Abstract
Neuropsychological functioning underlies behavioral symptoms of attention-deficit/hyperactivity disorder (ADHD). Children with all forms of ADHD are vulnerable to working memory deficits and children presenting with the inattentive form of ADHD (ADHD-I) appear particularly vulnerable to processing speed deficits. As ADHD-I is the most common form of ADHD presented by children in community settings, it is important to consider how treatment interventions for children with ADHD-I may be affected by deficits in processing speed and working memory. We utilize data collected from 199 children with ADHD-I, aged 7 to 11 years, who participated in a randomized clinical trial of a psychosocial-behavioral intervention. Our aims are first to determine whether processing speed or working memory predict treatment outcomes in ADHD-I symptom severity, and second whether they moderate treatment effects on ADHD-I symptom severity. Results of linear regression analyses reveal that baseline processing speed significantly predicts posttreatment ADHD-I symptom severity when controlling for baseline ADHD-I symptom severity, such that better processing speed is associated with greater symptom improvement. However, predictive effects of working memory and moderation effects of both working memory and processing speed are not supported in the present study. We discuss study limitations and implications of the relation between processing speed and treatment benefits from psychosocial treatments for children with ADHD-I.
This is a preview of subscription content, access via your institution.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Araujo Jiménez, E. A., Jané Ballabriga, M. C., Martin, A. B., Arrufat, F. J., & Giacobo, R. S. (2015). Executive functioning in children and adolescents with symptoms of sluggish cognitive tempo and ADHD. Journal of Attention Disorders, 19, 507–514. doi:10.1177/1087054713495442.
Arnett, A. B., Pennington, B. F., Willcutt, E. G., DeFries, J. C., & Olson, R. K. (2015). Sex differences in ADHD symptom severity. Journal of Child Psychology and Psychiatry, 56, 632–639. doi:10.1111/jcpp.12337.
Barkley, R. A. (1987). Defiant children: A clinician's manual for parent training. New York: Guilford Press.
Barkley, R. A. (1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121, 65–94. doi:10.1037/0033-2909.121.1.65.
Barkley, R. A. (2014). Sluggish cognitive tempo (concentration deficit disorder?): Current status, future directions, and a plea to change the name. Journal of Abnormal Child Psychology, 42, 117–125. doi:10.1007/s10802-013-9824-y.
Bauermeister, J. J., Barkley, R. A., Bauermeister, J. A., Martínez, J. V., & McBurnett, K. (2012). Validity of the sluggish cognitive tempo, inattention, and hyperactivity symptom dimensions: Neuropsychological and psychosocial correlates. Journal of Abnormal Child Psychology, 40, 683–697. doi:10.1007/s10802-011-9602-7.
Bidwell, L. C., Willcutt, E. G., DeFries, J. C., & Pennington, B. F. (2007). Testing for neuropsychological endophenotypes in siblings discordant for attention-deficit/hyperactivity disorder. Biological Psychiatry, 62, 991–998. doi:10.1016/j.biopsych.2007.04.003.
Biederman, J., Seidman, L. J., Petty, C. R., Fried, R., Doyle, A. E., Cohen, D. R., et al. (2008). Effects of stimulant medication on neuropsychological functioning in young adults with attention-deficit/hyperactivity disorder. Journal of Clinical Psychiatry, 69, 1150–1156. doi:10.4088/JCP.v69n0715.
Bink, M., van Nieuwenhuizen, C., Popma, A., Bongers, I. L., & van Boxtel, G. J. M. (2014). Neurocognitive effects of neurofeedback in adolescents with ADHD: A randomized controlled trial. Journal of Clinical Psychiatry, 75, 535–542. doi:10.4088/JCP.13m08590.
Burge, W. K., Ross, L. A., Amthor, F. R., Mitchell, W. G., Zotov, A., & Visscher, K. M. (2013). Processing speed training increases the efficiency of attentional resource allocation in young adults. Frontiers in Human Neuroscience, 7, 1–7. doi:10.3389/fnhum.2013.00684.
Buschkuehl, M., Jaeggi, S. M., & Jonides, J. (2012). Neuronal effects following working memory training. Developmental Cognitive Neuroscience, 2, S167–S179. doi:10.1016/j.dcn.2011.10.001.
Cortese, S., Ferrin, M., Brandeis, D., Buitelaar, J., Daley, D., Dittmann, R. W., & Sonuga-Barke, E. J. S. (2015). Cognitive training for attention-deficit/hyperactivity disorder: Meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials. Journal of the American Academy of Child & Adolescent Psychiatry, 54, 164–174. doi:10.1016/j.jaac.2014.12.010.
Dennis, M., Francis, D. J., Cirino, P. T., Schachar, R., Barnes, M. A., & Fletcher, J. M. (2009). Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15, 331–343. doi:10.1017/S1355617709090481.
Fabiano, G. A., Pelham Jr., W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O'Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29, 129–140. doi:10.1016/j.cpr.2008.11.001.
Fabiano, G. A., Vujnovic, R. K., Pelham, W. E., Waschbusch, D. A., Massetti, G. M., Pariseau, M. E., & Volker, M. (2010). Enhancing the effectiveness of special education programming for children with attention deficit hyperactivity disorder using a daily report card. School Psychology Review, 39, 219–239 Retrieved from http://search.proquest.com/docview/754058916?accountid=14496.
Finke, K., Dodds, C. M., Bublak, P., Regenthal, R., Baumann, F., Manly, T., & Müller, U. (2010). Effects of modafinil and methylphenidate on visual attention capacity: A TVA-based study. Psychopharmacology, 210, 317–329. doi:10.1007/s00213-010-1823-x.
Forehand, R., & McMahon, R. (1981). Helping the noncompliant child: A clinician’s guide to parent training. New York: Guilford Press.
Gadow, K. D., & Sprafkin, J. (1994). Child symptom inventories manual. Stony Brook, NY: Checkmate Plus.
Graziano, P. A., Geffken, G. R., & Lall, A. S. (2011). Heterogeneity in the pharmacological treatment of children with ADHD: Cognitive, behavioral, and social functioning differences. Journal of Attention Disorders, 15, 382–391. doi:10.1177/1087054710367772.
Hellwig-Brida, S., Daseking, M., Petermann, F., & Goldbeck, L. (2010). Intelligenz- und aufmerksamkeitsleistungen von jungen mit ADHS [Components of intelligence and attention in boys with ADHD]. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie, 58, 299–308. doi:10.1024/1661-4747/a000040.
Hunt, M. G., Bienstock, S. W., & Qiang, J. K. (2012). Effects of diurnal variation on the test of variables of attention performance in young adults with attention-deficit/hyperactivity disorder. Psychological Assessment, 24, 166–172. doi:10.1037/a0025233.
Jak, A. J., Seelye, A. M., & Jurick, S. M. (2013). Crosswords to computers: A critical review of popular approaches to cognitive enhancement. Neuropsychology Review, 23, 13–26. doi:10.1007/s11065-013-9226-5.
Kaufman, J., Birmaher, B., Brent, D., & Rao, U. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 980–988. doi:10.1097/00004583-199707000-00021.
Konrad, K., & Eickhoff, S. B. (2010). Is the ADHD brain wired differently? A review on structural and functional connectivity in attention deficit hyperactivity disorder. Human Brain Mapping, 31, 904–916. doi:10.1002/hbm.21058.
Lajoie, G., Anderson, V., Anderson, P., Tucker, A. R., Robertson, I. H., & Manly, T. (2005). Effects of methylphenidate on attention skills in children with attention deficit/hyperactivity disorder. Brain Impairment, 6, 21–32. doi:10.1375/brim.6.1.21.65479.
Lee, S., Burns, G. L., Snell, J., & McBurnett, K. (2014). Validity of the sluggish cognitive tempo symptom dimension in children: Sluggish cognitive tempo and ADHD-inattention as distinct symptom dimensions. Journal of Abnormal Child Psychology, 42, 7–19. doi:10.1007/s10802-013-9714-3.
Lei, D., Ma, J., Du, X., Shen, G., Jin, X., & Gong, Q. (2014). Microstructural abnormalities in the combined and inattentive subtypes of attention deficit hyperactivity disorder: A diffusion tensor imaging study. Scientific Reports, 4, 1–7. doi:10.1038/srep06875.
Mackey, A. P., Hill, S. S., Stone, S. I., & Bunge, S. A. (2011). Differential effects of reasoning and speed training in children. Developmental Science, 14, 582–590. doi:10.1111/j.1467-7687.2010.01005.x.
Martinussen, R., & Tannock, R. (2006). Working memory impairments in children with attention-deficit hyperactivity disorder with and without comorbid language learning disorders. Journal of Clinical and Experimental Neuropsychology, 28, 1073–1094. doi:10.1080/13803390500205700.
Mayes, S. D., Calhoun, S. L., Chase, G. A., Mink, D. M., & Stagg, R. E. (2009). ADHD subtypes and co-occurring anxiety, depression, and oppositional-defiant disorder: Differences in Gordon diagnostic system and Wechsler working memory and processing speed index scores. Journal of Attention Disorders, 12, 540–550. doi:10.1177/1087054708320402.
McBurnett, K., Pfiffner, L. J., & Frick, P. J. (2001). Symptom properties as a function of ADHD type: An argument for continued study of sluggish cognitive tempo. Journal of Abnormal Child Psychology, 29, 207–213. doi:10.1023/A:1010377530749.
Nielsen, N. P., & Wiig, E. H. (2011). AQT cognitive speed and processing efficiency differentiate adults with and without ADHD: A preliminary study. International Journal of Psychiatry in Clinical Practice, 15, 219–227. doi:10.3109/13651501.2011.582538.
Nigg, J. T., Stavro, G., Ettenhofer, M., Hambrick, D. Z., Miller, T., & Henderson, J. M. (2005). Executive functions and ADHD in adults: Evidence for selective effects on ADHD symptom domains. Journal of Abnormal Psychology, 114, 706–717. doi:10.1037/0021-843X.114.3.706.
Pelham Jr., W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 37, 184–214. doi:10.1080/15374410701818681.
Pfiffner, L. J. (2011). All about ADHD: The complete practical guide for classroom teachers (2nd ed.). New York: Scholastic.
Pfiffner, L. J., & McBurnett, K. (1997). Social skills training with parent generalization: Treatment effects for children with attention deficit disorder. Journal of Consulting and Clinical Psychology, 65, 749–757. doi:10.1037/0022-006X.65.5.749.
Pfiffner, L. J., Barkley, R. A., & DuPaul, G. (2006). Treatment of ADHD in school settings. In R. A. Barkley (Ed.), Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed., pp. 547–589). New York: Guilford Press.
Pfiffner, L. J., Hinshaw, S. P., Owens, E. B., Zalecki, C., Kaiser, N., Villodas, M., & McBurnett, K. (2014). A two-site randomized clinical trial of integrated psychosocial treatment for ADHD-inattentive type. Journal of Consulting and Clinical Psychology, 82, 1115–1127. doi:10.1037/a0036887.
Rossi, A. S. U., de Moura, L. M., de Mello, C. B., de Souza, A. A. L., Muszkat, M., & Bueno, O. F. A. (2015). Attentional profiles and white matter correlates in attention-deficit/hyperactivity disorder predominantly inattentive type. Frontiers in Psychiatry, 6, 1–10. doi:10.3389/fpsyt.2015.00122.
Sonuga-Barke, E., Bitsakou, P., & Thompson, M. (2010). Beyond the dual pathway model: Evidence for the dissociation of timing, inhibitory, and delay-related impairments in attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 49, 345–355. doi:10.1097/00004583-201004000-00009.
Stevens, M. C., Gaynor, A., Bessette, K. L., & Pearlson, G. D. (2016). A preliminary study of the effects of working memory training on brain function. Brain Imaging and Behavior, 10, 387–407. doi:10.1007/s11682-015-9416-2.
Takeuchi, H., & Kawashima, R. (2012). Effects of processing speed training on cognitive functions and neural systems. Reviews in the Neurosciences, 23, 289–301. doi:10.1515/revneuro-2012-0035.
Takeuchi, H., Taki, Y., & Kawashima, R. (2010). Effects of working memory training on cognitive functions and neural systems. Reviews in the Neurosciences, 21, 427–449. doi:10.1515/REVNEURO.2010.21.6.427.
Thaler, N. S., Bello, D. T., & Etcoff, L. M. (2013). WISC-IV profiles are associated with differences in symptomatology and outcome in children with ADHD. Journal of Attention Disorders, 17, 291–301. doi:10.1177/1087054711428806.
Todd, R. D., Rasmussen, E. R., Wood, C., Levy, F., & Hay, D. A. (2004). Should sluggish cognitive tempo symptoms be included in the diagnosis of attention-deficit/hyperactivity disorder? Journal of the American Academy of Child & Adolescent Psychiatry, 43, 588–597. doi:10.1097/00004583-200405000-00012.
van Ewijk, H., Heslenfeld, D. J., Zwiers, M. P., Buitelaar, J. K., & Oosterlaan, J. (2012). Diffusion tensor imaging in attention deficit/hyperactivity disorder: A systematic review and meta-analysis. Neuroscience and Biobehavioral Reviews, 36, 1093–1106. doi:10.1016/j.neubiorev.2012.01.003.
Waldman, I. D. (2005). Statistical approaches to complex phenotypes: Evaluating neuropsychological endophenotypes for attention-deficit/hyperactivity disorder. Biological Psychiatry, 57, 1347–1356. doi:10.1016/j.biopsych.2005.03.002.
Wechsler, D. (2003a). Wechsler intelligence scale for children–fourth edition. San Antonio, TX: Psychological Corporation.
Wechsler, D. (2003b). WISC-IV technical and interpretive manual. San Antonio, TX: Psychological Corporation.
Weiler, M. D., Bernstein, J. H., Bellinger, D. C., & Waber, D. P. (2000). Processing speed in children with attention deficit/hyperactivity disorder, inattentive type. Child Neuropsychology, 6, 218–234. doi:10.1076/chin.6.3.218.3156.
Weiler, M. D., Bernstein, J. H., Bellinger, D., & Waber, D. P. (2002). Information processing deficits in children with attention-deficit/hyperactivity disorder, inattentive type, and children with reading disability. Journal of Learning Disabilities, 35, 448–461. doi:10.1177/00222194020350050501.
Wells, K. C., Abikoff, H., Abramowitz, A., Courtney, M., Cousins, L., Del Carmen, R., & Pfiffner, L. (1996). Parent training for attention deficit hyperactivity disorder: MTA study manual. Durham, NC: Duke University Medical Center.
Willcutt, E. G. (2012). The prevalence of DSM-IV attention-deficit/hyperactivity disorder: A meta-analytic review. Neurotherapeutics, 9, 490–499. doi:10.1007/s13311-012-0135-8.
Willcutt, E. G., Chhabildas, N., Kinnear, M., DeFries, J. C., Olson, R. K., Leopold, D. R., & Pennington, B. F. (2014). The internal and external validity of sluggish cognitive tempo and its relation with DSM–IV ADHD. Journal of Abnormal Child Psychology, 42, 21–35. doi:10.1007/s10802-013-9800-6.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Funding
This study was funded by the National Institute of Mental Health (MH077671).
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
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. This article does not contain any studies with animals performed by any of the authors.
Informed Consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Adalio, C.J., Owens, E.B., McBurnett, K. et al. Processing Speed Predicts Behavioral Treatment Outcomes in Children with Attention-Deficit/Hyperactivity Disorder Predominantly Inattentive Type. J Abnorm Child Psychol 46, 701–711 (2018). https://doi.org/10.1007/s10802-017-0336-z
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10802-017-0336-z
Keywords
- ADHD
- Inattentiveness
- Processing speed
- Clinical trial
- Psychosocial intervention