Atypical auditory cortical processing in ADHD during early and middle childhood

Auditory perception emerges from the dynamic integration of bottom-up sensory encoding with higher-order predictive processes, and disruption of these processes is associated with poor attention and behavior regulation in children. Using an auditory oddball paradigm, we examined event-related potentials reflecting auditory deviance detection (mismatch negativity; MMN) and novelty-related orienting (novelty-P3) in early (n = 115) and middle (n = 71) childhood. Across both age-stratified cohorts, elevated attention-deficit/hyperactivity disorder (ADHD) symptoms or diagnosis were associated with altered MMN responses, whereas evidence for novelty-P3 differences was more limited. In early childhood, elevated ADHD symptoms were associated with larger negative-going MMN amplitudes and altered habituation to repeated standard and novel stimuli. In middle childhood, ADHD was associated with attenuated MMN amplitudes, while novelty-P3 group differences were sensitive to model specification. These results suggest that auditory deviance detection and novelty adaptation may be developmentally informative markers for understanding atypical attention regulation in ADHD-related phenotypes. Together, the findings support a systems-level account in which the integration of ascending sensory input with descending predictive signals supports adaptive responses to changing environments.