Internal and External Validity of Sluggish Cognitive Tempo and ADHD Inattention Dimensions with Teacher Ratings of Nepali Children

  • Girwan Khadka
  • G. Leonard Burns
  • Stephen P. Becker


The objective was to evaluate the validity of sluggish cognitive tempo (SCT) and ADHD-inattention (IN) symptoms in children from Nepal. Teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection dimensions in 366 children (50 % girls) in first through sixth grades (M age = 9.35, SD age = 1.96) on two separate occasions separated by 4-weeks. Seven of the eight SCT symptoms and all nine ADHD-IN symptoms showed convergent validity (substantial loadings on their respective factors) and discriminant validity (higher loadings on their respective factor than the alternative factor) at both time-points. Across all three separate analyses (assessment 1, assessment 2, and from assessment 1 to assessment 2), higher SCT scores were associated with lower ADHD-HI scores and higher depression, academic impairment, and social impairment scores after controlling for ADHD-IN while higher ADHD-IN scores were associated with higher ADHD-HI, ODD, academic impairment, and peer rejection scores after controlling for SCT. Also, as hypothesized, SCT scores were not related to ODD scores after controlling for ADHD-IN. The study provides the first evidence for the internal and external validity of the SCT dimension relative to the ADHD-IN dimension with teacher ratings of children from Nepal, thereby increasing the validity of the SCT construct beyond North America, Western Europe, South America, and South Korea.


Attention-deficit/hyperactivity disorder Culture Factor structure Nepal Sluggish cognitive tempo Validity 


Compliance with Ethical Standards

Conflict of Interest

Girwan Khadka, G. Leonard Burns, and Stephen P. Becker declare that they have no conflict of interest.

Experiment Participants

The current study was conducted with the informed consent of all participants. Washington State University’s Department of Psychology (the University IRB ruled the study exempt from IRB review) approved the study's protocol along with the three elementary schools.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Girwan Khadka
    • 1
  • G. Leonard Burns
    • 2
  • Stephen P. Becker
    • 3
  1. 1.Children’s Mercy HospitalKansas CityUSA
  2. 2.Department of PsychologyWashington State UniversityPullmanUSA
  3. 3.Cincinnati Children’s Hospital Medical CenterCincinnatiUSA

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