Cognitive Profile for Children with ADHD by Using WISC-IV: Subtype Differences? // Detección de perfiles cognitivos mediante WISC-IV en niños diagnosticados de TDAH: ¿Existen diferencias entre subtipos?

Abstract

ResumenEl presente estudio explora si se puede obtener un perfil cognitivo específico para niños/as con TDAH a partir de la Escala de Inteligencia Wechsler para Niños Cuarta Edición (WISC-IV), y si ese perfil es capaz de diferenciar entre los subtipos clínicos de TDAH. Se seleccionó un grupo de control de 47 niños/as y otro grupo clínico de 86 niños/as diagnosticados/as con TDAH, éste último dividido a su vez en dos subgrupos de acuerdo a sus características clínicas. El grupo clínico se caracterizó por una puntuación ICG>ICC respecto al grupo de control. Los subgrupos clínicos no obtuvieron puntuaciones significativamente diferentes en ninguno de los índices, pero sí lo hicieron respecto a la distancia entre el Índice de Memoria de Trabajo y el Índice de Velocidad de Procesamiento. Para el subgrupo TDAH predominantemente inatento esta distancia fue positiva, mientras que para el subgrupo TDAH-combinado fue negativa. Estos resultados aportan evidencia empírica a la hipótesis de la existencia de un perfil cognitivo específico del TDAH, con potencial para discriminar entre subtipos clínicos de TDAH.Palabras clave: TDAH, WISC-IV, patrón cognitivo específico, memoria de trabajo y velocidad de procesamiento. AbstractThis study explores whether a specific cognitive profile for children with ADHD can be obtained through the Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and whether this profile is capable of differentiating between ADHD clinical subtypes. A control group of 47 children was selected, together with a clinical group of 86 children diagnosed with ADHD and divided into 2 subgroups, according to their clinical characteristics. The clinical group was characterized by a GAI > CPI with respect to the control group. The clinical subgroups did not score significantly lower in any index, but they did in the difference between the working memory index and the processing speed index. For those diagnosed with inattentive ADHD, this distance was positive; for those diagnosed with ADHD combined group, it was negative. These findings contribute empirical evidence to the hypothesis that there is a characteristic ADHD cognitive profile, with a potential ability of differentiating between ADHD clinical subtypes.

Detecting Differences between Clinical Presentations in ADHD through the Cognitive Profile Obtained from WISC-IV

“…In line with previous research, no differences were found between the nominal groups and the General Ability Index (GAI), Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) [17,20,24,25].…”

“…Several studies have found that children diagnosed with ADHD and evaluated by the WISC-IV show a characteristic pattern in cognitive development [21,25]. Although in general intellectual functioning they get close to the normative score ranges [26], a moderate effect size in group differences has been noted regarding the indexes of Processing Speed (PS) and Working Memory (WM) whereas, on the other hand, they show an optimal level in tests related to both Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI) [18].…”

“…Recent research suggests that there are differences in the cognitive profile of ADHD subtypes [25][26]. Examples in the body of literature have highlighted Arithmetic, Digits, Symbols and Keys Tests [27], as those tests in which some children who are diagnosed with ADHD obtain much lower scores compared to the rest of the scores in WISC-IV Full Scale tests.…”

“…Put differently, the intensity with which the clinical symptoms associated with ADHD are presented and the relationship they maintain with the measured cognitive profile, through the main WISC-IV indexes. On the other hand, the aim is to confirm the hypothesis by taking into account the "cognitive step" that different investigations have related to the ADHD [18,21,25]. This latter step consists of significantly lower scores in the Working Memory Index (WMI) and Processing Speed Index (PSI) compared to the scores of the subject evaluated in the Verbal Comprehension Index (VCI) and Perceptual Reasoning Index (PRI), can establish a predictive relationship between the ADHD dimensions (inattention and hyperactivity/impulsivity) and the Working Memory Index (WMI) and Processing Speed Index (PSI) as measured by WISC-IV [28] a predictive relation that could be of great help in the diagnosis of ADHD and its clinical presentation.…”

Análisis de Perfiles Cognitivos en Población Clínica Infantil con Trastornos del Neurodesarrollo

“…Sin embargo, no se han encontrado grandes diferencias entre los demás diagnósticos ya que las puntuaciones en los índices son bastante similares y se mantienen dentro de la norma. Igualmente, cabe señalar que los grupos TDAH-I y TDAH-C de esta muestra han presentado perfiles idénticos con la misma tendencia en todos los índices, con lo cual en este estudio no se confirma la afectación de estos sujetos en ningún índice del WISC-IV (Bustillo & Servera, 2015;Fenollar-Cortés et al, 2015) ni la presencia de diferencias entre perfiles (Capdevila-Brophy et al, 2006;Fenollar-Cortés et al, 2015). Asimismo, resulta llamativa la falta de evidencia de déficits en el grupo TEL en el índice CV, cuya existencia ha sido sobradamente probada en estudios previos (Spanoudis & Natsopoulos, 2011;Taylor, Maybery, & Whitehouse, 2012;van Weerdenburg et al, 2006).…”