Reduced motor planning underlying inhibition of prepotent responses in children with ADHD

Abstract

To flexibly regulate their behavior, children’s ability to inhibit prepotent responses arises from cognitive and motor mechanisms that have an intertwined developmental trajectory. Subtle differences in planning and control can contribute to impulsive behaviors, which are common in Attention Deficit and Hyperactivity Disorder (ADHD) and difficult to be assessed and trained. We adapted a Go/No-Go task and employed a portable, low-cost kinematic sensor to explore the different strategies used by children with ADHD or typical development to provide a prepotent response (dominant condition) or inhibit the prepotent and select an alternative one (non-dominant condition). Although no group difference emerged on accuracy levels, the kinematic analysis of correct responses revealed that, unlike neurotypical children, those with ADHD did not show increased motor planning in non-dominant compared to dominant trials. Future studies should investigate whether motor control could help children with ADHD compensate for planning difficulties. This strategy might make inhibition harder in naturalistic situations that involve complex actions. Combining cognitive and kinematic measures is a potential innovative method for assessment and intervention of subtle differences in executive processes such as inhibition, going deeper than is possible based on accuracy outcomes alone.

Assessment of ADHD Subtypes Using Motion Tracking Recognition Based on Stroop Color–Word Tests

“…However, in terms of overall performance, there were no significant differences between ADHD subgroups based on age changes. This finding is similar to the conclusions of other studies related to RT in ADHD [ 22 , 47 , 48 ].…”

“…Some studies suggest that inhibition and variation in reaction times are core features of ADHD, although others question this view [ 16 , 17 , 19 ]. All these differences may be attributed only to specific subsets [ 18 ] and that children diagnosed with ADHD might exhibit comparable accuracy to typical controls in basic psychological testing tasks [ 22 ]. With the increasing popularity of computerized testing, numerous tests such as TOVA, Conners’ CPT, Flanker, Go/no-Go, and Stroop have been applied to diagnose and explore ADHD [ 18 , 19 , 23 ].…”

“…Children with ADHD have shown inferior motor proficiency in various domains compared to control groups, including gross and fine motor skills, visual-motor control, running speed, agility, balance, and bilateral coordination [ 27 ]. High-resolution motor features have captured different movement patterns in children with ADHD [ 22 , 28 , 29 , 30 , 31 ]. A study found that using mouse movements instead of the keypress method during a Go/no-Go task enhanced the mean response times’ difference and provided more variance in groups with high and low ADHD scores [ 32 ].…”

Agency and reward across development and in autism: A free-choice paradigm

“…Broadening the focus to the processes underlying individuals’ choices and actions, the motivation from agency and reward interacts with higher-level cognitive processes, which we can generally refer to as executive functions. For instance, action planning and control difficulties (that we have found in the autistic sample, as suggested by their reduced RTs) may be associated with reduced ability to inhibit prepotent responses and routine behaviours [ 70 ], thus impacting the way people make complex choices among numerous possible alternatives in everyday life situations. Although agency and reward are fundamental mechanisms for learning, it is crucial that our repertoire of actions is flexible, that we are able to reorient our choices when needs change.…”

“…These findings may indicate the presence of a general propensity for more automatic responses, but also increased variability and therefore uncertainty in the action timing (for a theoretical conceptualisation of predictive processing and volatility in autism, see [68]). Reduced RTs can be interpreted as a marker of less time spent planning the action before its execution and/or less time devoted to online monitoring and control of the ongoing movement [69][70][71]. In everyday life, people constantly perform actions that require both planning and control.…”