Executive Function Profile of Children With Attention Deficit Hyperactivity Disorder

We explored the neuropsychological profile for executive functions of children with attention deficit hyperactivity disorder (ADHD) to assess whether problems associated with the two most cited relevant processes-inhibition and attentional problems-were the core of any executive function difficulty. A battery of executive function tests was administered to 31 children with a clinical diagnosis of ADHD and to 33 normal control participants, all aged between 7 and 12. The executive function battery encompassed a number of tasks, selected because each had multiple measures: a sustained attention reaction time task, a related vigilance task, an adaptation of the Hayling Sentence Completion Test, an adaptation of the Brixton Spatial Rule Attainment Test, a Letter Fluency task, a number Stroop task, and an "n-back" working memory task. The overall pattern of the results fit well with those obtained in previous studies as far as abnormalities of the ADHD group in the domain of inhibitory processes, attentional functions, and executive functions. The children with ADHD, although performing well on baseline tasks, performed more poorly than the controls on all the experimental tasks with one borderline exception: Letter Fluency, where the children with ADHD showed a very different pattern than most adult frontal lobe subgroups. However, there was no specific impairment on measures of inhibitory processes. In addition, strategy generation and use were severely affected in the ADHD group. Particular findings fitted well with disorders of a high-level effort system and of a monitoring system.

[1]  W. Beatty,et al.  Performance of children with ADHD on tests sensitive to frontal lobe dysfunction. , 1990, Journal of the American Academy of Child and Adolescent Psychiatry.

[2]  A. Taylor,et al.  The contribution of the right parietal lobe to object recognition. , 1973, Cortex; a journal devoted to the study of the nervous system and behavior.

[3]  J. Meere The role of attention. , 2002 .

[4]  D. Stuss,et al.  The effects of focal anterior and posterior brain lesions on verbal fluency , 1998, Journal of the International Neuropsychological Society.

[5]  J. Swanson,et al.  Dopamine D4 receptor gene polymorphism is associated with attention deficit hyperactivity disorder. , 1996, Molecular psychiatry.

[6]  Tim Shallice,et al.  The Hayling and Brixton Tests , 1997 .

[7]  B. Pennington,et al.  Executive functions and developmental psychopathology. , 1996, Journal of child psychology and psychiatry, and allied disciplines.

[8]  Karl J. Friston,et al.  Investigations of the functional anatomy of attention using the stroop test , 1993, Neuropsychologia.

[9]  J. Sergeant,et al.  Inhibition in ADHD, aggressive, and anxious children: A biologically based model of child psychopathology , 1996, Journal of abnormal child psychology.

[10]  M. Posner,et al.  Attention-deficit/hyperactivity disorder: Symptom domains, cognitive processes, and neural networks. , 1998 .

[11]  T. Shallice,et al.  Confidence in Recognition Memory for Words: Dissociating Right Prefrontal Roles in Episodic Retrieval , 2000, Journal of Cognitive Neuroscience.

[12]  R. Tannock,et al.  Deficient inhibitory control in attention deficit hyperactivity disorder , 1995, Journal of abnormal child psychology.

[13]  T Shallice,et al.  The domain of supervisory processes and temporal organization of behaviour. , 1996, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[14]  J. Swanson,et al.  Association of the dopamine receptor D4 (DRD4) gene with a refined phenotype of attention deficit hyperactivity disorder (ADHD): a family-based approach , 1998, Molecular Psychiatry.

[15]  T. Shallice,et al.  Frontal lesions and sustained attention , 1987, Neuropsychologia.

[16]  H. Markus,et al.  The Cultural Psychology of Personality , 1998 .

[17]  T. Shallice,et al.  Right prefrontal cortex and episodic memory retrieval: a functional MRI test of the monitoring hypothesis. , 1999, Brain : a journal of neurology.

[18]  Tim Shallice,et al.  Introspective physicalism as an approach to the science of consciousness , 2001, Cognition.

[19]  D. Norman,et al.  Attention to Action: Willed and Automatic Control of Behavior Technical Report No. 8006. , 1980 .

[20]  G. Groth-Marnat,et al.  Handbook of psychological assessment, 4th ed. , 2003 .

[21]  Dc Washington Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[22]  E. Taylor,et al.  Attention-deficit hyperactivity disorder and hyperkinetic disorder , 1998, The Lancet.

[23]  H. Markus,et al.  Culture and the self: Implications for cognition, emotion, and motivation. , 1991 .

[24]  S. Faraone,et al.  Family-genetic and psychosocial risk factors in DSM-III attention deficit disorder. , 1990, Journal of the American Academy of Child and Adolescent Psychiatry.

[25]  R. Keith,et al.  Effects of Methylphenidate on the Auditory Processing Abilities of Children with Attention Deficit-Hyperactivity Disorder , 1991, Journal of learning disabilities.

[26]  M. Posner,et al.  Executive attention: Conflict, target detection, and cognitive control. , 1998 .

[27]  R. Epstein,et al.  Urinary monoamine metabolites in children with minimal brain dysfunction. , 1971, The American journal of psychiatry.

[28]  G. Robert J. Hockey,et al.  Cognitive-energetical control mechanisms in the management of work demands and psychological health. , 1993 .

[29]  V. Douglas,et al.  Attention deficit hyperactivity disorder and the frontal lobe syndrome , 1992, Brain and Cognition.

[30]  R. W. Jones,et al.  Behaviors analogous to frontal lobe dysfunction in children with attention deficit hyperactivity disorder , 1989 .

[31]  J. Rapoport,et al.  Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder. , 1996, Archives of general psychiatry.

[32]  M. Raichle,et al.  The anterior cingulate cortex mediates processing selection in the Stroop attentional conflict paradigm. , 1990, Proceedings of the National Academy of Sciences of the United States of America.

[33]  B. J. Casey,et al.  Implication of right frontostriatal circuitry in response inhibition and attention-deficit/hyperactivity disorder. , 1997, Journal of the American Academy of Child and Adolescent Psychiatry.

[34]  J. Meere,et al.  Information Processing and Energetic Factors in Attention-Deficit/Hyperactivity Disorder , 1999 .

[35]  J. Grossman,et al.  Handbook of Psychological Assessment, 4th ed. , 2004 .

[36]  T. Robbins,et al.  Spatial and non-spatial working memory at different stages of Parkinson's disease , 1997, Neuropsychologia.

[37]  M. Posner,et al.  Localization of a Neural System for Error Detection and Compensation , 1994 .

[38]  T. Shallice,et al.  Response suppression, initiation and strategy use following frontal lobe lesions , 1996, Neuropsychologia.

[39]  G Marzocchi,et al.  Disturbi di impulsività e ricerca visiva in bambini con deficit di attenzione/iperattività , 1998 .

[40]  Francis M. Crinella,et al.  Effect of Stimulant Medication on Children with Attention Deficit Disorder: A “Review of Reviews” , 1993 .

[41]  T. Shallice Specific impairments of planning. , 1982, Philosophical transactions of the Royal Society of London. Series B, Biological sciences.

[42]  I. Nimmo-Smith,et al.  The structure of normal human attention: The Test of Everyday Attention , 1996, Journal of the International Neuropsychological Society.

[43]  E. Gorenstein,et al.  Performance of inattentive-overactive children on selected measures of prefrontal-type function. , 1989, Journal of clinical psychology.

[44]  D. Cohen,et al.  Developmental psychopathology and neurobiology of Tourette's syndrome. , 1994, Journal of the American Academy of Child and Adolescent Psychiatry.

[45]  R. Barkley,et al.  Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report , 1992, Journal of abnormal child psychology.

[46]  N J Cox,et al.  Association of attention-deficit disorder and the dopamine transporter gene. , 1995, American journal of human genetics.

[47]  S. Faraone,et al.  Is Attention Deficit Hyperactivity Disorder Familial? , 1994, Harvard review of psychiatry.

[48]  S. Rauch,et al.  The counting stroop: An interference task specialized for functional neuroimaging—validation study with functional MRI , 1998, Human brain mapping.

[49]  Ilaria Grazzani-Gavazzi,et al.  The Experience of Emotions of Interdependence and Independence following Interpersonal Errors in Italy and Anglophone Canada , 1999 .

[50]  H. Nelson A Modified Card Sorting Test Sensitive to Frontal Lobe Defects , 1976, Cortex.

[51]  J. Fletcher,et al.  Executive functioning deficits in attention-deficit/hyperactivity disorder are independent of oppositional defiant or reading disorder. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[52]  J. Halperin ADHD and the Nature of Self-Control , 1999 .

[53]  C. Gillberg,et al.  Long-term stimulant treatment of children with attention-deficit hyperactivity disorder symptoms. A randomized, double-blind, placebo-controlled trial. , 1997, Archives of general psychiatry.

[54]  M. Posner,et al.  Images of mind , 1994 .

[55]  Karl J. Friston,et al.  Willed action and the prefrontal cortex in man: a study with PET , 1991, Proceedings of the Royal Society of London. Series B: Biological Sciences.

[56]  R. Barkley Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. , 1997, Psychological bulletin.

[57]  H. Quay Inhibition and Attention Deficit Hyperactivity Disorder , 1997, Journal of abnormal child psychology.

[58]  B. Maher,et al.  Segregation analysis of attention deficit hyperactivity disorder. , 1999, American journal of medical genetics.

[59]  A. Bradshaw Charting some challenges in the art and science of nursing , 1998, The Lancet.

[60]  Bryan Rodgers,et al.  What does a Man do after he Makes an Error? An Analysis of Response Programming , 1977 .

[61]  R. Barkley,et al.  The adolescent outcome of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status. , 1990, Journal of consulting and clinical psychology.

[62]  E. Warrington,et al.  Two Categorical Stages of Object Recognition , 1978, Perception.

[63]  G. Groth-Marnat Handbook of Psychological Assessment , 2016 .

[64]  Everett E. Davis,et al.  WISC-R, Wechsler Intelligence Scale for Children—Revised , 1975 .

[65]  M. Posner,et al.  The attention system of the human brain. , 1990, Annual review of neuroscience.

[66]  R. Diamond,et al.  Frontal lobe functioning in boys with attention‐deficit hyperactivity disorder , 1992 .

[67]  T. Robbins,et al.  Planning and spatial working memory following frontal lobe lesions in man , 1990, Neuropsychologia.

[68]  Tim Shallice,et al.  Bizarre Responses, Rule Detection and Frontal Lobe Lesions , 1996, Cortex.

[69]  T. Moffitt,et al.  A comparison of 13-year-old boys with attention deficit and/or reading disorder on neuropsychological measures , 1989, Journal of abnormal child psychology.

[70]  D. Stuss,et al.  Organizational strategies with unilateral or bilateral frontal lobe injury in word learning tasks. , 1994 .

[71]  Linda J. Schuerholz,et al.  Attention deficit hyperactivity disorder and executive dysfunction , 1994 .

[72]  G. Weiss,et al.  Cognitive styles in adolescents previously diagnosed as hyperactive. , 1972, Journal of child psychology and psychiatry, and allied disciplines.

[73]  G. Logan On the ability to inhibit thought and action , 1984 .

[74]  A. Benton,et al.  Visual Memory Test: The Simulation of Mental Incompetence , 1961 .

[75]  G D Logan,et al.  Response inhibition in AD/HD, CD, comorbid AD/HD + CD, anxious, and control children: a meta-analysis of studies with the stop task. , 1998, Journal of child psychology and psychiatry, and allied disciplines.

[76]  G. Weiss,et al.  Cognitive style in adults originally diagnosed as hyperactives. , 1979, Journal of child psychology and psychiatry, and allied disciplines.