Jeffrey M. Halperin, Ph.D.
Distinguished Professor of Psychology
Queens College and the Graduate Center
City University of New York
Mediators of longitudinal trajectories in children with ADHD: Is it possible to bend the curve and influence outcomes?
Attention-deficit/hyperactivity disorder (ADHD) and related behavioral problems unfold over early development in neurologically-vulnerable children resulting in life-long impairment for a substantial portion of afflicted individuals. These developmental processes are moderated and mediated by a series of bidirectional influences between the child and his/her environment that promote or inhibit brain development, cognitive functioning and emotional self-regulation, resulting in a diversity of trajectories and long-term outcomes. To date, few, if any, evidence-based interventions have been shown to substantially alter the trajectory of these developmental processes in an enduring manner or to improve the all-too-common adverse long-term course. Initially, a model of how pre- and post-natal factors influence genetic predispositions will be presented followed by data from longitudinal studies identifying potential mediators and moderators of developmental processes. Subsequently, an array of developmentally-sensitive tactics which have the potential to influence trajectories in young children and decrease adverse outcomes will be presented. Finally, the viability of time-limited interventions for yielding enduring influences will be addressed, and whether a comprehensive strategy designed to induce lifestyle changes might yield greater long-term benefits.