Evaluation of the Interplay Between Homework Motivation and Sluggish Cognitive Tempo in Youth With ADHD: Associations With Homework Performance

Smith, Zoe R.; Breaux, Rosanna; Green, Cathrin D.; Langberg, Joshua M.

doi:10.1177/1087054718763722

Cited by 12 publications

(6 citation statements)

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“…It seems likely that a solely behavior modification approach will not fully ameliorate SCT symptoms. Given academic impairment, low motivation, and internalizing problems associated with SCT (e.g., Becker, Langberg et al, 2014; Bernad et al, 2016; Smith, Breaux, Green, & Langberg, 2018) it is possible that a combination of behavior modification, organizational skills training, motivational interviewing, and cognitive–behavioral therapy will mitigate the negative outcomes associated with SCT. Inclusion of self-reported SCT will be imperative in intervention studies, as per observer report, SCT symptoms may not appear to be improved.…”

Section: Discussionmentioning

confidence: 99%

Sleepy, sluggish, worried, or down? The distinction between self-reported sluggish cognitive tempo, daytime sleepiness, and internalizing symptoms in youth with attention-deficit/hyperactivity disorder.

Smith¹,

Eadeh²,

Breaux³

et al. 2019

Psychological Assessment

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Sluggish cognitive tempo (SCT) consists of symptoms of slowness, sluggishness, daydreaming, and low motivation. SCT has been linked to attention-deficit/hyperactivity disorder (ADHD), internalizing symptoms, and daytime sleepiness. Although there is clear evidence that SCT and ADHD symptoms are distinct constructs, the distinction between SCT, anxiety/depression, and daytime sleepiness is less clear. Prior research has largely relied upon parent-report to evaluate potential overlap between SCT, sleep, and anxiety/depression, despite best practice suggesting that self-report should be used to assess internalizing symptoms. The present study used adolescent self-report to evaluate whether SCT was distinct from daytime sleepiness, anxiety, and depression. Participants were 285 middle school students comprehensively diagnosed with ADHD. Ten confirmatory factor analyses were conducted: four 1-factor models, three 2-factor models, one 3-factor model, one 4-factor model, and a higher order model. Results showed that SCT was indeed distinct from all tested constructs, with the four-factor model including self-report of SCT, anxiety, depression, and daytime sleepiness meeting adequate model fit criteria. All models including SCT as its own factor had improved model fit over models with SCT in a combined factor with another construct. Implications for the assessment and treatment of SCT are discussed. Public Significance StatementAlthough the construct of sluggish cognitive tempo (SCT) includes symptoms of low motivation, apathy, and sluggishness, it is empirically distinct in youth with ADHD from other constructs with similar clinical characteristics, including anxiety, depression, and daytime sleepiness.

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Section: Discussionmentioning

confidence: 99%

Sleepy, sluggish, worried, or down? The distinction between self-reported sluggish cognitive tempo, daytime sleepiness, and internalizing symptoms in youth with attention-deficit/hyperactivity disorder.

Smith¹,

Eadeh²,

Breaux³

et al. 2019

Psychological Assessment

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“…Another way to broaden our definition and measurement of academic success is to include measures of critical thinking and other aspects of learning that are not focused on in the current study. Finally, it will be important to understand how aspects of mental health affect motivation, as mental health is heterogeneous and may impact motivation differently (e.g., some aspects of anxiety increase motivation, while others decrease it; Elmelid et al., 2015; Smith et al., 2019).…”

Section: Discussionmentioning

confidence: 99%

Academic motivation decreases across adolescence for youth with and without attention‐deficit/hyperactivity disorder: Effects of motivation on academic success

Smith

Flax

Becker

et al. 2023

Child Psychology Psychiatry

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Background This longitudinal study examined growth trajectories of academic motivation in youth with and without attention‐deficit/hyperactivity disorder (ADHD) across the important developmental transition from middle school to high school, and associations with academic success. Consistent with self‐determination theory (SDT) of motivation, trajectories of amotivation, extrinsic motivation, and intrinsic motivation were modeled. Methods The study included a robust multi‐method, multi‐source assessment of academic outcomes, including homework performance ratings; reading and mathematics standardized test scores; and grade point average (GPA) obtained from school records. Participants included 302 adolescents (ages 12–14; Mage = 13.20) in eighth grade who were specifically recruited so that approximately half (n = 162) were diagnosed with ADHD and 140 adolescents comprising a comparison sample without ADHD. The sample was predominantly White (81.80%), with 7.90% identifying as bi/multiracial, 5.30% identifying as Black/African American, 4.60% identifying as Asian, and 0.30% identifying as Indigenous/Alaskan. Results Adolescents with ADHD had worse academic motivation at all timepoints. Growth curve analyses indicated the academic motivation of adolescents without ADHD decreased at faster rates across the transition to high school compared to adolescents with ADHD. However, for adolescents with ADHD, amotivation, extrinsic motivation, and intrinsic motivation each predicted GPA, with higher extrinsic and intrinsic motivation also predicting better homework performance and different aspects of math performance, whereas for youth without ADHD, only amotivation and extrinsic motivation predicted GPA. Conclusions Intervention and school policy implications are discussed, including the importance of fostering autonomy and internal motivation, and consideration of whether current ADHD interventions primarily foster extrinsic motivation.

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“…If psychosocial interventions for adolescents with ADHD do improve SCT symptoms, it will be important to determine which factors are associated with change in SCT. Prior work has demonstrated significant associations between SCT and inattention (Tamm, Brenner, Bamberger, & Becker, ), EF (Becker & Langberg, ), and motivation (Smith, Breaux, et al, ), though inattention and EF are distinct constructs from SCT (Barkley, ; Becker et al, ). As such, change in these variables may be associated with reductions in SCT symptoms.…”

Section: Introductionmentioning

confidence: 99%

“…Importantly, comorbid SCT is related to multiple forms of impairment in individuals with ADHD (e.g., grades, study skills, homework motivation, organizing/time management skills, metacognitive executive functioning (EF); Flannery, Luebbe, & Becker, ; Smith & Langberg, ; Smith, Breaux, Green, & Langberg, ) above and beyond other important predictors. SCT symptoms are associated with significant academic impairment above the influence of ADHD (e.g., lower GPA, poorer homework performance; Becker et al, ; Smith & Langberg, ).…”

Section: Introductionmentioning

confidence: 99%

Do sluggish cognitive tempo symptoms improve with school‐based ADHD interventions? Outcomes and predictors of change

Smith

Langberg

2019

Child Psychology Psychiatry

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Background: Sluggish cognitive tempo (SCT) is a construct that includes symptoms of slowness, excessive daydreaming, and drowsiness. SCT is often comorbid with attention-deficit/hyperactivity disorder (ADHD), and SCT symptoms are associated with significant academic impairment above the influence of ADHD. Despite the overlap between ADHD and SCT and associated impairments, no studies have evaluated how evidence-based psychosocial interventions for adolescents with ADHD impact symptoms of SCT. Methods: This study examined whether SCT symptoms improved in a sample of 274 young adolescents with ADHD who were randomly assigned to an organizational skills intervention, homework completion intervention, or to a waitlist control. SCT intervention response was evaluated broadly in all participants and, specifically, for participants in the clinical range for SCT symptom severity at baseline. Change in ADHD symptoms of inattention, executive functioning, and motivation were examined as potential predictors of improvement in SCT. Results: The two intervention groups were collapsed together for analyses because there were no significant differences in change in SCT symptoms. Multilevel modeling results indicate that parent-reported SCT symptoms significantly decreased when comparing the intervention group to waitlist control (d = .410). For adolescents with parent-reported clinical levels of SCT, the decrease in symptoms was more pronounced (d = .517). Self-reported SCT symptoms produced null results, though effect size calculations showed small improvement for the full sample (d = .313) and for the high-SCT group (d = .384). Change in behavior regulation executive functioning (d = .247), metacognitive executive functioning (d = .346), and inattention (d = .230) predicted change in parent-reported SCT symptoms. Conclusions: Although not specifically designed to decrease SCT symptoms, the ADHD interventions evaluated in this study resulted in significant improvements in parentreported SCT with small to moderate effect sizes. Clinical implications and future directions are discussed, including development of interventions for adolescents with high levels of SCT.It is unknown whether academic interventions for youth with attention-deficit/hyperactivity disorder will decrease symptoms of sluggish cognitive tempo (SCT) despite overlap in impairment and etiology.This study found that two school-based interventions for adolescents (N = 222) with ADHD decreased SCT symptoms. As such, academic interventions that focus on organization, time management, and planning skills as well as behavioral homework modification are beneficial in decreasing SCT.Change in executive functioning (EF) and inattention was associated with change in SCT symptoms, suggesting interventions that target metacognitive and behavior regulation EF and inattention may also decrease SCT symptoms. Current interventions should examine whether SCT symptoms decrease with treatment and what predictsthat change to inform intervention development.

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Evaluation of the Interplay Between Homework Motivation and Sluggish Cognitive Tempo in Youth With ADHD: Associations With Homework Performance

Abstract: SCT and motivation are significantly associated constructs. Clinically, youth with ADHD and comorbid SCT may be more likely to present with low motivation, placing them at risk for academic failure. The manuscript discusses potential clinical implications of these findings.

Cited by 12 publications

References 54 publications

Sleepy, sluggish, worried, or down? The distinction between self-reported sluggish cognitive tempo, daytime sleepiness, and internalizing symptoms in youth with attention-deficit/hyperactivity disorder.

Sleepy, sluggish, worried, or down? The distinction between self-reported sluggish cognitive tempo, daytime sleepiness, and internalizing symptoms in youth with attention-deficit/hyperactivity disorder.

Academic motivation decreases across adolescence for youth with and without attention‐deficit/hyperactivity disorder: Effects of motivation on academic success

Do sluggish cognitive tempo symptoms improve with school‐based ADHD interventions? Outcomes and predictors of change

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