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Understanding Developmental Differences in ADHD: Exploring Patterns of Symptoms, Impairment, Risk, and Compensatory Skills Based on Age of Initial Diagnosis

Hlavaty, Laura Elizabeth
http://orcid.org/0000-0001-8777-0283
http://rave.ohiolink.edu/etdc/view?acc_num=case1568222347708541

Abstract Details

2020, Doctor of Philosophy, Case Western Reserve University, Psychology.
Attention-Deficit/Hyperactivity Disorder (ADHD) is a chronic disorder associated with functional impairments in childhood, adolescence, and adulthood. Although externalizing behavior problems are the most common reason children are referred for ADHD diagnosis, disparities exist in when parents seek treatment. Differences between children who are referred for psychological evaluations in early childhood versus adolescence are not well understood. The purpose of this study is to explore the differences between children and adolescents that are referred for ADHD diagnosis and determine whether protective factors emerge for individuals referred at later ages. Participants included 1,331 youth referred for psychological evaluation at the ADHD Center for Evaluation and Treatment at Cleveland Clinic Children’s Hospital. Prior to evaluation, parents completed questionnaires about the child’s history (medical history, developmental history, family history), temperament, behavior problems and assets, and previous mental health services. In addition, parents and teachers completed rating scales on ADHD symptoms, stress, and impairment. Also in-person diagnostic assessment and intellectual assessment was completed. Structural equation modeling techniques were used to explore predictors of Age of ADHD diagnosis, including number of ADHD symptoms, parent and teacher ratings of impairment, and compensatory factors related to IQ, temperament, and behavioral assets. Severe behavioral problems at school, higher numbers of referrals concerns, and lower family and caregiver quality of life contributed to younger age of ADHD diagnosis. Older age of diagnosis was predicted by parents who rated low support in their relationships with their spouse. Examination of developmental assets revealed that easy temperament, better social functioning, and greater compliance at school predicted older age of ADHD diagnosis, whereas younger age of diagnosis predicted more positive attitudes toward school and greater emotional awareness. Results add to our understanding of developmental processes underlying age of diagnosis and factors that may delay diagnosis. Additionally, ADHD symptom presentation and severity of behavioral symptoms affected family quality of life in young children. In contrast, older children may benefit from focused treatments aimed at addressing motivation toward achievement and emotion regulation. Overall, these results lend to the development of psychoeducation and intervention strategies designed to promote better outcomes for individuals with ADHD.
Elizabeth Short, PhD (Committee Chair)
Sandra Russ, PhD (Committee Member)
Michael Manos, PhD (Committee Member)
Christopher Burant, PhD (Committee Member)
164 p.
Clinical Psychology
ADHD; childhood; developmental differences; assessment; diagnosis; psychology; structural equation modeling; temperament; behavioral assets; IQ; quality of life; impairment

Recommended Citations

Citations

  • Hlavaty, L. E. (2020). Understanding Developmental Differences in ADHD: Exploring Patterns of Symptoms, Impairment, Risk, and Compensatory Skills Based on Age of Initial Diagnosis [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1568222347708541

    APA Style (7th edition)

  • Hlavaty, Laura. Understanding Developmental Differences in ADHD: Exploring Patterns of Symptoms, Impairment, Risk, and Compensatory Skills Based on Age of Initial Diagnosis. 2020. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1568222347708541.

    MLA Style (8th edition)

  • Hlavaty, Laura. "Understanding Developmental Differences in ADHD: Exploring Patterns of Symptoms, Impairment, Risk, and Compensatory Skills Based on Age of Initial Diagnosis." Doctoral dissertation, Case Western Reserve University, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=case1568222347708541

    Chicago Manual of Style (17th edition)

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This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.