Data-driven subtyping of behavioural problems associated with ADHD in children

Abstract

IntroductionMany developmental disorders are associated with deficits in controlling and regulating behaviour. These difficulties are frequently observed across multiple groups of children including children with diagnoses of attention deficit hyperactivity disorder (ADHD), specific learning difficulties, autistic spectrum disorder, or conduct disorder. The co-occurrence of these behavioural problems across disorders typically leads to comorbid diagnoses and can complicate intervention approaches. An alternative to classifying children on the basis of specific diagnostic criteria is to use a data-driven grouping that identifies dimensions of behaviour that meaningfully distinguish groups of children.\n\nMethodsThe sample consisted of 442 children identified by health and educational professionals as having difficulties in attention, learning and/or memory. The current study applied community clustering, a data-driven clustering algorithm, to group children by similarities across scales on a commonly used rating scale, the Conners-3 questionnaire. Further, the current study investigated if the groups identified by the data-driven algorithm could be identified by white matter connectivity using a structural connectomics approach combined with partial least squares analysis.\n\nResultsThe data-driven clustering yielded three distinct groups of children with symptoms of either: (1) elevated inattention and hyperactivity/impulsivity, and poor executive function, (2) learning problems, and (3) aggressive behaviour and problems with peer relationships. These groups were associated with significant inter-individual variation in white matter connectivity of the prefrontal and anterior cingulate cortex.\n\nConclusionIn sum, data-driven classification of executive function difficulties identifies stable groups of children, provides a good account of inter-individual differences, and aligns closely with underlying neurobiological substrates.