This study examined executive functions, motor speed, and language processing in a diverse, preadolescent sample of 93 girls with attention-deficit/hyperactivity disorder (ADHD) combined type, 47 ADHD inattentive type, and 88 age-and ethnicity-matched comparison girls. Testing was performed without stimulant medication. All 10 neuropsychological variables showed significant omnibus subgroup differences, with 8 of 10 combined versus comparison contrasts significant (average effect size medium) and 6 of 10 inattentive versus comparison contrasts significant (average effect size small to medium), but only 2 of 10 combined versus inattentive contrasts significant (average effect size small). Results were robust to statistical control of demographic variables, comorbidities, and IQ. Discriminant function analysis revealed relatively high sensitivity but only modest specificity in predicting ADHD from comparison status from test performance; classification of the inattentive type was extremely poor.

Questions remain as to whether neuropsychological processing deficits associated with child attention-deficit/hyperactivity disorder (ADHD) are accounted for by co-occurring disorders, especially in clinical samples. The authors examined ADHD and comorbid oppositional defiant, conduct, and reading disorders. Boys with ADHD displayed hypothesized deficits on effortful neuropsychological tasks regardless of categorical or dimensional control of comorbid antisocial behavior problems. The same result held when reading problems were controlled, although boys with ADHD plus reading disorder (n = 16) exhibited specific impairment on linguistic output tasks. Simultaneous control of reading and behavior problems yielded the same result. Overall, results suggest that in a clinical sample, difficulties on effortful neuropsychological tasks that require planning or controlled motor output pertain at least in part to ADHD and are not fully accounted for by comorbid conditions.

We administered a neuropsychological battery to boys aged 6 to 12 years old diagnosed with attention-deficit hyperactivity disorder (ADHD; n = 51) and to comparison boys of the same age range (n = 31). Boys with ADHD had greater difficulty than comparison youngsters on nonautomated language and motor tasks administered with a fast instructional set and on one of two traditional frontal executive measures (Porteus mazes). When tasks requiring automatic processing were paired with similar tasks requiring greater use of selective attention processes, the latter, controlled processing tasks differentiated groups better than did automated tasks. This differential effect of otherwise similar tasks is interpreted in terms of an output deficit mediated by response organization as detailed in the information processing literature. The ADHD group also exhibited slow gross motor output, measured independently of verbal output. The findings are evaluated in terms of both Luria's (1973) tripartite model of neurocognitive organization and frontal striatal models, with an emphasis on output processes. The observed language deficits could represent frontal lobe processes intricately related to self-monitoring and planning. The utility of controlled processing, self-paced tasks with fast instructional sets in assessing language and motor skills in ADHD is highlighted.

Prospectively followed girls with attention-deficit/hyperactivity disorder (ADHD), along with a matched comparison sample, five years after childhood neuropsychological assessments. Follow-up neuropsychological measures emphasized attentional skills, executive functions, and language abilities. Paralleling childhood findings, the childhood-diagnosed ADHD group displayed moderate to large deficits in executive/attentional performance as well as rapid naming, relative to the comparison group, at follow-up (M age = 14.2 years). ADHD-Inattentive vs. ADHD-Combined contrasts were nonsignificant and of negligible effect size, even when a refined, "sluggish cognitive tempo" subgroup of the Inattentive type was examined. Although ADHD vs. comparison differences largely withstood statistical control of baseline demographics and comorbidities, control of childhood IQ reduced EF differences to nonsignificance. Yet when the subset of girls meeting diagnostic criteria for ADHD in adolescence were compared to the remainder of the participants, neuropsychological deficits emerged even with full statistical control. Overall, childhood ADHD in girls portends neuropsychological and executive deficits that persist for at least 5 years.Keywords attention-deficit hyperactivity disorder (ADHD); neuropsychology; executive function; longitudinal research; girls Neuropsychological measures tap a range of functions, including attention, inhibition, motor speed, and linguistic abilities. The construct of executive function (EF) refers to those neuropsychological skills, deemed essential for performance of complex human tasks, related to planning, set maintenance, set shifting, interference control, and working memory (e.g., Barkley, 1997;Pennington & Ozonoff, 1996). Considerable evidence exists that, in contrast Address correspondence to Stephen P. Hinshaw, Department of Psychology, Tolman Hall #1650, University of California, Berkeley, CA 94720-1650 (hinshaw@berkeley.edu). NIH Public Access Author ManuscriptNeuropsychology. Author manuscript; available in PMC 2010 September 1. Published in final edited form as:Neuropsychology. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript to non-diagnosed comparison individuals, samples of children and adults with attention-deficit/ hyperactivity disorder (ADHD) show significant neuropsychological deficits, particularly those linked with EF (see, for example, Hinshaw, Carte, Sami, Treuting, & Zupan, 2002;Klorman et al., 1999; Nigg, Blaskey, Huang-Pollack, & Rappley, 2002;Seidman, Biederman, Faraone, Weber, & Ouellette, 1997;Seidman et al., 2005; see reviews of Barkley, Grodzinsky, & duPaul, 1992;Hervey, Epstein, & Curry, 2004;Seidman et al., 2004; Sergeant, Guerts, & Oosterlaan, 2002). Such deficits appear on a number of different tests and are largely independent of comorbid conditions that accompany ADHD Seidman et al., 1997). Because EF deficits are particularly likely to predict continuing academic failure in youth with ADHD (Biederman et al., 2004) and because th...

In spite of a multitude of scoring approaches, the ability of the Rey-Osterrieth Complex Figure (ROCF) to measure executive functions versus grapho-motor skill is still open to question. To clarify this issue, we examined the performance of an ethnically and socioeconomically diverse sample of preadolescent girls (ADHD-Combined, n = 93; ADHD-Inattentive, n = 47; and comparison girls, n = 88) on the ROCF, scoring both immediate copy and delayed recall performance. Girls with ADHD performed the task following a stimulant medication washout. Dependent measures were the established Developmental Scoring System variables of Organization, Accuracy, and Style, plus an operationalized and extensively detailed scoring of errors, featuring an error proportion score (EPS). The major finding is that only EPS differentiated girls with ADHD from comparison girls (a) on both immediate and delayed performance and (b) with stringent statistical control of Performance IQ, fine motor speed, and performance on the Porteus Mazes (as well as comorbidities), with effect sizes in the medium range. Perseverative errors contributed significantly to EPS. Overall, error scores on the ROCF appear to tap planning, a key executive function, and are quite sensitive to deficits in this domain for girls with ADHD.

The factor structure of the Revised Behavior Problem Checklist (RBPC) was examined in a large sample of suburban kindergarten children. Teacher-rated dimensions of Conduct Disorder, Attention Problems-Immaturity, Anxiety-Withdrawal, and Psychotic Behavior were closely replicated, and a new factor labeled Unmotivated-Isolated was also revealed. These principal components were consistent across gender and across subsamples of children differing as to risk status for learning failure. Evidence was found for the divergent validity of the externalizing dimensions of Conduct Disorder and Attention Problems-Immaturity with respect to criterion measures of alternative behavior ratings, cognitive functioning, and academic achievement. Parent-rated components of Conduct Disorder, Attention Problems-Immaturity, Hyperactive-Impatient, Tense-Withdrawn, Anxiety, and Passive-Conforming were less clearly validated, and parent-teacher agreement was modest. It was concluded that the RBPC shows promise for the assessment of preschool-aged children and that narrow-band externalizing dimensions of inattentive versus conduct-disordered behavior are reasonably distinct at this age.

The role of cognitive, perceptual, visual-motor, behavioral, achievement, and demographic factors affecting nonpromotion at kindergarten was examined in a sample of 34 nonpromoted and 34 promoted kindergarten children of a suburban area in Northern California. The major findings of the study, part of a longitudinal follow-up study, indicated that retained students were more likely to be male, of younger age, and of lower socioeconomic status. In addition, retained students had lower IQ and preacademic achievement test scores and demonstrated increased problems in the areas of visual-motor integration, perceptual organization, and behavior. A discriminant analysis indicated that perceptual problems, inattention, age, preacademic reading achievement, and sex were factors that provided the maximum differentiation between retained and promoted students at the end of kindergarten. The findings are suggestive of interventions that may prove beneficial in preparing retained children for entry into first grade.

Of 270 learning disabled children with average intelligence and significant delays in reading comprehension a sample of 37 were evaluated for signs of neurobehavioral dysfunction. All such signs--primitive reflexes, equilibrium reactions, and postrotary nystagmus--were reliably assessed. A subsample of 19 children was compared with developmentally normal and mentally retarded samples for the occurrence of tonic neck reflexes and equilibrium reactions. The learning disabled children consistently showed deviancies like those of the retarded children; both of these groups differed from the normal children on most measures. These deviant responses persisted over a 9-mo. period for the learning disabled group. Compared with norms, the total learning disabled sample displayed hyponystagmus, and this depressed nystagmus persisted for 11 mo. Results are discussed in relation to the lack of correlation among the various signs of neurobehavioral dysfunction in the learning disabled children.