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IQ and Academic Achievement in Children with ADHD: the Differential Effects of Specific Cognitive Functions

Abstract

The co-occurrence of lower full-scale intellectual abilities (FSIQ) and academic achievement deficits in children with ADHD is well established; however, the extent to which the relation reflects the influence of a general factor (g) deficiency or deficiencies in one or more specific intellectual abilities remains speculative and was the focus of the current investigation. Twenty-eight boys with ADHD-combined presentation and 26 neurotypical (NT) boys between 8 and 12 years of age were administered the WISC-IV and standardized measures of reading and math. FSIQ and achievement scores in both reading and math were significantly lower for the ADHD relative to the NT group; however, examination of WISC-IV index scores revealed that group level differences in FSIQ resulted from lower scores on two of the four specific intellectual ability indices—Working Memory (WMI) and Verbal Comprehension (VCI). Bias-corrected bootstrapped mediation analyses revealed that both WMI and VCI contributed uniquely to the ADHD-Academic Achievement relation. The contribution of WMI to ADHD-related academic underachievement reflected lower scores on the Letter-Number Sequencing (LNS) but not the Digit Span (DS) subtest. Both LNS and VCI explained ADHD-related differences in reading, whereas LNS alone explained ADHD-related differences in math. Collectively these findings suggest that strengthening deficient higher-level WM abilities, in conjunction with empirically based academic instruction, is needed to improve learning outcomes in children with ADHD.

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Notes

  1. 1.

    The FDI, which included an arithmetic subtest, was discontinued in the WISC-IV and replaced with the Working Memory Index (WMI) to eliminate the potentially biasing effect of arithmetic knowledge on FSIQ.

  2. 2.

    The working component of WM (i.e., the central executive [CE]) is considered a domain general attentional controller that involves multiple executive processes (e.g., updating, manipulation/dual processing, serial reordering, interference control) responsible for the mental processing of information held temporarily in the phonological and visuospatial short-term memory stores (Baddeley 2012).

  3. 3.

    A posteriori analyses including PRI and PSI as potential mediators confirmed that neither included significant indirect effects.

  4. 4.

    Epiphenomena effects reflect a situation in which two variables are correlated and significant mediators when modeled separately, but only one is a true mediator of the relation and the other a correlated process that arises from but does not causally influence the process; cf. Hayes 2018, for an expanded discussion.

  5. 5.

    Neither Digit Span Forward nor Digit Span Backward served as significant mediators of the ADHD-Academic Achievement relation when examined separately.

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Calub, C.A., Rapport, M.D., Friedman, L.M. et al. IQ and Academic Achievement in Children with ADHD: the Differential Effects of Specific Cognitive Functions. J Psychopathol Behav Assess 41, 639–651 (2019). https://doi.org/10.1007/s10862-019-09728-z

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Keywords

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Cognitive ability
  • FSIQ
  • WISC-IV
  • Working memory
  • Academic achievement