Joseph H. Beitchman

Young adult academic outcomes in a longitudinal sample of early identified language impaired and control children.

BACKGROUNDnThe long-term academic consequences of childhood language impairment are both theoretically and clinically important. An unbiased appraisal of these outcomes, however, requires carefully designed, longitudinal research.nnnMETHODnA group of children first identified as having speech and/or language impairment in a community-based, longitudinal study at 5 years of age and matched controls were re-examined during young adulthood (age 19). A comprehensive battery of speech and language, cognitive and achievement tests, psychiatric interviews, and questionnaires were completed by subjects, their parents and teachers.nnnRESULTSnWhile children with early speech problems showed only a few academic differences from controls in young adulthood, early language impaired (LI) young adults lagged significantly behind controls in all areas of academic achievement, even after controlling for intelligence. Further, rates of learning disabilities (LD) were significantly higher in the LI group than both the controls and community base rates. Concurrent individual difference variables, including phonological awareness, naming speed for digits, non-verbal IQ, verbal working memory, and executive function, all contributed unique variance to achievement in specific areas.nnnCONCLUSIONnEarly LI rather than speech impairment is clearly associated with continued academic difficulties into adulthood. These results speak to the need for intensive, early intervention for LI youngsters.

Early Language Impairment and Young Adult Delinquent and Aggressive Behavior.

Clinic and forensic studies have reported high rates of language impairments in conduct disordered and incarcerated youth. In community samples followed to early adolescence, speech and language impairments have been linked to attention deficits and internalizing problems, rather than conduct problems, delinquency, or aggression. This study examines the young adult antisocial outcomes of speech or language impaired children. Language impaired boys had higher levels of parent-rated delinquency symptoms by age 19 than boys without language impairment, controlled for verbal IQ and for demographic and family variables. Language impaired boys did not differ from controls in self-reported delinquency or aggression symptoms on a standardized checklist; however, language impaired boys reported higher rates of arrests and convictions than controls. Language impairment was not related to aggression or delinquency in girls. We examine alternate models of the interrelationships between language, academics, and behavior, at ages 5, 12, and 19.

The serotonin transporter gene in aggressive children with and without ADHD and nonaggressive matched controls.

Abstract: Using an ethnically homogeneous sample of highly aggressive Caucasian children and their matched controls, we report differential associations of the 5HTTLPR and VNTR polymorphisms with ADHD and aggression, respectively. Given the small sample size and the peliminary nature of our findings, replication is necessary.

MAOA and persistent, pervasive childhood aggression

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COMORBIDITY OF PSYCHIATRIC AND SUBSTANCE USE DISORDERS IN LATE ADOLESCENCE: A CLUSTER ANALYTIC APPROACH

Cluster analysis was used to identify subgroups of youths with past-year substance and/or psychiatric disorders (N = 110, mean age 19.0 years). Data for this study came from a community-based, prospective longitudinal investigation of speech/language (S/L) impaired children and matched controls who participated in extensive diagnostic and psychosocial assessments at entry into the study at 5 years of age and again at follow-up. Clustering variables were based on five DSM diagnostic categories assessed at age 19 with the University of Michigan Composite International Diagnostic Interview. Using Wards method, the five binary variables were entered into a hierarchical cluster analysis. An iterative clustering method (K-means) was then used to refine the Ward solution. Finally, a series of analyses of variance (ANOVAs) were run to analyze group differences between clusters on measures of Global Assessment of Functioning (GAF), criminal involvement, anxiety and depressive symptomatology, and frequency of drug use and heavy drinking. The analysis yielded eight replicable cluster groups, which were labeled as follows: (a) anxious (20.9%); (b) anxious drinkers (5.5%); (c) depressed (16.4%); (d) depressed drug abusers (10%); (e) antisocial (16.4%); (f) antisocial drinkers (10%); (g) drug abusers (8.2%); (h) problem drinkers (12.7%). These groups were differentiated by external criteria, thus supporting the validity of our cluster solution. Cluster membership was associated with a history of S/L impairment: A large proportion of the depressed drug abusers and the antisocial cluster group had S/L impairment that was identified at age 5. Clarification of the developmental progress of the youths in these cluster groups can inform our approach to early intervention and treatment.

Dopaminergic system genes in childhood aggression: Possible role for DRD2

Abstract Excessive or deficient levels of extracellular dopamine have been hypothesized to contribute to a broad spectrum of mood, motor, and thought abnormalities, and dopaminergic system genes have been implicated in aggressive behaviour from animal and human studies. Objective. We examined selected members of the dopaminergic system genes for association with child aggression. Method. We analyzed polymorphisms in the dopamine transporter DAT1/SLC6A3, dopamine receptor DRD2, and DRD4 genes in our sample of pervasive childhood aggression consisting of 144 cases paired with 144 healthy controls, matched for sex and ethnicity. Results. Aggressive children were significantly more likely to have the at least one copy of the G allele for the DRD2 A-241G polymorphism (genotypic P=0.02; allelic P=0.01). The DRD2 rs1079598 CC genotype was overrepresented in aggressive children compared to controls (genotype P=0.04). The DRD2 TaqIA T allele (P=0.01) and the TT genotype (P=0.01) were also significantly overrepresented in aggressive children. Conclusions. Our preliminary results suggest that three polymorphisms in DRD2 are associated with childhood aggression. Future studies are required to replicate the current results and to further explore the relationship between the dopamine system and aggressive behaviour in children.

Study of the catechol-o-methyltransferase (COMT) gene with high aggression in children.

The etiology of childhood-onset aggression (COA) is poorly understood, but early COA can be considered as a strong risk factor for adult delinquency and criminal behavior. Callous-unemotional (CU) traits have been proposed as a developmental model of antisocial behavior. Catechol O-methyltransferase (COMT) has been associated with aggression, attention deficit/hyperactivity disorder (ADHD), and other psychiatric disorders. We report an association study between COMT single-nucleotide polymorphisms (SNPs), childhood aggression, and the CU trait in our sample of 144 children with scores at or exceeding the 90th percentile on the aggression subscale of the parent-reported Child Behavior Checklist and the Teachers Report Form. The genotype analysis of rs6269 showed nominally significant association (P = .019) and rs4818 showed a trend (P = .064) with COA. Trends were observed for rs6269 and rs4818 with CU scores (P < .10) as well. The analyses stratified by ADHD, or gender showed no significant results. This is the first report to our knowledge evaluating COMT SNPs with the phenotype of high aggression in children with a possible role for the COMT marker in CU traits. Given the importance of CU traits in antisocial behavior, further investigation of COMT is warranted.

Psychiatric and Substance Use Disorders in Late Adolescence: The Role of Risk and Perceived Social Support

This article explores how measures of risk and perceived social support relate to different configurations of adolescent psychopathology using data from a community-based, longitudinal investigation of 284 individuals interviewed in 1982 at age 5 and again at age 19. Discriminant analysis was used to assess differences in risk and social support variables among eight clusters of youth: anxious, anxious drinkers, depressed, depressed drug abusers, antisocial, antisocial drinkers, drug abusers, problem drinkers, and a ninth group representing those participants without a diagnosis. The results indicated that one function, defined by loadings for (low) family support and (high) early cumulative risk, accounted for the majority of between-group associations. Two groups of drug-abusing youth with multiple adjustment problems were highest on this function, while non-disordered youth and a group of participants with substance abuse alone were lowest. Findings are discussed in terms of the need to consider comorbidity when examining risk factors for later disorder.

Mental health trajectories from adolescence to adulthood: Language disorder and other childhood and adolescent risk factors.

Longitudinal research on mental health development beyond adolescence among nonclinical populations is lacking. This study reports on psychiatric disorder trajectories from late adolescence to young adulthood in relation to childhood and adolescent risk factors. Participants were recruited for a prospective longitudinal study tracing a community sample of 5-year-old children with communication disorders and a matched control cohort to age 31. Psychiatric disorders were measured at ages 19, 25, and 31. Known predictors of psychopathology and two school-related factors specifically associated with language disorder (LD) were measured by self-reports and semistructured interviews. The LD cohort was uniquely characterized by a significantly decreasing disorder trajectory in early adulthood. Special education was associated with differential disorder trajectories between LD and control cohorts, whereas maltreatment history, specific learning disorder, family structure, and maternal psychological distress were associated with consistent trajectories between cohorts. From late adolescence to young adulthood, childhood LD was characterized by a developmentally limited course of psychiatric disorder; maltreatment was consistently characterized by an elevated risk of psychiatric disorder regardless of LD history, whereas special education was associated with significantly decreasing risk of psychiatric disorder only in the presence of LD.

Validating a self-report screen for ADHD in early adulthood using childhood parent and teacher ratings.

Objective: This article evaluates the diagnostic utility of a self-report screening tool for adults based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) ADHD criteria. Method: Children with speech/language (S/L) impairment and typically developing controls had ADHD symptoms rated by parents and teachers at ages 5 and 12. At age 19, participants completed the Adult Attention Problems Scale (AAPS), an 18-item screen. Receiver operative characteristic curve analyses were used to assess the efficiency of this instrument in screening for ADHD. Results: The AAPS had moderate sensitivity and high specificity, but only for adults without a history of communication disorders. Conclusion: The AAPS provides clinicians with the only self-report scales for ADHD in adulthood, validated with childhood ADHD symptoms assessed by multiple raters. However, scale characteristics were poor for the S/L-impaired cohort. Given the overlap between language impairment and ADHD, adult ADHD measures validated in S/L-impaired samples are needed.