Timing of maternal vocal responses linked to childhood ADHD in preliminary study

Babies whose mothers were less likely to respond vocally within one second were more likely to receive certain psychiatric diagnoses years later, particularly ADHD and other disruptive behaviour disorders, in a study published in PLOS One.

Early conversations between babies and caregivers do not resemble adult dialogue, but they still involve turn-taking. A baby makes a sound, a parent responds, and the child may answer again. This predictable back-and-forth has been linked with communication, emotion regulation and social development. Previous research has connected broad measures of parental responsiveness with later outcomes, but determining precisely what aspect of an interaction carries useful information has proved difficult.

The researchers therefore focused on timing rather than simply counting how much mothers and infants talked. They asked whether the probability of responding within a particular period could provide a measurable feature of early interaction associated with children’s mental health several years later.

Led by Bethany Stanley from the University of Glasgow, the study used data from the Avon Longitudinal Study of Parents and Children in England. At around 12 months of age, infants and caregivers had been video-recorded looking at a picture book together in a room designed to resemble a living room.

After excluding unsuitable recordings, the researchers analysed 158 mother-infant pairs. Of the children, 55 later received at least one psychiatric diagnostic classification and 103 served as controls. Diagnoses assessed around age seven included disruptive behaviour disorders such as ADHD and conduct disorder, autism and emotional disorders such as anxiety or depression.

Researchers identified the start and end of each vocalisation and calculated how likely each member of the pair was to respond within different time windows. Their data suggested that one second was the most informative threshold for mothers and eight seconds for children. Statistical models then tested whether these measures were associated with later diagnoses while considering characteristics such as birth weight and maternal age.

Maternal response timing produced the clearest result. For every 10-percentage-point increase in a mother’s probability of answering within one second, the researchers estimated a 17% reduction in the odds that her child later fell into the “any disorder” group. Associations were particularly evident for disruptive behaviour disorders and ADHD, but not for autism or emotional disorders.

Infants’ own eight-second response measure was much less consistent. One analysis suggested a higher probability of the child responding might be associated with ADHD, and a subgroup analysis produced a possible pattern among boys, but the researchers themselves characterised the latter as weak and requiring further investigation.

Stanley and colleagues concluded, “these findings demonstrate the potential clinical value of the analysis of caregiver–infant vocalisations in predicting later development of childhood psychiatric disorders.”

Limitations are to be noted. Diagnostic groups were small — only six children, for example, were in the autism category — and the researchers explicitly describe the results as preliminary. Additionally, old recordings had limited sound quality, preventing analysis of meaning, tone or whether one utterance was truly a direct response to another.

The study, “Probability of a timely vocal response in mother-infant interaction and later psychiatric diagnosis: A case-control study,” was authored by Bethany Stanley, Clare S. Allely, Jenna Charlton, Christopher Gillberg, James Law, Penny Levickis, Alex McConnachie, Christine Puckering, Lucy Thompson and Philip Wilson.

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