Around 15% of children worldwide have a neurodevelopmental disorder like autism or dyslexia, and 8% have a disruptive behaviour disorder such as conduct disorder—yet researchers have barely studied what happens when these conditions overlap in the same child. This matters because children with both types of disorder face compounded educational challenges that can cascade into worse health and economic outcomes across their lives. The project will map how these conditions co-occur in six longitudinal cohorts from the UK, Norway, and the US, then untangle the genetic and environmental roots of their combined impact on schooling. Crucially, the team will identify protective environments—specific home, school, or peer-group conditions—that can narrow the educational gap for children with multiple diagnoses. If successful, this work could transform how schools screen for and support neurodivergent students. Instead of treating autism, ADHD, conduct disorder, and learning disorders as separate boxes, educators could use a dimensional approach that recognises overlapping symptoms and shared genetic risks. The findings may lead to targeted interventions that improve educational trajectories for millions of children, particularly those with less-studied conditions that current research largely ignores.
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Neurodevelopmental disorders (NDD) and Disruptive Behaviour Disorders (DBD) represent significant health concerns, affecting approximately 15% and 8% of children and adolescents, respectively, across the world. NDD (e.g., autism spectrum disorder, specific learning disorders) are characterized by challenges in cognition, communication, adaptive behaviour, and psychomotor skills, while DBD (e.g., conduct disorder, oppositional defiant disorder) are typified by underlying features of impulsivity, aggressiveness, and pathological rule breaking. Starting from childhood, NDD and DBD are associated with educational challenges, leading to important life-course cascading effects on health and socioeconomic outcomes. Despite sharing several common features, such as their developmental onset, their partly overlapping cognitive and affective profiles, and clinical observations of their co-occurrence, the overlap between NDD and DBD is critically under-researched. Previous studies, including ours, have shown that both NDD and DBD are partly heritable and that a high proportion of genetic and environmental risk is shared across them. Yet, there is a major gap in our understanding of their co-occurrence, which has not been investigated across most disorders identified by diagnostic manuals. This project seeks to bridge this gap in our knowledge by investigating the combined impact of NDD and DBD on education, considering both genetic and environmental risk and their interplay. We aim to pinpoint protective environments that can narrow the educational gap between children with different neurodivergent and behavioural profiles, a gap that is likely amplified when multiple disorders co-occur. The project, leveraging data from six longitudinal cohorts across the United Kingdom, Norway, and the United States, has three primary aims which have emerged as research priorities from focus groups with educators and clinicians working with youth with NDD and DBD. First, we will map the co-occurrence of all NDD and DBD in youth and their shared aetiological risk. Second, we will assess the joint effects of NDD and DBD risk on educational outcomes, unravelling the underlying genetic and environmental pathways as well as causal links. Third, we will investigate how children and adolescents with a higher genetic risk experience and select differential environments (home, school, peer groups) that relate to educational outcomes (gene-environment correlation), therefore identifying protective factors that foster learning. These three objectives will be refined throughout the project in co-production with young people with lived experiences of NDD and DBD, parents, clinicians, and educators. The outcomes of this research will transform our understanding of NDD and DBD and their impact on education offering new perspectives on screening and intervention by addressing both the general (transdiagnostic symptoms and risk) and specific (unique symptoms and risks) features of these conditions. A first key innovation is our consideration of NDD and DBD as quantitative dimensions that overlap to different degrees, moving beyond a monolithic conceptualization of developmental conditions as separate entities, to embrace a transdiagnostic and dimensional approach. A second key innovation is our focus on all neurodevelopmental and behavioural conditions identified by diagnostic manuals, rebalancing research efforts towards less investigated conditions and resulting in new important discoveries. A third key innovation is our recognition of the role of genetic factors alongside environmental influences. By providing new knowledge on how genetic and environmental risk combine developmentally, we will identify causal environmental pathways and consequently provide a platform for successful interventions aimed at enhancing educational and developmental trajectories for youth with a wide range of behavioural and neurodiverse profiles.
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