Predicting ADHD symptoms and diagnosis at age 14 from objective activity levels at age 7 in a large UK cohort

Hyperactivity is one of the three core symptoms in children with attention deficit hyperactivity disorder (ADHD). Diagnosing ADHD typically involves self-report, third party report and observations. Objective activity data can make a valuable contribution to the diagnostic process. Small actigraphy studies in clinical samples have shown that children with ADHD move more than children without ADHD. However, differences in physical activity between children with and without ADHD have not been assessed in large community samples or longitudinally. This study used data from the Millennium Cohort Study to test whether symptoms of ADHD (parent-rating Strengths and Difficulties Questionnaire) and ADHD diagnosis at age 14 (reported by parents) could be predicted from objective activity data (measured with actigraphs) at age 7 in N = 6675 children (final N = 5251). Regressions showed that less sedentary behavior at age 7 predicted more ADHD symptoms at age 14 (β = − 0.002, CI − 0.004 to − 0.001). The result remained significant when controlled for ADHD symptoms at age 7, sex, BMI, month of birth, SES and ethnicity (β = − 0.001, CI − 0.003 to − 0.0003). ADHD diagnosis at age 14 was also significantly predicted by less sedentary behavior at age 7 (β = − 0.008). Our findings show that symptoms of ADHD can be predicted by objective activity data 5 years in advance and suggest that actigraphy could be a useful instrument aiding an ADHD diagnosis. Interestingly, the results indicate that the key difference between children with and without ADHD lies in reduced sedentary activity, i.e., times of rest. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00787-020-01566-9) contains supplementary material, which is available to authorized users.