Inattention in Pediatric Attention-Deficit/Hyperactivity Disorder and Anxiety: Neurophysiological Evidence for
Marija Pranjić1,2, Virginia Peisch1, Yena Li1
1Division of Developmental Medicine, Boston Children's Hospital, Brookline, MA, USA.
Journal of Attention Disorders
|May 7, 2026
Summary
Inattention in children with ADHD and anxiety stems from shared and distinct neurophysiological mechanisms. Early attention and stimulus processing are similarly affected, while error monitoring and behavioral adjustment differ between disorders.
Area of Science:
- Neuroscience
- Developmental Psychology
- Clinical Psychology
Background:
- Inattention is common in pediatric Attention Deficit Hyperactivity Disorder (ADHD) and anxiety disorders.
- Neurocognitive mechanisms underlying inattention in these conditions are not fully understood.
- This study investigates shared versus distinct neural pathways of attention in children with ADHD, anxiety, and typically developing peers.
Purpose of the Study:
- To compare behavioral and neurophysiological attention mechanisms in children with ADHD-only, Anxiety-only, ADHD+Anxiety, and typically developing (TD) groups.
- To identify shared and distinct event-related potential (ERP) markers across different stages of attention.
- To explore the diagnostic and therapeutic implications of neurophysiological biomarkers.
Main Methods:
- 111 children (7-11 years) completed computerized attention tasks with high-density electroencephalography (EEG) recording.
- Analyzed behavioral indices: accuracy, reaction time, and post-error slowing.
- Examined ERP/EEG markers: aperiodic exponent (attentional engagement), N2 (stimulus discrimination), P3 (action selection), ERN (performance monitoring), and Pe (performance evaluation).
Main Results:
- All clinical groups showed reduced dynamic arousal and stimulus discrimination compared to TD children.
- Anxiety-only group exhibited heightened error detection but reduced conscious appraisal of errors.
- ADHD-only group demonstrated weaker self-monitoring and adaptive control, evidenced by reduced post-error slowing.
Conclusions:
- Inattention in ADHD and anxiety involves both common and unique neurophysiological underpinnings.
- Shared deficits in early attention and stimulus processing are present, alongside disorder-specific differences in error monitoring.
- Neurophysiological biomarkers offer potential for differential diagnosis and tailored interventions for pediatric attention and anxiety disorders.
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