Previous examinations of working memory impairments in children with attention-deficit/hyperactivity disorder (ADHD) have predominantly focused on discreet visuospatial and phonological subsystem processes, as well as the domain-general central executive. The episodic buffer component of working memory, a neurocognitive process that allows for temporary storage and maintenance of bound episodes/features of information, is understudied in ADHD and initial findings have been equivocal. Heterogeneity in previous findings may reflect between-study methodological variability, floor effects unrelated to episodic buffer processes (i.e., excessive central executive demands), and limitations associated with previous investigations' use of novel paradigms. This study examined ADHD-related episodic buffer processing via an established paradigm (Allen et al., 2006) in well-defined groups of children with attention-deficit/hyperactivity disorder (ADHD) and typically developing peers (TD). Seventy-one children (ADHD n = 34, TD n = 37) aged 8-12 years (M = 9.81, SD = 1.50; 32% female) completed two conditions of a computerized working memory task that presented single feature stimuli (color and shape), and a third condition that presented dual-feature stimuli (color/shape binding). Overall, the ADHD group exhibited a large-magnitude deficit during the color/shape binding condition (d = .77), and both groups evinced worse performance accuracy in the color/ shape binding condition compared to the single feature color and shape conditions. Collectively, these findings appear to provide evidence that children with ADHD exhibit large magnitude episodic buffer deficits that are not attributable to visuospatial subsystem or domain-general central executive processes.
Objective: Phonological working memory impairments associated with attention-deficit/hyperactivity disorder (ADHD) have garnered interest due to reliable evidence of moderate-to large-magnitude between-group (ADHD vs. control) effects, as well their association with a wide range of secondary impairments. However, previous studies are methodologically limited in their ability to identify potential underlying mechanistic processes. This study aimed to examine converging and diverging patterns of omission, intrusion, and transposition errors to parse-specific mechanistic processes that contribute to ADHD-related phonological working memory deficits. Method: Fifty-four children with ADHD (45 males, nine females) and 65 typically developing (TD; 50 males, 15 females) children aged 8-12 (M = 9.62, SD = 1.52) years completed a computer-based phonological working memory task that aurally presented a random series of jumbled numbers and one letter. Children were instructed to verbally respond by stating the numbers from least to greatest, followed by the letter. Children's incorrect responses were coded as errors of omission, intrusion errors, or transposition errors. Results: Results indicated a significant moderatemagnitude between-group difference in total omission and transposition errors, and a significant smallmagnitude between-group difference in total intrusion errors. An examination of specific error types supported evidence of ADHD-related deficits in reordering and updating central executive processes. Conclusion: Collectively, these findings contribute to a more precise understanding of underlying mechanistic processes in ADHD-related working memory deficits and hold potential to inform the development of novel working memory metrics and working memory-based interventions for ADHD. Key PointsQuestion: What mechanistic processes are involved in phonological working memory impairments in children with ADHD? Findings: Phonological working memory impairments in ADHD appear to be associated with central executive-related updating and reordering processes. Importance: Findings contribute to a more precise understanding of underlying mechanistic processes in ADHD-related working memory deficits and are expected to improve the development of novel working memory metrics and working memory-based interventions. Next Steps: Additional examinations of central executive-related deficits in children with ADHD are needed.
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