Does ADHD worsen inhibitory control in preschool children born very premature and/or with very low birth weight?

Abstract

Introduction: Deficits in executive functioning, especially in inhibitory control, are present in children born very premature and/or with very low birth weight (VP/VLBW) and in children with attention-deficit/ hyperactivity disorder (ADHD). Objective: To evaluate whether ADHD imposes additional inhibitory control (IC) deficits in preschoolers born VP/VLBW. Methods: 79 VP/VLBW (4 to 7 years) children were assessed for ADHD using the Schedule for Affective Disorders and Schizophrenia for School Aged Children-Present and Lifetime Version (K-SADS-PL). IC was measured with Conners' Kiddie Continuous Performance Test (K-CPT 2) and the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P). Results: No significant differences were found between ADHD (n = 24) and non-ADHD children (n = 55) for any of the measures (p = 0.062 to p = 0.903). Both groups had deficits in most K-CPT 2 scores compared to normative samples, indicating poor IC and inconsistent reaction times. Conclusions: ADHD does not aggravate IC deficits in VP/VLBW children. Either neuropsychological tasks and parent reports of executive functions (EFs) may not be sensitive enough to differentiate VP/VLBW preschoolers with and without ADHD, or these children's EFs are already so impaired that there is not much room for additional impairments imposed by ADHD.

Executive function profiles of preschool children with autism spectrum disorder and attention‐deficit/hyperactivity disorder: A systematic review

“…Schneider et al (2016) did not find any group differences, though their sample was slightly older and different components of the CPT were assessed. Lacerda et al (2020), did not find any group differences in K-CPT scores in their sample of children born prematurely, in line with the lack of group differences reported for the other domains.…”

“…Lacerda et al. ( 2020 ) did not find a significant group difference in informant ratings and measures of response inhibition, though their sample consisted of children that were born very premature/with very low birth weight. The authors suggest that the absence of differences could be attributed to the comparison group already being very cognitively impaired.…”

“…Four studies measured WM using different laboratory tasks; three of those reported significant group differences. Lacerda et al (2020) found no group differences on the BRIEF-P in their sample of children born prematurely/with low birth weight. Similarly to ASD studies, no study found a significant association between WM and ADHD symptoms.…”

“…One study out of the five that found planning impairments reported a medium effect size, and one study did not report effect sizes. Only Lacerda et al (2020) did not find a significant difference in parentrated planning in their sample of prematurely-born preschoolers.…”

A Review of Cognitive Disorders in Attention Deficit Hyperactivity Disorder with Emphasis on Executive Functions and Brain Structures

“…EF deficits in ADHD involve inhibiting or stopping behavior. 59 These deficits, especially inhibitory behavior, which is known as an executive skill that evolved during childhood, are at the center of ADHD and have been the subject of many studies. 60 As an example, in a study of children with ADHD and children with reading disabilities, those who have ADHD, with and without comorbid learning disabilities, showed impairments in the speed of processing, naming objects, inhibitory behavior, and had variability in reaction time.…”