Performance of Girls With ADHD and Comparison Girls On the Rey-Osterrieth Complex Figure: Evidence for Executive Processing Deficits

Abstract

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.

Neuropsychological functioning of girls with attention-deficit/hyperactivity disorder followed prospectively into adolescence: Evidence for continuing deficits?

“…The priority was placed on well-established and well-validated neuropsychological tests, most of which were parallel forms to those used at baseline (see Hinshaw et al, 2002) Figure (ROCF), which at baseline had been our most sensitive neuropsychological/executive test for discriminating the ADHD from the comparison sample (Hinshaw, 2002;Sami et al, 2003). The ROCF is used to evaluate planning, perceptual organization, and graphomotor abilities (Lezak, 1983;Spreen & Strauss, 1998).…”

“…The current scoring system was parallel to the one used at baseline, which had been developed from our modifications of the procedures of Bernstein and Waber (1996), as described in Sami et al (2003). Drawings were scored by a group of three extensively trained, independent raters who were unaware of diagnostic status.…”

“…Note that Digit Span is a supplemental test of the WISC-III, so that full-scale IQ scores (used as a covariate in our analyses) are independent of Digit Span scores. (Hinshaw, 2002;Sami et al, 2003). The ROCF is used to evaluate planning, perceptual organization, and graphomotor abilities (Lezak, 1983;Spreen & Strauss, 1998).…”

“…The TCFT is the only major alternative to the ROCF in a test-retest situation (Helmes, 2000). We administered only the copy condition of the TCFT because, at baseline, the delayed recall condition yielded weak evidence for ADHD vs. comparison differences (Sami et al, 2003).Our primary dependent measure is the error proportion score (EPS), calculated using the number of segments drawn incorrectly (errors) divided by the sum of all segments drawn (correct plus incorrect). The current scoring system was parallel to the one used at baseline, which had been developed from our modifications of the procedures of Bernstein and Waber (1996), as described in Sami et al (2003).…”

Associations Between Performance on the Rey-Osterrieth Complex Figure and Regional Brain Volumes in Children with and without Velocardiofacial Syndrome

“…Within the extant pediatric literature, the ROCF has been utilized as a measure of visuospatial perception, learning and memory (Baron, 2000) in research with several populations including typically developing youth (Beebe, Ris, Brown, & Dietrich, 2004), epilepsy (Hernandez et al, 2003), phenylketonuria (Antshel & Waisbren, 2003), preterm children (Waber & McCormick, 1995), learning disabilities (Kirkwood et al, 2001) and ADHD (Sami, Carte, Hinshaw, & Zupan, 2003;Seidman et al, 1995). All of these studies found the ROCF to be a sensitive measure to the cognitive difficulties of the identified clinical group.…”