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Consistently Inconsistent Working Memory Performance Among Children with ADHD: Evidence of Response Accuracy Variability (RAV)

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Abstract

Heterogeneity in cognitive performance, once regarded as noise, is now considered a causal mechanism or core deficit of ADHD and its related symptoms in most etiological models of the disorder. Previous research on cognitive performance variability has documented increased heterogeneity in response latencies using reaction time data. In contrast, variability in response accuracy remains understudied. The present study is the first to examine Response Accuracy Variability (RAV) among children with ADHD. Children with ADHD (N = 54) and typically developing children (N = 50) completed phonological working memory tasks with four set size conditions. RAV was calculated for each set size using the adjusted coefficient of variation (ζ). Results from a mixed model ANOVA indicated that children with ADHD evinced significantly greater variation in working memory performance relative to typically developing children when engaged in tasks within their cognitive capacity (i.e., set sizes 3 and 4), whereas all children exhibit similar, high levels of variability on tasks that exceeded their cognitive capacity (i.e., set sizes 5 and 6). Findings are aligned with the extant literature in documenting consistently inconsistent cognitive performance among children ADHD.

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Notes

  1. RT data are restricted on the lower end to be greater than zero but could vary within an infinitely large set of possible values on the upper end. Accuracy data exist on a finite continuum bounded on the lower end by 0 and on the upper end by the number of stimuli presented (e.g., 5 out of 5 stimuli correct).

  2. Scores for one TD child exceeded 1.5 SDs on one of the two parents’ but not teachers’ rating scales. Parent interview revealed no significant ADHD symptoms or symptoms associated with other clinical disorders for the child. Six children with ADHD had subthreshold scores on teacher-rated hyperactivity/impulsivity. Follow-up clinical interviews, however, indicated the subthreshold symptoms were attributable to substantial psychostimulant effects while they were rated, and that all children demonstrated a history of significant, persistent levels of hyperactivity/impulsivity both at home and at school.

  3. KTEA version was examined as a potential covariate in relevant models but was nonsignificant.

  4. While ζ overcomes many of the limitations inherent to traditional variability metrics when applied to accuracy data (e.g., shares no linear relation to mean performance), a limitation associated with the statistic is that values may become unreliable when task difficulty is too high or low (see Golay et al., 2013). This phenomenon occurred under the two largest set size conditions (5 and 6), characterized by either a precipitous decline (ADHD) or no increase in cognitive performance (TD children) as the number of stimuli to be recalled exceeded four. Consequently, a mean composite score of RAV at set sizes 3 and 4 was used to best evaluate the outcomes.

  5. WISC and KTEA version was examined as a potential covariate but failed to reach significance; therefore, a simple model without covariates is presented.

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Authors and Affiliations

  1. Department of Psychology, Arizona State University, 900 S. McAllister Ave, Tempe, AZ, 85281, USA

    Lauren M. Friedman & Gabrielle Fabrikant-Abzug

  2. Department of Psychology, University of Central Florida, 4000 Central Florida Blvd, Orlando, FL, 32816, USA

    Mark D. Rapport

Authors
  1. Lauren M. Friedman
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  2. Mark D. Rapport
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  3. Gabrielle Fabrikant-Abzug
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Correspondence to Lauren M. Friedman.

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Ethical Approval

Institutional Review Board approval from the University of Central Florida was obtained prior to and maintained throughout data collection. Informed consent/assent was obtained from all parent and child participants, respectively.

Conflict of Interest

Lauren M. Friedman, Mark D. Rapport, and Gabrielle Fabrikant-Abzug declare that they have no conflict of interest.

Experiment Participants

All procedures performed were in accordance with the ethical standards of the institution and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Friedman, L.M., Rapport, M.D. & Fabrikant-Abzug, G. Consistently Inconsistent Working Memory Performance Among Children with ADHD: Evidence of Response Accuracy Variability (RAV). J Psychopathol Behav Assess 44, 787–799 (2022). https://doi.org/10.1007/s10862-022-09967-7

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  • DOI: https://doi.org/10.1007/s10862-022-09967-7

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