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Preventive Interventions for ADHD: A Neurodevelopmental Perspective

  • Published:
Neurotherapeutics

Abstract

It is proposed that the time is ripe for the development of secondary preventive interventions for attention-deficit/hyperactivity disorder (ADHD). By targeting preschool children, a developmental stage during which ADHD symptoms first become evident in most children with the disorder, many of the adverse long-term consequences that typify the trajectory of ADHD may be avoided. A dynamic/interactive model of the biological and environmental factors that contribute to the emergence and persistence of ADHD throughout the lifespan is proposed. Based on this model, it is argued that environmental influences and physical exercise can be used to enhance neural growth and development, which in turn should have an enduring and long-term impact on the trajectory of ADHD. Central to this notion are 2 hypotheses: 1) environmental influences can facilitate structural and functional brain development, and 2) changes in brain structure and function are directly related to ADHD severity over the course of development and the degree to which the disorder persists or remits with time. We present experimental and correlational data supporting the first hypothesis and longitudinal data in individuals with ADHD supporting the second. The case is made for initiating such an intervention during the preschool years, when the brain is likely to be more “plastic” and perhaps susceptible to lasting modifications, and before complicating factors, such as comorbid psychiatric disorders, academic failure, and poor social and family relationships emerge, making successful treatment more difficult. Finally, we review recent studies in young children with ADHD that might fall under the umbrella of secondary prevention.

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Acknowledgments

This work was supported by grants (R21/R33 MH085898 and R01 MH68286) from the National Institute of Mental Health to Jeffrey Halperin, and by a Canadian Institutes of Health Research Fellowship Award to Anne-Claude Bédard. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health, the National Institutes of Health, or the Canadian Institutes of Health Research. None of the authors have any real or perceived conflicts of interest.

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Authors and Affiliations

  1. Department of Psychology, Queens College of the City University of New York, Flushing, New York, 11367, USA

    Jeffrey M. Halperin & Jocelyn T. Curchack-Lichtin

  2. Department of Psychiatry, Mount Sinai School of Medicine, New York, New York, 10029, USA

    Jeffrey M. Halperin & Anne-Claude V. Bédard

  3. Neuropsychology Doctoral Program, The Graduate Center of the City University of New York, New York, New York, 10016, USA

    Jeffrey M. Halperin & Jocelyn T. Curchack-Lichtin

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  1. Jeffrey M. Halperin
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Halperin, J.M., Bédard, AC.V. & Curchack-Lichtin, J.T. Preventive Interventions for ADHD: A Neurodevelopmental Perspective. Neurotherapeutics 9, 531–541 (2012). https://doi.org/10.1007/s13311-012-0123-z

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