Temperament and executive functioning correlates of ADHD symptom severity during early versus middle childhood
Virginia Peisch1, Erica Ferrara1, Gaelle Gourdet1
1Division of Developmental Medicine, Boston Children's Hospital, Boston, MA, USA.
Background:
This study investigated associations among temperament, executive functioning (EF), and attention-deficit/hyperactivity disorder (ADHD) symptom severity at two developmental stages.
Methods:
Participants were 61 4-year-old children and 165 8-11-year-old children (126 ADHD, 39 typically developing [TD]). Caregivers reported on temperament (effortful control [EC], negative affect, and surgency), and ADHD symptoms. Three aspects of EF (working memory, inhibitory control, and processing speed) were measured with neuropsychological tests.
Results:
Among 4-year-olds, variance in ADHD symptom severity was only explained by the temperament variables. EC was not significantly correlated with any of the EFs in this cohort. Among school-aged children, low EC, high surgency, high negative affect, and reduced working memory were associated with greater ADHD symptom severity. EC was significantly and positively correlated with processing speed in the school-aged children.
Conclusions:
Results are consistent with a neurodevelopmental model of ADHD, wherein dysregulated temperament is associated with ADHD in young children, while both dysregulated temperament and cognitive skills are associated with ADHD in middle childhood. Results could inform the selection of clinical tools for diagnostic evaluation of pediatric ADHD symptoms and clinical follow-up.
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