Advertisement

Child Psychiatry & Human Development

, Volume 50, Issue 6, pp 1049–1057 | Cite as

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

  • Nathan E. CookEmail author
  • Ellen B. Braaten
  • Pieter J. Vuijk
  • B. Andi Lee
  • Anna R. Samkavitz
  • Alysa E. Doyle
  • Craig B. H. Surman
Original Article
  • 165 Downloads

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.

Keywords

Attention-deficit/hyperactivity disorder Processing speed Sluggish cognitive tempo Pediatric Functional outcomes 

Notes

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.

Compliance with Ethical Standards

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.

Informed Consent

It was obtained from all individual participants included in the study.

References

  1. 1.
    Visser SN, Danielson ML, Bitsko RH, Holbrook JR, Kogan MD, Ghandour RM et al (2014) Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003–2011. J Am Acad Child Adolesc Psychiatry. 53(1):34–46e2.  https://doi.org/10.1016/j.jaac.2013.09.001 CrossRefPubMedGoogle Scholar
  2. 2.
    Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA (2015) Annual research review: a meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry 56(3):345–365.  https://doi.org/10.1111/jcpp.12381 CrossRefPubMedGoogle Scholar
  3. 3.
    American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, ArlingtonCrossRefGoogle Scholar
  4. 4.
    Pritchard AE, Nigro CA, Jacobson LA, Mahone EM (2012) The role of neuropsychological assessment in the functional outcomes of children with ADHD. Neuropsychol Rev 22(1):54–68.  https://doi.org/10.1007/s11065-011-9185-7 CrossRefPubMedGoogle Scholar
  5. 5.
    Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF (2005) Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review. Biol Psychiatry 57(11):1336–1346.  https://doi.org/10.1016/j.biopsych.2005.02.006 CrossRefPubMedGoogle Scholar
  6. 6.
    Goth-Owens TL, Martinez-Torteya C, Martel MM, Nigg JT (2010) Processing speed weakness in children and adolescents with non-hyperactive but inattentive ADHD (ADD). Child Neuropsychol 16(6):577–591.  https://doi.org/10.1080/09297049.2010.485126 CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Shanahan MA, Pennington BF, Yerys BE, Scott A, Boada R, Willcutt EG et al (2006) Processing speed deficits in attention deficit/hyperactivity disorder and reading disability. J Abnorm Child Psychol 34(5):585–602.  https://doi.org/10.1007/s10802-006-9037-8 CrossRefPubMedGoogle Scholar
  8. 8.
    Braaten EB, Willoughby BLB (2014) Bright kids who can’t keep up: help your child overcome slow processing speed and succeed in a fast-paced world. Guilford, New YorkGoogle Scholar
  9. 9.
    Mayes SD, Calhoun SL (2007) Learning, attention, writing, and processing speed in typical children and children with ADHD, autism, anxiety, depression, and oppositional-defiant disorder. Child Neuropsychol 13(6):469–493.  https://doi.org/10.1080/09297040601112773 CrossRefPubMedGoogle Scholar
  10. 10.
    Cook NE, Braaten EB, Surman CBH (2018) Clinical and functional correlates of processing speed in pediatric attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Child Neuropsychol 24(5):598–616.  https://doi.org/10.1080/09297049.2017.1307952 CrossRefPubMedGoogle Scholar
  11. 11.
    Thaler NS, Bello DT, Etcoff LM (2013) WISC-IV profiles are associated with differences in symptomatology and outcome in children with ADHD. J Atten Disord 17(4):291–301.  https://doi.org/10.1177/1087054711428806 CrossRefPubMedGoogle Scholar
  12. 12.
    Rosnow RL, Rosenthal R (2003) Effect sizes for experimenting psychologists. Can J Exp Psychol 57(3):221–237CrossRefGoogle Scholar
  13. 13.
    Penny AM, Waschbusch DA, Klein RM, Corkum P, Eskes G (2009) Developing a measure of sluggish cognitive tempo for children: content validity, factor structure, and reliability. Psychol Assess 21(3):380–389.  https://doi.org/10.1037/a0016600 CrossRefPubMedGoogle Scholar
  14. 14.
    Lee S, Burns GL, 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. J Abnorm Child Psychol 42(1):7–19.  https://doi.org/10.1007/s10802-013-9714-3 CrossRefPubMedGoogle Scholar
  15. 15.
    Becker SP, Leopold DR, Burns GL, Jarrett MA, Langberg JM, Marshall SA et al (2016) The internal, external, and diagnostic validity of sluggish cognitive tempo: a meta-analysis and critical review. J Am Acad Child Adolesc Psychiatry 55(3):163–178.  https://doi.org/10.1016/j.jaac.2015.12.006 CrossRefPubMedGoogle Scholar
  16. 16.
    Barkley RA (2014) Sluggish cognitive tempo (concentration deficit disorder?): current status, future directions, and a plea to change the name. J Abnorm Child Psychol 42:117–125CrossRefGoogle Scholar
  17. 17.
    Barkley RA (2013) Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. J Clin Child Adolesc Psychol 42:161–173CrossRefGoogle Scholar
  18. 18.
    Wahlstedt C, Bohlin G (2010) DSM-IV-defined inattention and sluggish cognitive tempo: independent and interactive relations to neuropsychological factors and comorbidity. Child Neuropsychol 16:350–365CrossRefGoogle Scholar
  19. 19.
    Willcutt EG, Chhabildas N, Kinnear M, DeFries JC, Olson RK, Leopold DR et al (2014) The internal and external validity of sluggish cognitive tempo and its relation with DSM-IV ADHD. J Abnorm Child Psychol 42:21–35CrossRefGoogle Scholar
  20. 20.
    American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders : DSM-IV-TR. American Psychiatric Association, Washington, DCGoogle Scholar
  21. 21.
    Landis JR, Koch GG (1977) The measurement of observer agreement for categorical data. Biometrics 33(1):159–174CrossRefGoogle Scholar
  22. 22.
    Gadow KD, Sprafkin J (2002) Child symptom inventory-4 screening and norms manual. Checkmate Plus, Stony BrookGoogle Scholar
  23. 23.
    Achenbach TM, Rescorla LA (2001) Manual for the ASEBA school-age forms & profiles. University of Vermont, Research Center for Children, Youth, and Families, BurlingtonGoogle Scholar
  24. 24.
    Harrison PL, Oakland T (2003) Adaptive behavior assessment system manual, 2nd edn. Western Psychological Services, Los AngelesGoogle Scholar
  25. 25.
    Wechsler D (2003) Wechsler Intelligence Scale for Children®, 4th edn. Pearson, San AntonioGoogle Scholar
  26. 26.
    Wechsler D (2014) Wechsler Intelligence Scale for Children®, 5th edn. Pearson, San AntonioGoogle Scholar
  27. 27.
    Wechsler D (2014) WISC-V technical and interpretive manual. NCS Pearson, Inc., BloomingtonGoogle Scholar
  28. 28.
    Wechsler D (2009) Wechsler Individual Achievement Test®, 3rd edn. Pearson, San AntonioGoogle Scholar
  29. 29.
    Cohen J (1992) A power primer. Psychol Bull 112(1):155–159CrossRefGoogle Scholar
  30. 30.
    Calhoun SL, Mayes SD (2005) Processing speed in children with clinical disorders. Psychol Sch 42:333–343CrossRefGoogle Scholar
  31. 31.
    Becker SP, Luebbe AM, Joyce AM (2015) The Child Concentration Inventory (CCI): initial validation of a child self-report measure of sluggish cognitive tempo. Psychol Assess 27(3):1037–1052.  https://doi.org/10.1037/pas0000083 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment ProgramMassachusetts General Hospital; & MassGeneral Hospital for Children™ Sport Concussion ProgramBostonUSA
  2. 2.Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment Program and Clay Center for Young Healthy MindsMassachusetts General HospitalBostonUSA
  3. 3.Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic MedicineMassachusetts General HospitalBostonUSA
  4. 4.Department of Psychiatry, Harvard Medical School; Learning and Emotional Assessment Program & Psychiatric & Neurodevelopmental Genetics Unit, Center for Genomic MedicineMassachusetts General HospitalBostonUSA
  5. 5.Department of Psychiatry, Harvard Medical School; Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHDMassachusetts General HospitalBostonUSA
  6. 6.Department of Physical Medicine and RehabilitationMassachusetts General Hospital, Spaulding Rehabilitation Hospital, and Harvard Medical SchoolBostonUSA

Personalised recommendations