Executive function deficits in preschool children with ADHD and DBD
Kim Schoemaker1, Tessa Bunte, Sandra A Wiebe
1Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands. k.schoemaker@umcutrecht.n
Journal of Child Psychology and Psychiatry, and Allied Disciplines
|October 26, 2011
Summary
Preschoolers with ADHD show significant inhibition deficits. Children with disruptive behavior disorder struggle with inhibition, especially when motivated by rewards. Comorbid ADHD and disruptive behavior disorder present severe inhibition impairments.
Area of Science:
- Developmental Psychology
- Neuroscience
- Child Psychiatry
Background:
- Executive function (EF) deficits are linked to ADHD and disruptive behavior disorder (DBD) in school-aged children.
- Limited research exists on EF impairments in clinically diagnosed preschool children with ADHD, DBD, or comorbid conditions.
- Early diagnosis and intervention are crucial for preschoolers with these disorders.
Purpose of the Study:
- To investigate executive function (EF) impairments in preschool children diagnosed with ADHD, DBD, or both.
- To compare EF performance across clinically referred preschoolers with ADHD, DBD, ADHD + DBD, and typically developing children.
- To explore the role of comorbidity in EF deficits during early development.
Main Methods:
- A sample of 202 preschoolers (aged 3.5-5.5 years) including 61 with ADHD only, 33 with DBD only, 52 with ADHD + DBD, and 56 typically developing children.
- Administration of five distinct executive function (EF) tasks.
- Confirmatory factor analysis to evaluate EF models (one-factor vs. two-factor).
Main Results:
- A two-factor model of inhibition and working memory best explained EF in this clinical sample.
- Preschoolers with ADHD exhibited significant inhibition deficits, independent of IQ.
- Preschoolers with DBD showed impaired inhibition, particularly on tasks with high motivational demands; this effect was more pronounced in the comorbid ADHD + DBD group. Working memory differences were minimal across groups.
Conclusions:
- Preschoolers diagnosed with ADHD demonstrate robust inhibition deficits.
- Preschoolers with DBD exhibit impaired inhibition, especially when motivational incentives are high.
- The severity of inhibition impairment in children with comorbid ADHD and DBD is comparable to that seen in children with ADHD alone.
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