Evidence map›Paper›PMID 29963709›Full record

ArticleJournal of child psychology and psychiatry, and allied disciplines2019

Early developmental pathways to childhood symptoms of attention-deficit hyperactivity disorder, anxiety and autism spectrum disorder.

Elizabeth Shephard, Rachael Bedford, Bosiljka Milosavljevic, Teodora Gliga, Emily J H Jones, Andrew Pickles, Mark H Johnson, Tony Charman, BASIS Team

Registry-linked trialOpen access · hybridAbstract read
In one paragraph

Article in Journal of child psychology and psychiatry, and allied disciplines, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04601779 (INFANT HEALTH- Supporting Infants' Mental Health and Healthy Weight Development Through Community Health Nurses' Promoting Sensitive Parenting), which is not on this map. Cited by 60 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
60citing papers in PubMed, 3 pooled it
10.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04601779 nacompletednot on this mapstarted 2021, after this paper: background citation

INFANT HEALTH- Supporting Infants' Mental Health and Healthy Weight Development Through Community Health Nurses' Promoting Sensitive Parenting

TypeinterventionalSponsorUniversity of Southern DenmarkRan2021 to 2025Enrolled406ConditionsInfant Mental Health, Parenting, Parent-Child RelationsArmsVIPP-PUF
3 · Its place in the literature

Who cites it

60 citing papers in PubMed, 3 syntheses or guidelines pooled it, 131 citations in OpenAlex.

  1. Pooled it
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  5. Identification of Early Temperament Profiles in Infants at Elevated Likelihood for Autism and Attention-Deficit/Hyperactivity Disorder.Clinical psychological science : a journal of the Association for Psychological Science · 2026
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  7. Patterns of Early Development in Children with ADHD.Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53 · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Elizabeth ShephardDepartment of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0002-5952-3565
Rachael BedfordBiostatistics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Bosiljka MilosavljevicDepartment of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Teodora GligaCentre for Brain and Cognitive Development, Birkbeck, University of London, London, UK.
Emily J H JonesCentre for Brain and Cognitive Development, Birkbeck, University of London, London, UK.ORCID 0000-0001-5747-9540
Andrew PicklesBiostatistics Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
Mark H JohnsonCentre for Brain and Cognitive Development, Birkbeck, University of London, London, UK.
Tony CharmanDepartment of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.ORCID 0000-0003-1993-6549
BASIS Team
King's College London · GBBirkbeck, University of London · GB

Funding

Department of HealthMedical Research Council G0701484Medical Research Council MR/R011427/1Wellcome Trust
6 · The paper itself

Abstract

backgroundChildren with autism spectrum disorder (ASD) often have co-occurring symptoms of attention-deficit/hyperactivity disorder (ADHD) and/or anxiety. It is unclear whether these disorders arise from shared or distinct developmental pathways. We explored this question by testing the specificity of early-life (infant and toddler) predictors of mid-childhood ADHD and anxiety symptoms compared to ASD symptoms.

methodsInfants (n = 104) at high and low familial risk for ASD took part in research assessments at 7, 14, 24 and 38 months, and 7 years of age. Symptoms of ASD, ADHD and anxiety were measured by parent report at age 7. Activity levels and inhibitory control, also measured by parent report, in infancy and toddlerhood were used as early-life predictors of ADHD symptoms. Fearfulness and shyness measured in infancy and toddlerhood were used as early-life predictors of anxiety symptoms. Correlations and path analysis models tested associations between early-life predictors and mid-childhood ADHD and anxiety symptoms compared to mid-childhood ASD symptoms, and the influence of controlling for ASD symptoms on those associations.

resultsIncreased activity levels and poor inhibitory control were correlated with ADHD symptoms and not ASD or anxiety; these associations were unchanged in path models controlling for risk-group and ASD symptoms. Increased fearfulness and shyness were correlated with anxiety symptoms, but also ASD symptoms. When controlling for risk-group in path analysis, the association between shyness and anxiety became nonsignificant, and when further controlling for ASD symptoms the association between fearfulness and anxiety became marginal.

conclusionsThe specificity of early-life predictors to ADHD symptoms suggests early developmental pathways to ADHD might be distinct from ASD. The overlap in early-life predictors of anxiety and ASD suggests that these disorders are difficult to differentiate early in life, which could reflect the presence of common developmental pathways or convergence in early behavioural manifestations of these disorders.

Indexed as

Anxiety DisordersAttention Deficit Disorder with HyperactivityAutism Spectrum DisorderChildChild DevelopmentChild, PreschoolComorbidityFemaleHumansInfantLongitudinal StudiesMaleanxietyattention-deficit/hyperactivity disorderAutism spectrum disordercomorbidityearly developmental pathways

Identifiers

PMID29963709
PMCPMC6694009
OpenAlexW2810180159

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.