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


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.


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



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.


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.


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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

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