Clock face drawing in children with attention-deficit/hyperactivity disorder

Area of Science:

• Neuropsychology
• Pediatric Psychology

Background:

• The Clock Drawing Test (CDT) assesses visual-spatial, graphomotor, verbal reasoning, and executive functions in adults.
• Previous research indicates CDT's sensitivity to frontal lobe maturation in children.
• The CDT's utility as a neuropsychological tool in pediatric populations requires further investigation.

Purpose of the Study:

• To evaluate the clock drawing test as a neuropsychological measure in children aged 6-12 years.
• To compare clock drawing performance between children with ADHD and typically developing controls.
• To identify specific cognitive deficits associated with ADHD using the CDT.

Main Methods:

• A cohort of 41 children with ADHD (all subtypes) and 41 age-, gender-, and handedness-matched controls participated.
• Clock drawing performance was assessed using a normed scoring system evaluating time conceptualization and clock face construction.
• Neuropsychological measures of executive functioning, constructional praxis, and receptive vocabulary were administered.

Main Results:

• Children with ADHD, irrespective of subtype (Inattentive or Combined), performed significantly worse on the CDT compared to controls.
• Qualitative analysis indicated planning and executive dysfunction errors in children with ADHD during clock construction.
• Executive functioning, constructional praxis, and receptive vocabulary were significant predictors of clock drawing performance in children with ADHD.

Conclusions:

• The clock drawing test is a valuable neuropsychological tool for identifying executive dysfunction in pediatric ADHD.
• CDT performance reflects planning deficits and executive functioning impairments in children with ADHD.
• Findings support the use of CDT in assessing cognitive abilities and deficits in school-aged children.