Primary prevention of AD-HKD, like that of other mental health disorders, requires that the population health-risk factors strongly associated with the disorder be identified before they can be altered to change outcomes. A range of psychosocial, biological, and developmental risks of AD-HKD has been identified, but each accounts for only a small portion of the variance in the incidence of the disorder. All these risk factors must be altered before a significant impact on the outcome is possible because we do not yet know which of these factors is primary.

We are now reasonably certain that preschoolers with the triad of AD-HKD, aggression, and impairment of language and learning are at particularly high risk for persistent AD-HKD, and for significant impairment in later life. (!.03) Nevertheless, many of these early cases of AD-HKD will dissipate without specific intervention, other severe cases will appear among older school-aged children, and most cases will not be identified by identifying preschoolers with AD-HKD, aggression, and impaired language and learning.

Early detection and intervention for targeted groups of children with AD-HKD may reduce impairment for the affected child and the burden of suffering for the families and communities. The modest results achieved in research to date indicate that these interventions will have to be very intensive, comprehensive (i.e. involve children, parents, and schools), and multidimensional (in other words, target behaviour, social interaction, and academic skills).

Given the high prevalence of AD-HKD, it is unreasonable to assume that traditional clinic-based services will be able to meet this considerable mental health need. Nevertheless, there is a clear need for a multidimensional, multidisciplinar^, and comprehensive clinical assessment to establish the initial diagnosis, plan treatment, and support the long-term management of affected persons.

Pregnancy And Childbirth

Pregnancy And Childbirth

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