Neurocognitive overlap across DSM-5-TR presentations in pediatric ADHD under digital assessment

We examined whether DSM-5-TR ADHD presentations (inattentive, hyperactive/impulsive, combined) exhibit meaningful neurocognitive differences under examiner-supervised digital assessment. Children with ADHD (N = 193; 7-12 years) completed the CNS Vital Signs battery following diagnostic reconfirmation and stimulant washout; presentation specifiers were derived from parent SNAP-IV ratings. Ten age-normed domains were analyzed using Kruskal-Wallis tests with false discovery rate control (q = .05), Bayesian ANOVA, and equivalence testing (TOST; d =  ±0.30). No domain differed by presentation after correction (all FDR-adjusted p values = .980; ε² ≤ 0.015). Bayesian factors favored models excluding the presentation factor (BF_inclusion = 0.005-0.011). Observed differences were small (max d = 0.25) and fell within prespecified equivalence bounds, although TOST did not reach p < .05 for strict equivalence confirmation. Multivariately, presentation labels explained negligible variance. In contrast, unsupervised clustering identified two "Average" and "Low" performance profiles that were independent of DSM-5-TR labels. Results support substantial neurocognitive overlap across presentations under standardized testing conditions. Data-driven profiles provided a complementary, descriptive framework for characterizing heterogeneity to inform educational planning alongside symptom reports. Findings should be interpreted in light of mono-informant presentation assignment and potential underdetection of comorbidities.