Differences in cognitive control in children and adolescents with combined and inattentive subtypes of ADHD

The aim of the present study was to investigate the ability of children with attention deficit/hyperactivity disorder-combined subtype (ADHD-C) and predominantly inattentive subtype (ADHD-PI) to direct their attention and to exert cognitive control in a forced attention dichotic listening (DL) task. Twenty-nine, medication-naive participants with ADHD-C, 42 with ADHD-PI, and 40 matched healthy controls (HC) between 9 and 16 years were assessed. In the DL task, two different auditory stimuli (syllables) are presented simultaneously, one in each ear. The participants are asked to report the syllable they hear on each trial with no instruction on focus of attention or to explicitly focus attention and to report either the right- or left-ear syllable. The DL procedure is presumed to reflect different cognitive processes: perception (nonforced condition/NF), attention (forced-right condition/FR), and cognitive control (forced-left condition/FL). As expected, all three groups had normal perception and attention. The children and adolescents with ADHD-PI showed a significant right-ear advantage also during the FL condition, while the children and adolescents in the ADHD-C group showed a no-ear advantage and the HC showed a significant left-ear advantage in the FL condition. This suggests that the ADHD subtypes differ in degree of cognitive control impairment. Our results may have implications for further conceptualization, diagnostics, and treatment of ADHD subtypes.