Transdiagnostic associations across communication, cognitive, and behavioural problems in a developmentally at-risk population: a network approach

Abstract

Background: Communication, behavioural, and executive function problems often co-occur in childhood. Previous attempts to identify the origins of these comorbidities have typically relied on comparisons of different deficit groups and/or latent variable models. Here we apply a network approach to a heterogeneous sample of struggling learners to conceptualise these comorbidities as a dynamic system of interacting difficulties.Methods: 714 children struggling with attention, learning, and/or memory were included. The sample consisted of children with both diagnosed (41%) and undiagnosed difficulties. The conditional independence network of parent ratings of everyday behaviour, cognition, and communication was estimated.Results: A clustering coefficient identified four areas of difficulty: (1) structural language and learning; (2) pragmatics and peer relationships; (3) behavioural and emotional problems; and (4) cognitive skills. Emotional and behavioural symptoms shared multiple direct connections with pragmatic abilities and cognitive problems, but not with structural language skills or learning problems. Poor structural language and cognitive skills were associated with learning problems. Centrality indices highlighted working memory and language coherence as symptoms bridging different problem areas. Conclusions: The network model identified four areas of difficulty and potential bridging symptoms. Although the current analytic framework does not provide causal evidence, it is possible that bridging symptoms may be the origins of comorbidities observed on a dimensional level; problems in these areas may cascade and activate problems in other areas of the network. The potential value of applying dynamic systems network approach to symptoms of developmental disorders is discussed.

Exploring Neural Heterogeneity in Inattention and Hyperactivity

“…Variations in this communication network may coincide with differences in cognition and behaviour, in line with empirical observations in children (e.g. Mareva et al, 2019; Siugzdaite et al, 2020). In the current study, we explored how node-level measures in the structural brain network relate to variations in hyperactivity- and inattention-related behaviours.…”

Is atypical rhythm a risk factor for developmental speech and language disorders?

“…This research suggests that it is unusual to have discrete, categorical developmental disorders, and that it may be more efficient to search for underlying deficits that can be identified across disorders in large samples of children. In accordance with these results, the possibility of the transdiagnostic approach has arisen in research, diagnosis and treatment of disorders ( Mareva & Holmes, 2019 ).…”

“…The Atypical Rhythm Risk Hypothesis is in line with the transdiagnostic approach ( Mareva & Holmes, 2019 ) emphasizing the need for large-scale epidemiological studies (e.g., Raghavan et al, 2018 ). This work needs to incorporate various known and to-be-determined risk factors into prediction models and disentangle gene–environment interactions, intermediary neural endophenotypes, and underlying biological mechanisms.…”

Segregation and integration of the functional connectome in neurodevelopmentally ‘at risk’ children

“…In the present study, we explored ICN development in a sample that reflects the large heterogeneous population of children experiencing neurodevelopmental difficulties in cognition and behaviour (Astle et al., 2019; Bathelt, Gathercole, Butterfield et al., 2018; Bathelt, Gathercole, Johnson et al., 2018; Bathelt, Holmes et al., 2018; Holmes et al., 2019, 2020; Mareva & Holmes, 2019; Siugzdaite et al., 2020). These young people were recruited on the basis of experiencing difficulties in attention, learning, language and/or memory, as identified by practitioners across a variety of children's professional services.…”