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In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
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Executive Functioning Heterogeneity in Pediatric ADHD.

Michael J Kofler1, Lauren N Irwin2, Elia F Soto2

  • 1Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA. kofler@psy.fsu.edu.

Journal of Abnormal Child Psychology
|April 30, 2018
PubMed
Summary
This summary is machine-generated.

ADHD exhibits significant neurocognitive heterogeneity, with 89% of children showing executive function deficits. Working memory impairments correlate with ADHD symptoms, unlike deficits in inhibitory control or set shifting.

Keywords:
ADHDExecutive functionHeterogeneityInhibitionShiftingWorking memory

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Area of Science:

  • Neuroscience
  • Child Psychology
  • Cognitive Science

Background:

  • Neurocognitive heterogeneity is increasingly recognized in Attention-Deficit/Hyperactivity Disorder (ADHD).
  • Previous estimates of executive dysfunction in ADHD (33%-50%) are questioned due to reliance on single, gross impairment tasks.
  • A comprehensive assessment of executive functions in ADHD is needed to understand its heterogeneity.

Purpose of the Study:

  • To comprehensively assess heterogeneity in all three primary executive functions (working memory, inhibitory control, set shifting) in children with ADHD.
  • To determine the prevalence of objectively-defined executive function impairments in ADHD using a criterion battery.
  • To investigate the relationship between specific executive function deficits and ADHD symptomology.

Main Methods:

  • A cohort of 136 children aged 8-13, with and without ADHD, completed a counterbalanced series of executive function tests.
  • A criterion battery with multiple tests per construct (working memory, inhibitory control, set shifting) was utilized.
  • Task unreliability was accounted for to improve sensitivity and specificity of the assessments.

Main Results:

  • 89% of children with ADHD demonstrated objectively-defined impairment in at least one executive function.
  • Prevalence of impairment: 62% in working memory, 27% in inhibitory control, 38% in set shifting.
  • Children with working memory deficits showed higher ADHD symptom ratings and were younger than those without.

Conclusions:

  • ADHD is characterized by significant neurocognitive heterogeneity, with most children exhibiting executive function impairments.
  • Working memory deficits are particularly associated with ADHD symptoms, suggesting a key role.
  • Cognitively-informed criteria may offer improved precision for identifying neuropsychologically-impaired ADHD subtypes.