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Behavioral and cognitive subtypes of ADHD.

G J August, B D Garfinkel

    Journal of the American Academy of Child and Adolescent Psychiatry
    |September 1, 1989
    PubMed
    Summary

    Attention-deficit hyperactivity disorder (ADHD) presents in two subtypes: behavioral and cognitive. The behavioral subtype, common in elementary students, shows inattention and impulsivity, while the cognitive subtype involves academic underachievement and information processing deficits.

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    Area of Science:

    • Child Psychology
    • Neurodevelopmental Disorders
    • Educational Psychology

    Background:

    • Attention-deficit hyperactivity disorder (ADHD) affects a significant portion of the elementary school population.
    • ADHD is characterized by symptoms of inattention, impulsivity, and hyperactivity.
    • Previous research has not clearly distinguished between different presentations of ADHD.

    Purpose of the Study:

    • To identify and differentiate subtypes of attention-deficit hyperactivity disorder (ADHD) in elementary school children.
    • To characterize the distinct clinical and cognitive features of each ADHD subtype.
    • To investigate the relationship between ADHD subtypes and academic performance, particularly reading disabilities.

    Main Methods:

    • Teacher-based screening of elementary school students to identify ADHD symptoms.
    • Clinical assessment to differentiate between cognitive and behavioral subtypes of ADHD.
    • Neuropsychological testing to evaluate information processing skills in children with different ADHD presentations and reading disabilities.

    Main Results:

    • Two subtypes of ADHD were identified: a behavioral subtype (approx. 80% of cases) and a cognitive subtype (approx. 20% of cases).
    • The behavioral subtype is characterized by inattention, impulsivity, and hyperactivity, with some cases overlapping with conduct disorder features.
    • Children with the cognitive subtype exhibited significant academic underachievement and specific information processing deficits in linguistic encoding and retrieval, similar to those seen in reading disabilities.
    • Children with the behavioral subtype did not show the specific neuropsychological deficits characteristic of reading disabilities.

    Conclusions:

    • ADHD presents with distinct subtypes that have different underlying cognitive profiles and clinical implications.
    • The cognitive subtype of ADHD is strongly associated with academic underachievement and specific learning deficits, particularly in reading.
    • Differentiating between ADHD subtypes is crucial for targeted interventions and understanding the heterogeneity of the disorder.

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