The Developmental Course of Teacher-Rated ADHD Symptom Levels in an Early Childhood Community Sample

Objective: This study examined trajectories of inattention and hyperactivity/impulsivity symptom levels across one preschool year and explored variation in trajectories by age, sex, and end-of-year impairment. Method: Participants were 261 preschoolers (87% Head Start; 59% Caucasian; 53% boys; M-age = 3.97 years). Teachers rated ADHD symptom levels four times throughout one academic year. Results: Results showed a course of increasing inattention that decelerated over time and steadily increasing hyperactivity/impulsivity. Group-based finite mixture modeling revealed three trajectories of inattention: stable low (57%), change (32%), and stable high (11%), as well as three trajectories of hyperactivity/impulsivity: stable low (63%), increasing (26%), and stable high (11%). Compared to children with increasing or changing symptoms levels, children with stable high levels were more impaired and children with stable low symptom levels were less impaired. Conclusion: Findings suggest a "wait and see" approach to treatment may miss an important opportunity for early intervention.