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Slow Processing Speed and Sluggish Cognitive Tempo in Pediatric Attention-Deficit/Hyperactivity Disorder: Evidence for Differentiation of Functional Correlates

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Abstract

The association between slow processing speed and sluggish cognitive tempo (SCT), a phenotype described within attention-deficit/hyperactivity disorder (ADHD) samples over the past decade, remains unclear. We examined whether SCT and processing speed predict different functional correlates within children and adolescents with ADHD. Participants were 193 clinically-referred youth meeting DSM ADHD criteria without comorbid conditions (mean age = 9.9 years, SD = 2.5; age range 6–16). The incremental utility of SCT and processing speed to predict (1) adaptive functioning and (2) academic achievement, after controlling for age, sex, medication status, and ADHD symptom burden, was assessed using hierarchical multiple regressions. SCT symptoms significantly predicted adaptive functioning, accounting for 6% of the variance, but did not predict academic achievement. Processing speed did not add incrementally to the prediction of adaptive functioning, but did predict academic achievement, accounting for 4% of the variance. Results suggest that SCT and processing speed differentially predict functional abilities not accounted for by ADHD symptom burden.

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Acknowledgements

Project development and data analysis was supported by: Shire Pharmaceuticals (PI Surman, Co-I Braaten, Co-I Cook). Data collection was supported by: Stanley Center for Psychiatric Research (PI Doyle) and David Judah Fund (Co-Is Doyle & Braaten). The authors thank the patients and their parents who participated in this study. The authors also wish to thank Anthony Guarino, Ph.D. for his feedback on an early version of our data analytic plan.

Funding

Dr. Surman (PI) received an unrestricted research grant to support data analysis and manuscript preparation from Shire Pharmaceuticals.

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Author notes

  1. Nathan E. Cook

    Present address: Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Spaulding Rehabilitation Hospital, and Harvard Medical School, Boston, MA, USA

Authors and Affiliations

  1. Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment Program, Massachusetts General Hospital; & MassGeneral Hospital for Children™ Sport Concussion Program, 101 Merrimac Street, 10th Floor Room 1060, Boston, MA, 02114, USA

    Nathan E. Cook

  2. Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment Program and Clay Center for Young Healthy Minds, Massachusetts General Hospital, 151 Merrimac Street 5th Floor, Boston, MA, 02114, USA

    Ellen B. Braaten

  3. Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, CPZN 6240, Boston, MA, 02114, USA

    Pieter J. Vuijk, B. Andi Lee & Anna R. Samkavitz

  4. Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment Program & Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge Street, CPZN 6240, Boston, MA, 02114, USA

    Alysa E. Doyle

  5. Department of Psychiatry, Harvard Medical School; Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA

    Craig B. H. Surman

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  1. Nathan E. Cook
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  7. Craig B. H. Surman
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Correspondence to Nathan E. Cook.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Cook, N.E., Braaten, E.B., Vuijk, P.J. et al. Slow Processing Speed and Sluggish Cognitive Tempo in Pediatric Attention-Deficit/Hyperactivity Disorder: Evidence for Differentiation of Functional Correlates. Child Psychiatry Hum Dev 50, 1049–1057 (2019). https://doi.org/10.1007/s10578-019-00904-6

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