Shared neurodevelopmental spectrum could link ADHD, autism and dyslexia to later outcomes

by Queen Mary, University of London

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A paper published in Molecular Psychiatry, led by researchers from Queen Mary University of London and Royal Holloway, University of London, challenges the way we think about neurodevelopmental conditions.

The study suggests it would be better for experts to focus on a broad constellation of traits (a "neurodevelopmental spectrum") to identify potential challenges and support children and young people, rather than looking at individual conditions like autism, ADHD and dyslexia in isolation.

This study used data from more than 10,000 children in the U.K. (the Twins Early Development Study) and is the first to take a large-scale, in-depth look at how traits of different neurodevelopmental conditions overlap and relate to a wide set of outcomes from childhood through adolescence.

Around 15% of individuals worldwide have one or more neurodevelopmental conditions. These conditions are categorized separately in psychiatric manuals used for diagnosis and supported across a range of separate health care and community services.

However, the focus on individual neurodevelopmental conditions has significant limitations, as most people with neurodevelopmental conditions have more than one condition or traits of multiple conditions. This can lead to co-occurring conditions and associated needs being overlooked. Instead, research indicates it is more useful to consider all these traits and needs jointly when thinking about how best to support children and young people.

The research identified a common underlying dimension, called the neurodevelopmental spectrum, that reflects the constellation of traits characterizing these conditions across development. The study combines developmental, genetic and environmental information to understand the architecture of this novel spectrum. It also shows how it relates to a wider set of emotional and behavioral challenges and predicts future real-world outcomes, such as school achievement and special educational needs and disability (SEND) status.

Dr. Giorgia Michelini, senior lecturer in neurodiversity and mental health at Queen Mary University of London and lead author of this paper, said, "It is striking that this aggregate index of neurodevelopmental traits showed strong associations with academic performance and related challenges, explaining up to 21% of differences between children in real-world outcomes.

"For example, a child with a high neurodevelopmental spectrum score at age 7 was more than twice as likely to have a SEND statement at age 12 as a child with a low score. And elevated scores across childhood and adolescence were closely linked to poor school performance, with medium-to-large effects.

"These associations were not better explained by other emotional and behavioral challenges that are often experienced by neurodivergent children. Together, our study highlights that focusing on a broad set of neurodevelopmental traits spanning autism, ADHD and other forms of neurodivergence is crucial for understanding and supporting children's needs, while also helping to predict later outcomes."

Importantly, findings closely mirror and provide novel scientific evidence for the concept of neurodivergence, which is increasingly used as an umbrella term for neurodevelopmental conditions and differences.

Michelini said, "In recent years, we have seen a growing advocacy and community-led movement to reconceptualize neurodevelopmental conditions as forms of neurodivergence, bringing different conditions under the same umbrella. Yet, identification and support for these conditions is still provided by different groups of professionals (i.e., child psychiatrists, pediatricians, speech and language therapists) across separate settings.

"Our findings provide strong evidence that a more joined-up (transdiagnostic) approach to identification and support will likely be more beneficial, as it provides a fuller picture of an individual's needs and strengths."

The utility of this approach was also recently highlighted by government-commissioned reports on autism and ADHD.

Dr. Kaili Rimfeld, associate professor at Royal Holloway and co-lead author, added, "Our findings have important implications for influencing SEND provision, psychiatric classification and clinical pathways, and personalizing care. The findings support the use of broad needs-based approaches to assessment of neurodevelopmental differences beyond traditional diagnostic categories in school and clinical settings.

"A shift toward more joined-up, personalized, inclusive practices can improve identification and ensure support is tailored to individual strengths and needs, leading to better outcomes for neurodivergent children and young people."

This work builds on Michelini's previous work.

Publication details

Giorgia Michelini et al, The neurodevelopmental spectrum: phenotypic architecture, etiology, predictive utility, and specificity across development, Molecular Psychiatry (2026). DOI: 10.1038/s41380-026-03714-0

Journal information: Molecular Psychiatry

Key medical concepts

Autistic DisorderAttention Deficit Hyperactivity DisorderDyslexia

Clinical categories

PsychiatryPsychology & Mental healthPediatricsChildren's health Provided by Queen Mary, University of London Who's behind this story?

Sadie Harley

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