this sample indicates its promise. Correlations between MAPS-AR-IT scores at 12 months and continuous scores on the PAPA ADHD domain at 24-30 months were moderate and significant (r = 0.32, p < 0.001). Preliminary modeling of the continuum via the MAPS-AR-IT up to 24 months of age indicates the potential non-linearity of these trajectories, as well as the existence of distinct profiles of developmental patterning. We propose to characterize the developmental patterning of attention dysregulation and investigate the utility of applying such patterns to clinical outcomes at preschool age (~3-5 years) within this sample.
Conclusions: While preliminary, this work demonstrates the feasibility and appropriateness of our planned analyses to model the typical:atypical continuum and trajectories of development across the transition to toddlerhood. This work, predicting to ADHD outcomes later in childhood, holds the potential for improved accuracy, timeliness of identification, and appropriateness of intervention starting at even younger ages than are currently feasible.

Authors

• Amanda Nili, Northwestern University
  Presenting Author

• Yudong Zhang, Northwestern University

• James L. Burns

• Meghan Miller, University of California - Davis

• Anne R. Zola

• Lauren S Wakschlag, Northwestern University