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Assessing the Contribution of Measures of Attention and Executive Function to Diagnosis of ADHD or Autism

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Abstract

Attention and executive function (EF) dysregulation are common in a number of disorders including autism and attention-deficit/hyperactivity disorder (ADHD). Better understanding of the relationship between indirect and direct measures of attention and EF and common neurodevelopmental diagnoses may contribute to more efficient and effective diagnostic assessment in childhood. We obtained cognitive (NIH Toolbox, Little Man Task, Matrix Reasoning Task, and Rey Delayed Recall) and symptom (CBCL, and BPMT) assessment data from the Adolescent Brain and Cognitive Development (ABCD) database for three groups, autistic (N = 110), ADHD (N = 878), and control without autism or ADHD diagnoses (N = 9130) and used ridge regression to determine which attention and EF assessments were most strongly associated with autism or ADHD. More variance was accounted for in the model for the ADHD group (31%) compared to the autism group (2.7%). Finally, we ran odds ratios (using clinical cutoffs where available and 2 standard deviations below the mean when not) for each assessment measure, which generally demonstrated a greater significance within the indirect measures when compared to the direct measures. These results add to the growing literature of symptom variably across diagnostic groups allowing for better understanding of presentations in autism and ADHD and how best to assess diagnosis. It also highlights the increased difficulty in differentiating autism and controls when compared to ADHD and controls and the importance of indirect measures of attention and EF in this differentiation.

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Abbreviations

ADHD:

Attention-Deficit Hyperactivity Disorder

ABCD:

Adolescent Brain and Cognitive Development

EF:

Executive Function

CBCL:

Childhood Behavioral Checklist

BPMT:

Brief Problem Monitoring Teacher Report

KSAD:

Kiddie Score for Affective Disorders and Schizophrenia

RAVLT:

Rey Auditory Verbal Learning Test

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Funding

This study was supported by the Alberta Children’s Hospital Foundation and the Owerko Centre at the Alberta Children’s Hospital Research Institute.

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Authors and Affiliations

  1. Faculty of Graduate Studies, University of Calgary, Calgary, AB, Canada

    Kelsey Harkness

  2. Alberta Children’s Hospital Research Institute, Calgary, AB, Canada

    Kelsey Harkness, Signe Bray, Deborah Dewey & Kara Murias

  3. Hotchkiss Brain Institute, Calgary, AB, Canada

    Kelsey Harkness, Signe Bray, Deborah Dewey & Kara Murias

  4. Alberta Health Services, Calgary, AB, Canada

    Chelsea M. Durber

  5. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

    Signe Bray, Deborah Dewey & Kara Murias

Authors
  1. Kelsey Harkness
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  4. Deborah Dewey
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  5. Kara Murias
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Contributions

KH: Conceptualization, Methodology, Formal Analysis, Data Curation, Writing – Original Draft, Writing – Review & Editing, Visualization SB: Conceptualization, Methodology, Writing – Review & Editing, Supervision CMD: Writing – Review & Editing DD: Writing – Review & Editing KM: Conceptualization, Methodology, Resources, Writing – Review & Editing, Supervision.

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Correspondence to Kelsey Harkness.

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Harkness, K., Bray, S., Durber, C.M. et al. Assessing the Contribution of Measures of Attention and Executive Function to Diagnosis of ADHD or Autism. J Autism Dev Disord (2024). https://doi.org/10.1007/s10803-024-06275-9

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  • DOI: https://doi.org/10.1007/s10803-024-06275-9

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