Early Life Neurodevelopmental Indicators of Attention-Deficit/Hyperactivity Disorder at Age 10: A Prospective Cohort Study

Acta Paediatr. 2026 Jul 20. doi: 10.1111/apa.70696. Online ahead of print.

ABSTRACT

AIM: Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder associated with long-term adverse outcomes, yet diagnosis often occurs years after symptoms first emerge. Because ADHD involves impairments across multiple developmental domains, early deviations in language, cognition, motor development and behavioural regulation may indicate later risk before core ADHD symptoms can be reliably assessed. However, previous studies have often relied on questionnaires or registry data rather than objective early-life assessments combined with later clinical ADHD diagnosis and genetic risk.

METHODS: We studied 590 children from the prospective COPSAC₂₀₁₀ birth cohort to examine associations between neurodevelopmental measures from birth to age 3 and clinical ADHD diagnosis and trait manifestations at age 10. Associations were analysed using adjusted logistic and linear regression models, and ADHD polygenic risk scores were examined in relation to early neurodevelopment and later ADHD outcomes.

RESULTS: ADHD at age 10 was associated with lower word production (OR 0.69 [0.48; 0.95] 0.028), shorter sentence length (OR 0.71 [0.56; 0.88] 0.003), reduced cognitive functioning (OR 0.96 [0.93; 0.99] 0.025) and more behavioural/emotional problems (OR 1.05 [1.00; 1.09] 0.034) in early life.

CONCLUSION: Early language, cognitive and behavioural/emotional difficulties may serve as indicators of later ADHD and support earlier identification of vulnerable children.

PMID:42473716 | DOI:10.1111/apa.70696