801 - The association between the prevalence of attention deficit hyperactivity disorder and family activities among children aged 3 to 5 years in the United States

Publication Number: 801.6710

Anushree Rana, Georgetown University School of Medicine, Washington, DC, United States; Elizabeth M. Chawla, Georgetown University School of Medicine, Washington, DC, United States

Background: Attention-deficit hyperactivity disorder is a neurodevelopmental disorder affecting nearly 9% of school-age children in the US, emerging as early as 3 to 5 years in some children. The development of ADHD involves a complex interplay of genetic predispositions and environmental influences. While cognitive enrichment through executive function training has been shown to improve inhibitory control and cognitive flexibility in preschoolers, there is still insufficient data on the role of supportive parenting strategies in altering the ADHD trajectory. Interventions within family settings could serve as accessible, low-cost strategies to promote healthy development in children at risk for ADHD.

Objective: To examine the association between the prevalence of ADHD and family activities among children aged 3-5 years, to identify potential early interventions within family settings.

Design/Methods: This cross-sectional study utilized data from the 2020-21 National Survey of Children’s Health to explore the relationship between family activities and parent-reported ADHD diagnosis in children aged 3 to 5 years. Primary exposures were the frequency of reading to children and shared meals. Analyses were conducted on a subset of the NSCH dataset with non-missing values for relevant covariates. Sociodemographic differences by frequency of family activities were assessed and are presented in Table 1. Multivariate logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for ADHD, accounting for potential confounders. Statistical analyses were performed using Stata/BE Version 17.0

Results: A total of 16,272 children were included in the analysis. The distribution of participants by sociodemographic characteristics is given in Table 1. Findings indicate engagement in daily reading and family meals is associated with a lower likelihood of reported ADHD in children aged 3 to 5 years (Table 2); children whose families read to them daily had significantly lower odds of ADHD [adjusted OR of 0.585 (p = 0.030)], as well as those who ate meals together daily [adjusted OR of 0.492 (p = 0.032)].

Conclusion(s): This study suggests that supportive parenting practices, such as daily reading and family meals, are associated with a reduced likelihood of ADHD symptoms in early childhood. Given the critical period for brain development during the preschool years, these interventions may offer potential benefits in influencing the trajectory of ADHD. Future longitudinal research is needed to confirm these associations and assess the long-term impact of these practices on ADHD symptoms.

Table 1: Participant sociodemographic characteristics by the number of days family reads to children aged 3 to 5 years every week.


Table 2: Logistic regression estimating the association between parent-reported prevalence of ADD/ADHD and ‘Family reads to children’ and ‘Family eats meals together’.
*Adjusted OR: Controlling for the age of the child, race, mother's overall health status, adverse childhood events, household income level, and the highest education of adult in the child's household.