Neuropsychological functioning in subgroups of children with and without social perception deficits and/or hyperactivity--impulsivity

The shifting role of fluid reasoning in reading among children evaluated for ADHD

Children with attentional difficulties are more likely than their peers to experience challenges in basic reading skills, including phonemic decoding and word recognition. Such challenges may require reliance on higher-order cognitive functions such as fluid reasoning (Gf) to attain reading proficiency. The present study sought to clarify the role of Gf in phonemic decoding and word recognition among children-in grades 1-7 (n = 156)-being evaluated for attention-deficit/hyperactivity disorder (ADHD). Effects of Gf were examined in relation to crystallized knowledge (Gc). Results indicated that Gf exerted a direct effect onto phonemic decoding in early grades (grades 1-2) but not in later grades (grades 3-7). Gf also exerted an indirect effect onto phonemic decoding-through Gc-in later grades (grades 3-7) but not in early grades (grades 1-2). Finally, Gf exerted an indirect effect onto word recognition through phonemic decoding in grades 1-4 but not in grades 5-7. Altogether, findings show that Gf plays a direct role in younger children's phonemic decoding and an indirect role in word recognition (through Gc) in later grades, suggesting a shift in Gf's role across grade levels. Although findings need replication in longitudinal research, current results have implications for both typical and atypical reading development.

Are sluggish cognitive tempo symptoms associated with executive functioning in preschoolers?

The aim of this study is to investigate whether sluggish cognitive tempo (SCT) symptoms are associated with neurocognitive task performance and ratings of real-world executive functioning (EF) in preschoolers at risk for attention-deficit/hyperactivity disorder (ADHD). The associations between parent- and teacher-rated SCT symptoms and neuropsychological task performance and ratings of EF in 61 4-year-old preschool children (51 boys, 10 girls) with self-regulation difficulties were examined, with regression analyses controlling for the effects of ADHD inattention symptoms. In the study sample, higher teacher-rated SCT symptoms are significantly associated with poorer performance on tasks of visual-perceptual abilities, auditory and visual attention, sustained and selective attention, inhibitory control, pre-numerical/numerical concepts, and slower processing speed, but SCT symptoms are not significantly associated with working memory, attention shifting or cognitive flexibility when controlling for ADHD inattention. Higher parent-rated SCT symptoms are significantly associated with visual-perceptual abilities. ADHD inattention symptoms are more strongly associated than SCT with daily life EF ratings; neither parent- nor teacher-rated SCT symptoms are significantly associated with daily life ratings of inhibition, working memory, or planning/organization after controlling for ADHD inattention. This study suggests that SCT symptoms contribute to EF deficits at least on neurocognitive tasks assessing visual-perceptual/spatial abilities, attention to detail and processing speed, as observed in this sample of young children at risk for ADHD, and may be an important intervention target.

Fluid reasoning deficits in children with ADHD: evidence from fMRI

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with deficits in fluid reasoning, which may be related to self-regulation of cognition and behavior, and requires intact attention, working memory, and inhibition skills. No functional magnetic resonance imaging (fMRI) studies have directly examined fluid reasoning in ADHD which is surprising given that studies demonstrate a consistent network of brain regions involved in fluid reasoning that are also implicated in the pathogenesis of ADHD. Twenty-two right-handed, non-medicated children (12 ADHD, 10 controls) ages 8-12 years completed a fluid reasoning task during which fMRI data were collected. The primary comparison of interest was activation during the fluid reasoning compared to the control condition. Behavioral data showed that children with ADHD tended to be less accurate with faster reaction times in the fluid reasoning condition compared to controls, and were significantly less accurate in the control condition. Controls activated more than participants with ADHD in the right intraparietal sulcus and the left lateral cerebellum in the fluid reasoning condition. Results showed hypoactivation in ADHD in regions critical for fluid reasoning. These results add to the literature suggesting a role for parietal and cerebellar regions in cognition and ADHD.

The role of inattention and social perception and performance in two subtypes of ADHD

This study evaluated the social perception and social functioning of children with Attention Deficit Hyperactivity Disorder-Combined (ADHD-C), ADHD-predominately inattentive (ADHD-PI), and controls. Two-hundred and seventy children with ADHD-C, ADHD-PI, or controls were evaluated using direct and indirect measures of social functioning. The ADHD-C and ADHD-PI groups showed significant differences in interpretation of emotional and nonverbal cues on a direct measure of social perception compared with controls. The number of inattentive symptoms was significantly related to poor performance for interpretation of both emotional and nonverbal cues, whereas hyperactivity and impulsivity symptoms showed a less robust relation. Children with ADHD-C were rated by parents and teachers as showing significant problems with social performance and problem behaviors compared with those with ADHD-PI or with controls. These findings show a link between inattention and social perception that is separate from impulsivity difficulties. These findings have important implications for treatment.

Social cognition in attention-deficit hyperactivity disorder (ADHD)

Attention-deficit hyperactivity disorder (ADHD) is associated with a range of cognitive deficits and social cognition impairments, which might be interpreted in the context of fronto-striatal dysfunction. So far only few studies have addressed the issue of social cognition deficits in ADHD.

METHOD

Medline and Psyclit searches were performed for a 30-year period (1979-2009) using the words 'ADHD' and 'social cognition', 'theory of mind', 'prosody', 'face perception', 'humour' or 'social information processing'. Inclusion criteria consisted of a diagnosis according to DSM as well as the inclusion of a control group or a follow-up assessment following the treatment with methylphenidate.

RESULTS

ADHD is clearly associated with social cognition impairments involving emotional face and prosody perception. Although the database is sparse so far, there is some evidence for theory of mind deficits and reduced empathy in ADHD.

CONCLUSIONS

In summary, the social cognition impairments are consistent with fronto-striatal dysfunction in ADHD, but other functional networks of brain areas also appear to be implicated.

Sensitivity of the test of memory and learning to attention and memory deficits in children with ADHD

Children with attention deficit hyperactivity disorder (ADHD) exhibit a number of cognitive deficits. The current study compared patterns of attention, learning, and memory impairment on the Test of Memory and Learning (TOMAL) between 80 children with ADHD and 80 normal comparisons who were matched for age and gender. Results demonstrated that children with ADHD performed significantly worse than matched controls on the Attention/Concentration Index and the Sequential Recall Index. ROC analysis indicated that these two indexes had good classification accuracy with AUCs of.76 and.77 respectively. There were also group differences on the other index scores except the Associative Recall Index. Factor analysis of the ADHD sample extracted five factors, including an Attention factor that significantly correlated with performance on nonverbal memory tasks. Significant correlations between the TOMAL Index scores and tests of intelligence and visuomotor integration supported the convergent and discriminant validity of the test. These results provide support for the criterion validity of the TOMAL in assessing neurocognitive deficits in children with ADHD.