Early Childhood Assessments of Community Pediatric Professionals Predict Autism Spectrum and Attention Deficit Hyperactivity Problems

For clinically referred children with Autism Spectrum Disorder (ASD) or Attention Deficit/Hyperactivity Disorder (ADHD) several
early indicators have been described. However, knowledge is lacking on early markers of less severe variants of ASD and ADHD
from the general population. The aim of the present study is to identify early indicators of high risk groups for ASD and
ADHD problems based on routine data from community pediatric services between infancy and age four. Data are from 1,816 participants
who take part in Tracking Adolescents’ Individual Lives Survey (TRAILS), a longitudinal study. Information on early developmental
factors was extracted from charts of routine Preventive Child Healthcare (PCH) visits. To assess ASD and ADHD problems, respectively,
we used the Children’s Social Behavior Questionnaire (CSBQ) and the Child Behavior Checklist (CBCL), filled out by parents
three times between the ages of 11 and 17. Note that these are parent ratings and not diagnostic instruments performed by
trained clinicians. Male gender, low birth weight, low level of education of the mother, social, behavioral, language, psychomotor
and eating problems significantly predicted ASD problems (odds ratios (OR) between 1.34 and 2.41). ADHD problems were also
predicted by male gender and low level of education of the mother and by maternal smoking during pregnancy, good gross motor
skills in first year, early attention and hyperactivity problems, and absence of parent-reported positive behavior (ORs between 1.36 and 1.74).
Routine data on early childhood from PCH services are predictive for ASD and ADHD problems in adolescents in the general population.
The PCH services are a useful setting to identify high risk groups, and to monitor them subsequently.