How important is early home environment in the prediction of attention‐deficit hyperactivity disorder in adolescence? The protective role of early cognitive stimulation

Abstract

Attention‐deficit hyperactivity disorder (ADHD) is highly heritable; however, an adequate home environment may moderate its development. This study examined the early home environment of 70 male adolescents (M age = 13.5 years, SD = 0.95) participating in a prospective high‐risk longitudinal study. Results demonstrated that adolescents who were eventually diagnosed with ADHD tended to have higher home chaos and less enriched home environments in early childhood. Within the different aspects of enriched home environment, less cognitive stimulation—but not less emotional/physical support—was found between diagnosed and nondiagnosed adolescents. This effect was also found among the subgroup of those who, a priori, were at familial risk for ADHD. Early cognitive stimulation longitudinally predicted both ADHD diagnosis and ADHD symptom domains, above and beyond parental ADHD symptoms and other aspects of the early home environment. Results suggest the possible protective role of early cognitive stimulation in the development of ADHD. Highlights This study examined the aspects of early childhood home environment that serve as risk/protective factors in the developmental course of ADHD. Early cognitive stimulation, but not home chaos and emotional/physical environment, longitudinally predicted both ADHD symptoms and diagnosis in adolescence. Early cognitive stimulation might have a protective role in the developmental course of ADHD.

Exploring the Perspectives of South African Parents and Primary Caregivers Living in Low-Income Communities on What Children Need to Thrive within the First 1000 Days of Life

“…Cognitive stimulation is another need of children [14,15]. Opportunities for early learning such as reading to the child during the first 1000 days has been associated with improved language development, mathematical and problem-solving capacity and higher earning capacity later in life [23][24][25]. In addition, studies have shown that parental warmth, nurturance and responsiveness during the first 1000 days of life, affect infants' emotional regulation, capacity for wealth creation, behavioural problems, health and cognitive development throughout their lifespan [26][27][28][29].…”

Prospective associations between parenting and attention deficit hyperactivity problems: A sibling comparison analysis

“…They also suggested that a cognitively stimulating home environment might improve children's self-regulation, which in turn might enhance their ability to be attentive, especially in school settings. The inverse association between learning stimulation and ADHP is still found after controlling for parental ADHD symptoms, other aspects of the home environment, as well as other environmental risk factors like socioeconomic status, birth weight, and alcohol/cigarette exposure (Einziger et al, 2019;Jester et al, 2005;Mulligan et al, 2013). Additionally, it appears that the in uence of an enriched home environment on later ADHP might be speci c to the cognitive rather than the emotional or physical aspects of the environment (Einziger et al, 2019;Schmiedeler et al, 2014).…”

“…This is in line with previous ndings that have supported the role of learning stimulation in the development of ADHD. For example, Einziger et al (2019) found that higher levels of cognitive stimulation at age 4 predicted lower risk for ADHD diagnoses in adolescence. The literature also supports the role of learning stimulation beyond the confounding in uence of factors like low SES (e.g., Bradley et al, 1989;Mulligan et al, 2013;Schmiedeler et al, 2014), which is consistent with our ndings.…”

“…The literature also supports the role of learning stimulation beyond the confounding in uence of factors like low SES (e.g., Bradley et al, 1989;Mulligan et al, 2013;Schmiedeler et al, 2014), which is consistent with our ndings. Overall, it appears that the link between learning stimulation and ADHP goes beyond familial confound factors like risk for ADHD and parental symptoms of ADHD, however, no study to our knowledge has attempted to disentangle environmental effects from possible genetic effects (Einziger et al, 2019). Thus, our results add to the existing learning stimulation literature by suggesting that the link from early learning stimulation to later ADHP is free from confounding factors that are shared by biological siblings, and key factors like birth order, sex, ethnicity, baseline ADHP, prenatal maternal substance use, maternal delinquency, and maternal IQ, education, and income.…”

“…Other risk factors include pregnancy complications, low socioeconomic status, and psychosocial adversity (Sagiv et al, 2013). In addition, many parental practices have been linked to ADHP, including warmth, involvement, responsiveness, harshness (e.g., corporal punishment), and learning stimulation (e.g., Alizadeh et al, 2007;Einziger et al, 2019). Consequently, it is important to understand how such factors in uence the development of ADHP.…”