How specific are executive functioning deficits in attention deficit hyperactivity disorder and autism?

BACKGROUND The objective of this study is to identify intact and deficient cognitive processes in children with attention deficit hyperactivity disorder (ADHD) and children with high functioning autism (HFA). METHOD Three rigorously diagnosed groups of children aged between 6 and 12 years (54 ADHD, 41 HFA, and 41 normal controls) were tested on a wide range of tasks related to five major domains of executive functioning (EF): inhibition, visual working memory, planning, cognitive flexibility, and verbal fluency. In addition, the role of comorbid oppositional defiant disorder (ODD) and comorbid conduct disorder (CD) in ADHD was investigated by directly comparing 20 children with ADHD and 34 children with comorbid ADHD + ODD/CD. RESULTS ADHD was associated with EF deficits in inhibiting a prepotent response and verbal fluency. Children with HFA demonstrated deficits in all EF domains, except interference control and working memory. The HFA group showed more difficulties than the ADHD group with planning and cognitive flexibility. The comorbid ADHD + ODD/CD group did not show a distinctive pattern of performance on the EF tests compared to the ADHD group. CONCLUSION The present study indicates that children with HFA exhibit more generalised and profound problems with EF tasks compared to children with ADHD.

[1]  Paul J. Eslinger,et al.  Conceptualizing, describing, and measuring components of executive function: A summary. , 1996 .

[2]  Jaap Oosterlaan,et al.  Response inhibition and response re-engagement in attention-deficit/hyperactivity disorder, disruptive, anxious and normal children , 1998, Behavioural Brain Research.

[3]  P. McGuffin,et al.  Examining the comorbidity of ADHD-related behaviours and conduct problems using a twin study design , 2001, British Journal of Psychiatry.

[4]  G. Hynd,et al.  Neuropsychological development of behavior attributed to frontal lobe functioning in children , 1985 .

[5]  A. Bailey,et al.  Autism: towards an integration of clinical, genetic, neuropsychological, and neurobiological perspectives. , 1996, Journal of child psychology and psychiatry, and allied disciplines.

[6]  G. Baird,et al.  Parent and teacher report of pragmatic aspects of communication: use of the children's communication checklist in a clinical setting. , 2001, Developmental medicine and child neurology.

[7]  D. Shaffer,et al.  NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[8]  D. LeBihan,et al.  Functional anatomy of cognitive development , 2000, Neurology.

[9]  B. Milner,et al.  Interhemispheric differences in the localization of psychological processes in man. , 1971, British medical bulletin.

[10]  G. F. Tremblay,et al.  The Prefrontal Cortex , 1989, Neurology.

[11]  J. Max.  Practitioner's Guide to Psychoactive Drugs for Children and Adolescents , 1994 .

[12]  U. Frith,et al.  The neuropsychology of autism. , 1996, Brain : a journal of neurology.

[13]  J. Laros,et al.  The Construction and Validation of a Nonverbal Test of Intelligence: The revision of the Snijders-Oomen tests , 1993 .

[14]  B. Milner,et al.  Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man , 1982, Neuropsychologia.

[15]  Bruce F. Pennington,et al.  Executive functions and working memory: Theoretical and measurement issues. , 1996 .

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

[17]  D. Bishop,et al.  Annotation: autism, executive functions and theory of mind: a neuropsychological perspective. , 1993, Journal of child psychology and psychiatry, and allied disciplines.

[18]  Karl J. Friston,et al.  A PET study of word finding , 1991, Neuropsychologia.

[19]  Timothy A Kelly,et al.  A Guide to Treatments That Work. , 2000 .

[20]  M. Prior,et al.  Do Executive Function Deficits Differentiate Between Adolescents with ADHD and Oppositional Defiant/Conduct Disorder? A Neuropsychological Study Using the Six Elements Test and Hayling Sentence Completion Test , 2000, Journal of abnormal child psychology.

[21]  Gordon D. Logan,et al.  Effects of methylphenidate on inhibitory control in hyperactive children , 1989, Journal of abnormal child psychology.

[22]  T. Ordoña.  Handbook of Autism and Pervasive Developmental Disorders , 1989 .

[23]  C. Lord,et al.  Using the ADI-R to diagnose autism in preschool children , 1993 .

[24]  D. Zabel,et al.  Diagnostic and Statistical Manual of Mental Disorders, 4th ed , 1995 .

[25]  A. Couteur,et al.  Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders , 1994, Journal of autism and developmental disorders.

[26]  S. Ozonoff,et al.  Brief Report: Specific Executive Function Profiles in Three Neurodevelopmental Disorders , 1999, Journal of autism and developmental disorders.

[27]  J. A. Sergeant,et al.  Vragenlijst voor Gedragsproblemen bij Kinderen (VvGK): Handleiding. Lisse: Swets en Zeitlinger, 2000 , 2000 .

[28]  Alan C. Evans,et al.  Dissociation of human mid-dorsolateral from posterior dorsolateral frontal cortex in memory processing. , 1993, Proceedings of the National Academy of Sciences of the United States of America.

[29]  R. Krikorian,et al.  Tower of London procedure: a standard method and developmental data. , 1994, Journal of clinical and experimental neuropsychology.

[30]  J. Laros,et al.  Snijders-Oomen Nonverbal Intelligence Test SONR 2,5-7: Manual and Research Report , 1998 .

[31]  E. Bullmore,et al.  Hypofrontality in attention deficit hyperactivity disorder during higher-order motor control: a study with functional MRI. , 1999, The American journal of psychiatry.

[32]  D. Strayer,et al.  Further Evidence of Intact Working Memory. , 2001 .

[33]  R E Gross,et al.  Wisconsin Card Sorting Test performance following head injury: dorsolateral fronto-striatal circuit activity predicts perseveration. , 1999, Journal of clinical and experimental neuropsychology.

[34]  M. J. Emerson,et al.  The Unity and Diversity of Executive Functions and Their Contributions to Complex “Frontal Lobe” Tasks: A Latent Variable Analysis , 2000, Cognitive Psychology.

[35]  J. Larrieu,et al.  Differential Diagnosis Between Attention-Deficit/Hyperactivity Disorder and Pervasive Developmental Disorder—Not Otherwise Specified , 1997, Clinical pediatrics.

[36]  S. Faraone,et al.  Psychiatric, neuropsychological, and psychosocial features of DSM-IV subtypes of attention-deficit/hyperactivity disorder: results from a clinically referred sample. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[37]  C. L. Gerstadt,et al.  The relationship between cognition and action: Performance of children Article| PDF (1504 K)| View Record in Scopus| Cited by in Scopus (424) 3 1 2-7 years old on a Stroop-like day-night test , 1994 .

[38]  B. Schefft,et al.  Neurologic validity of the Wisconsin Card Sorting Test with a pediatric population. , 1999, The Clinical neuropsychologist.

[39]  J. Naglieri,et al.  Performance of delinquent and nondelinquent males on planning, attention, simultaneous, and successive cognitive processing tasks. , 1992, Journal of clinical psychology.

[40]  Daniel Tranel,et al.  Development of the concept of "executive function" and its relationship to the frontal lobes , 1994 .

[41]  C. Stern,et al.  Differentiation of Attention-Deficit/Hyperactivity Disorder Subtypes: Application of a Neuropsychological Model of Attention , 2001, Journal of clinical and experimental neuropsychology.

[42]  David L. Strayer,et al.  Inhibitory Function in Nonretarded Children with Autism , 1997, Journal of autism and developmental disorders.

[43]  Gordon D. Logan,et al.  Dependence and independence in responding to double stimulation: A comparison of stop, change, and dual-task paradigms. , 1986 .

[44]  J. Bachorowski,et al.  Impulsivity in adults: Motor inhibition and time-interval estimation. , 1985 .

[45]  J. Russell.  Autism as an executive disorder , 1997 .

[46]  Russell A. Barkley,et al.  ADHD and The Nature of Self-Control , 1997, Journal of Cognitive Psychotherapy.

[47]  R. Joseph,et al.  Neuropsychological frameworks for understanding autism. , 1999, International review of psychiatry.

[48]  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.

[49]  J. Bachorowski,et al.  Impulsive motor behavior: effects of personality and goal salience. , 1990, Journal of personality and social psychology.

[50]  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.

[51]  B. Pennington,et al.  A Comparison of the Neuropsychological Profiles of the DSM-IV Subtypes of ADHD , 2001, Journal of abnormal child psychology.

[52]  W. Rosen,et al.  Verbal fluency in aging and dementia , 1980 .

[53]  A. Hariri,et al.  Attention-deficit/hyperactivity disorder: perspectives from neuroimaging. , 2000, Mental retardation and developmental disabilities research reviews.

[54]  M. Ghaziuddin.  Asperger Syndrome , 2002 .

[55]  J. Russell,et al.  Evidence for executive dysfunction in autism , 1994, Neuropsychologia.

[56]  R. Peschel,et al.  Integrating the neurobiological revolution into child and adolescent psychiatry and into society. , 1992, New directions for mental health services.

[57]  C. Gillberg,et al.  Executive Function/Attention Deficits in Boys with Asperger Syndrome, Attention Disorder and Reading/Writing Disorder , 1999 .

[58]  J. Nigg,et al.  The ADHD Response-Inhibition Deficit as Measured by the Stop Task: Replication with DSM–IV Combined Type, Extension, and Qualification , 1999, Journal of abnormal child psychology.

[59]  M. Lezak.  Neuropsychological assessment, 3rd ed. , 1995 .

[60]  N. Minshew.  Brief report: Brain mechanisms in autism: Functional and structural abnormalities , 1996, Journal of autism and developmental disorders.

[61]  Bruce F. Pennington,et al.  An interactive framework for examining prefrontal cognitive processes. , 1996 .

[62]  G. Band,et al.  Inhibitory motor control in stop paradigms: review and reinterpretation of neural mechanisms. , 1999, Acta psychologica.

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

[64]  J. Nigg,et al.  Is ADHD a disinhibitory disorder? , 2001, Psychological bulletin.

[65]  R. Tannock.  Attention deficit hyperactivity disorder: advances in cognitive, neurobiological, and genetic research. , 1998, Journal of child psychology and psychiatry, and allied disciplines.

[66]  R. Cabeza,et al.  Imaging Cognition II: An Empirical Review of 275 PET and fMRI Studies , 2000, Journal of Cognitive Neuroscience.

[67]  Robert K. Heaton,et al.  Wisconsin Card Sorting Test Manual – Revised and Expanded , 1993 .

[68]  J. Fuster.  The Prefrontal Cortex , 1997 .

[69]  A R Damasio,et al.  A neurological model for childhood autism. , 1978, Archives of neurology.

[70]  D. Berch,et al.  The Corsi Block-Tapping Task: Methodological and Theoretical Considerations , 1998, Brain and Cognition.

[71]  C. Jarrold,et al.  An experimental approach to executive fingerprinting in young children , 2002 .

[72]  M. Denckla,et al.  A theory and model of executive function: A neuropsychological perspective. , 1996 .

[73]  R. Elwood.  Episodic and Semantic Memory Components of Verbal Paired-Associate Learning , 1997 .

[74]  David A. Rettinger,et al.  How are visuospatial working memory, executive functioning, and spatial abilities related? A latent-variable analysis. , 2001, Journal of experimental psychology. General.

[75]  J Townsend,et al.  Impairment in shifting attention in autistic and cerebellar patients. , 1994, Behavioral neuroscience.

[76]  M. Rutter.  Thinking and relationships : Mind and brain (some reflections on theory of mind and autism) , 1993 .

[77]  Jaap Oosterlaan,et al.  How specific is a deficit of executive functioning for Attention-Deficit/Hyperactivity Disorder? , 2002, Behavioural Brain Research.

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

[79]  Alan C. Evans,et al.  Developmental trajectories of brain volume abnormalities in children and adolescents with attention-deficit/hyperactivity disorder. , 2002, JAMA.

[80]  W. Pelham,et al.  Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[81]  H. Geurts,et al.  Executive functioning in children with autism and Tourette syndrome , 2005, Development and Psychopathology.

[82]  R. Pihl,et al.  Executive functions and physical aggression after controlling for attention deficit hyperactivity disorder, general memory, and IQ. , 1999, Journal of child psychology and psychiatry, and allied disciplines.

[83]  G. Dawson,et al.  The screening and diagnosis of autistic spectrum disorders. , 2004, Journal of autism and developmental disorders.

[84]  G D Logan,et al.  Strategies and mechanisms in nonselective and selective inhibitory motor control. , 1995, Journal of experimental psychology. Human perception and performance.

[85]  Philip M. Corsi.  Human memory and the medial temporal region of the brain. , 1972 .

[86]  H. Sauer,et al.  Hypofrontality in neuroleptic-naive schizophrenic patients during the Wisconsin Card Sorting Test – a fMRI study , 2001, European Archives of Psychiatry and Clinical Neuroscience.

[87]  Phil A. Silva,et al.  NEUROPSYCHOLOGICAL TESTS PREDICTING PERSISTENT MALE DELINQUENCY , 1994 .

[88]  A. Dagher,et al.  Mapping the network for planning: a correlational PET activation study with the Tower of London task. , 1999, Brain : a journal of neurology.

[89]  A. Scheres,et al.  Response execution and inhibition in children with AD/HD and other disruptive disorders: the role of behavioural activation. , 2001, Journal of child psychology and psychiatry, and allied disciplines.

[90]  R. Heaton.  Wisconsin Card Sorting Test manual , 1993 .

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

[92]  J. Nigg,et al.  Parent personality traits and psychopathology associated with antisocial behaviors in childhood attention-deficit hyperactivity disorder. , 1998, Journal of child psychology and psychiatry, and allied disciplines.

[93]  D. Bishop,et al.  Development of the Children's Communication Checklist (CCC): a method for assessing qualitative aspects of communicative impairment in children. , 1998, Journal of child psychology and psychiatry, and allied disciplines.

[94]  R. E. Passingham,et al.  Imaging the mental components of a planning task , 2001, Neuropsychologia.

[95]  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.

[96]  John L. Bradshaw,et al.  The Neurodevelopmental Frontostriatal Disorders: Evolutionary Adaptiveness and Anomalous Lateralization , 2000, Brain and Language.

[97]  J. Nigg,et al.  Neuropsychological correlates of childhood attention-deficit/hyperactivity disorder: explainable by comorbid disruptive behavior or reading problems? , 1998, Journal of abnormal psychology.

[98]  A. Baddeley,et al.  Pattern span: a tool for unwelding visuo–spatial memory , 1999, Neuropsychologia.

[99]  R. Dolan,et al.  Neural systems engaged by planning: a PET study of the Tower of London task , 1996, Neuropsychologia.

[100]  K. Pugh,et al.  Progress in imaging attention deficit hyperactivity disorder , 1999 .

[101]  R. Barkley,et al.  YOUNG ADULTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER: SUBTYPE DIFFERENCES IN COMORBIDITY, EDUCATIONAL, AND CLINICAL HISTORY , 2002, The Journal of nervous and mental disease.

[102]  S Eliez,et al.  MRI neuroimaging of childhood psychiatric disorders: a selective review. , 2000, Journal of child psychology and psychiatry, and allied disciplines.

[103]  F. Castellanos,et al.  Neuroscience of attention-deficit/hyperactivity disorder: the search for endophenotypes , 2002, Nature Reviews Neuroscience.

[104]  I. Nimmo-Smith,et al.  The differential assessment of children's attention: the Test of Everyday Attention for Children (TEA-Ch), normative sample and ADHD performance. , 2001, Journal of child psychology and psychiatry, and allied disciplines.

[105]  Bruce F. Pennington,et al.  Assessing frontal lobe functioning in children: Views from developmental psychology , 1988 .

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

[107]  F. Volkmar,et al.  Handbook of Autism and Pervasive Developmental Disorders , 1987 .

[108]  D. A. Grant,et al.  A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. , 1948, Journal of experimental psychology.

[109]  G. Canino,et al.  Criterion validity of the NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3). , 1996, Journal of the American Academy of Child and Adolescent Psychiatry.

[110]  J. Nigg,et al.  Neuropsychological executive functions and DSM-IV ADHD subtypes. , 2002, Journal of the American Academy of Child and Adolescent Psychiatry.

[111]  R. Gonzalez.  Applied Multivariate Statistics for the Social Sciences , 2003 .

[112]  E. Hollander,et al.  Neuropsychiatric and neuropsychological findings in conduct disorder and attention-deficit hyperactivity disorder. , 1994, The Journal of neuropsychiatry and clinical neurosciences.

[113]  D. Stuss,et al.  Neuropsychological studies of the frontal lobes. , 1984, Psychological bulletin.

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

[115]  A. Couteur,et al.  Autism diagnostic interview: A standardized investigator-based instrument , 1989, Journal of autism and developmental disorders.

[116]  S. Ozonoff.  Components of executive function in autism and other disorders. , 1997 .

[117]  R. Spinks.  The Prefrontal Cortex: Anatomy, Physiology, and Neuropsychology of the Frontal Lobe, 3rd ed. , 2000 .