Transdiagnostic profiles of behaviour and communication relate to academic and socioemotional functioning and neural white matter organisation

Abstract

Background: Behavioural and language difficulties co-occur in multiple neurodevelopmental conditions. Our understanding of these problems has arguably been slowed by an overreliance on study designs that compare diagnostic groups and fail to capture the overlap across different neurodevelopmental disorders and the heterogeneity within them. Methods: We recruited a large transdiagnostic cohort of children with complex needs (N = 805) to identify distinct subgroups of children with common profiles of behavioural and language strengths and difficulties. We then investigated whether and how these data-driven groupings could be distinguished from a comparison sample (N = 158) on measures of academic and socioemotional functioning and patterns of global and local white matter connectome organisation. Academic skills were assessed via standardised measures of reading and maths. Socioemotional functioning was captured by the parent-rated version of the Strengths and Difficulties Questionnaire. Results: We identified three distinct subgroups of children, each with different levels of difficulties in structural language, pragmatic communication, and hot and cool executive functions. All three subgroups struggled with academic and socioemotional skills relative to the comparison sample, potentially representing three alternative but related developmental pathways to difficulties in these areas. The children with the weakest language skills had the most widespread difficulties with learning, whereas those with more pronounced difficulties with hot executive skills experienced the most severe difficulties in the socioemotional domain. Each data-driven subgroup could be distinguished from the comparison sample based on both shared and subgroup-unique patterns of neural white matter organisation. Children with the most pronounced deficits in language, cool executive, or hot executive function were differentiated from the comparison sample by altered connectivity in predominantly thalamocortical, temporal-parietal-occipital, and frontostriatal circuits, respectively. Conclusions: These findings advance our understanding of commonly co-morbid behavioural and language problems and their relationship to behavioural outcomes and neurobiological substrates.

Neurodiversity: Towards an interdisciplinary approach

“…Joni's research group uses the core principles of empirical psychological research to provide mechanistic accounts of child development and understand childhood neurodevelopmental differences from a transdiagnostic perspective (e.g. Astle et al, 2018; 2022; Bathelt et al, 2018; Guy et al, 2022; Holmes et al, 2019; 2020; 2021; 2022; Mareva et al, 2019; 2023; Siugzdaite et al, 2020; Williams et al, 2022). Punit's research group focuses on neurodiversity in adulthood, including a pioneering body of work testing the strengths putatively associated with neurodivergence (e.g.…”

Exploring functional connectivity in clinical and data-driven groups of preterm and term adults

“…Similarly, individuals belonging to distinct diagnostic and non-diagnostic psychiatric groups also exhibit within- and between-group heterogeneity in terms of phenotypic profiles. Recent studies implementing such approaches in psychiatric populations have successfully identified patterns of structural and functional connectivity characterising distinct data-driven behavioural subgroups irrespective of diagnostic labels (Astle et al, 2019; Bathelt et al, 2018; Jones et al, 2021; Mareva et al, 2023; Siugzdaite et al, 2020; Vandewouw et al, 2023). A small number of studies in VPT children followed similar methodological approaches and investigated the underlying brain changes differentiating within-group behavioural heterogeneity.…”

Heated Behaviour in the Classroom for Children with FASD: The Relationship between Characteristics Associated with ADHD, ODD and ASD, Hot Executive Function and Classroom Based Reward Systems

“…The focus on diagnostic threshold assumes a homogenous approach to understanding the cognitive and behavioural characteristics of a heterogeneous population [ 20 ]. A trans-diagnostic approach, which aims to understand clusters of behavioural symptoms which may not map on to a diagnosis, shifts the focus from diagnostic-understanding to a need-based one [ 21 ]. Moving beyond the clinical silos has the potential to shape effective interventions to support individuals by meeting their need where there is a challenge to their daily functioning, rather than based on diagnostic labelling.…”

“…FASD, ADHD, ODD, and ASD are known to share similarities in patterns of challenge to executive function [ 6 , 21 , 22 , 23 ]. Cognitive processes in the form of executive function (EF) are essential to complete daily life tasks.…”