Trajectories of participation, mental health, and mental health problems in adolescents with self-reported neurodevelopmental disorders

Abstract

Purpose: Having a neurodevelopmental disorder (NDD) increases the risk of mental health problems and lower participation. We investigated the trajectories of mental health problems and participation in adolescents with NDD and compared these with trajectories for peers without NDD. In addition, the relationship between participation, mental health (well-being), and mental health problems were investigated. Materials and methods: Data from a Swedish longitudinal survey study (LoRDIA) was used and adolescents with and without self-reported NDD were followed from 12/13 to 17 years, in three waves. Mental health problems were measured using the Strength and Difficulties Questionnaire, and well-being was measured with the Mental Health Continuum short form. Results: Adolescents with NDD experience more mental health problems than adolescents without NDD. Hyperactivity, a key feature of NDD, remains stable, while emotional problems and psychosomatic complaints, increase over time for girls, independent of NDD. Participation is stable over time but is more related to well-being than to NDD or mental health problems. Conclusions: Gender is an important factor with girls exhibiting more problems. Mental health explains more of the variation in participation than mental health problems and NDD. Probably participation intervention can enhance mental health which may protect from mental health problems. ä IMPLICATIONS FOR REHABILITATIONMental health, i.e., emotional-, social-, and psychological well-being is more strongly related to participation and to reduced levels of mental health problems than having an NDD or not, thus assessing mental health separately from measuring NDD is important. Interventions focusing on participation may lead to higher mental health and having high mental health (flourishing) may facilitate participation. Girls with self-reported NDD seem to have a higher burden of mental health problems, especially if they also are languishing, i.e., having low mental health, therefore a strong focus on this group is needed both in research and clinical practice. Half of all adolescents are flourishing, independently of NDD or not, even if they are experiencing some symptoms of mental health problems, adolescents with NDD who are also languishing, have much higher ratings of mental health problems.

Common neural substrates of diverse neurodevelopmental disorders

“…Neurodevelopmental disorders—or congenital disorders of brain system development causing cognitive and behavioral impairments—have wide-ranging consequences for academic, social, and mental health outcomes. 1 , 2 These disorders—affecting ∼53 million children within the first 5 years of life (i.e. a prevalence of 12%) 3 —are the third-ranked form of child disability, after vision and hearing loss.…”

Patterns of observed child participation and proximity to a small group including teachers in Swedish preschool free play

“…If some children rarely become engaged in activities with other children or adults, objects, or symbols, on a regular basis over long periods of time, less proximal processes will occur, leading to a negative impact on child development (Bronfenbrenner and Morris, 2006;Merçon-Vargas et al, 2020). Children's health and well-being will probably also suffer as these outcomes are closely related to participation (e.g., Augustine et al, 2022). A recent Swedish longitudinal preschool study using cluster analysis (Gustafsson et al, 2021) showed that children displaying more extreme behavioral patterns (e.g., highly favorable or unfavorable) tend to display similar patterns over time, while children in clusters close to the mean tend to change patterns more often.…”

Patterns of mental health problems and well-being in children with disabilities in Sweden: A cross-sectional survey and cluster analysis

“…Hyperactivity, for example, is a common coexisting problem for many children with disabilities, and some may exhibit hyperactive behaviour without having conduct or emotional problems [ 9 ]. In adolescents with neurodevelopmental disorders (NDD), hyperactivity seems to be more stable over time than conduct and emotional problems, and rather be related to the NDD [ 4 ]. Likewise, peer problems may be a consequence of difficulties inherent to a child’s disability, such as communication problems.…”

“…Likewise, peer problems may be a consequence of difficulties inherent to a child’s disability, such as communication problems. Peer problems may also be related to the behaviour of others, rather than an expression of mental health problems of the child [ 4 , 10 ]. Including hyperactivity and peer problems in studies of children with disabilities may therefore lead to an overestimation of the prevalence of mental health problems.…”