Attention-deficit hyperactivity disorder and executive dysfunction in preschool children. A comparison of NEPSY and
S Ohmann1, M Wurzer2, C Popow1
1Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Insights
Preschool children with ADHD often exhibit executive function (EF) deficits. Comprehensive assessment using multiple methods is crucial for accurately identifying these dysexecutive problems.
Area of Science:
- Child Psychology
- Neurodevelopmental Disorders
- Cognitive Assessment
Background:
- Attention-Deficit/Hyperactivity Disorder (ADHD) is prevalent in preschool children.
- Executive functions (EF) are critical for cognitive and behavioral regulation.
- Understanding EF in young children with ADHD is essential for early intervention.
Purpose of the Study:
- To determine the prevalence and interrelations of psychopathology, intelligence, and EF in preschool children with ADHD.
- To evaluate the accuracy of different assessment methods for EF in this population.
Main Methods:
- Prospective investigation of 115 preschool children diagnosed with ADHD (ages 2.1-6.5 years).
- Utilized clinical history, psychosocial problem checklists (CBCL, C-TRF), ADHD ratings (DISYPS), cognitive tests (WPPSI-III, K-ABC), and EF assessments (BRIEF-P, NEPSY).
Main Results:
- High frequency of dysexecutive problems reported: up to 64% by parents (BRIEF-P), 62% by teachers (BRIEF-P), and 62% in functional assessments (NEPSY).
- Limited correlation between parental and teacher BRIEF-P scores (only inhibition subscale correlated).
- No significant correlation found between NEPSY and BRIEF-P assessments.
Conclusions:
- Approximately two-thirds of preschool children with ADHD show detectable executive function dysfunctions.
- Multi-method testing is mandatory for a comprehensive assessment of dysexecutive problems in this age group.
- Findings highlight the complexity of assessing EF in young children with ADHD and the need for diverse evaluation tools.
Objective:
The aim of the study was to explore prevalence, interrelations and accuracy of assessing psychopathology, intelligence, and executive functions (EF) in preschool children with ADHD (age 2.1-6.5 years).
Method:
We prospectively investigated 115 preschool outpatient children (91 boys, 24 girls, aged 4.3±1.0 years) with the clinical diagnosis of ADHD. Assessment included clinical history, background, psychosocial problems (CBCL, C-TRF), ADHD (DISYPS external ratings), cognitive performance (WPPSI-III, K-ABC), and executive functions (BRIEF-P, NEPSY).
Results:
We found a high frequency of dysexecutive problems in up to 64 % in the parental BRIEF-P assessments, up to 62 % in the BRIEF-P teachers' assessments, and 62 % in the NEPSY functional assessments. Parental and teachers' BRIEF-P scores were only correlated in one subscale, inhibition, and NEPSY and BRIEF-P were not correlated at all. It was found that 42.5 % of the children with noticeable findings had agreeing results in all three, and another 45 % in two tests.
Conclusions:
About 2/3 of the ADHD preschool children had detectable EF dysfunctions. In order to assess dysexecutive problems, multi-method testing is mandatory.
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