Neonatal Surgency Moderates the Association Between the Home Environment and Executive Functions in Children With a Family History of ADHD

Contemporary perspectives suggest that some children are more sensitive to their caregiving environment than others. This prospective longitudinal study examined the role of environmental sensitivity in the developmental pathways of attention-deficit/hyperactivity disorder (ADHD), focusing on its early identification during the neonatal period. Ninety-five Israeli boys, varying in their likelihood of developing ADHD, based on parental ADHD symptoms, were followed from birth to age 7 years. Both neonatal temperamental surgency and parental ADHD symptoms moderated the correlation between the early home environment (measured at 54 months) and child executive functions (EF; measured at 7 years), with medium effect sizes (double moderation; ΔR² = 0.12, β = 0.32 and 0.28, respectively). Among children with elevated levels of both parental ADHD symptoms and neonatal surgency, a more enriched home environment predicted higher EF. Very early and accurate detection of sensitivity to the environment can facilitate early preventive interventions to moderate the development of ADHD symptoms.