Title

The predictive power of combined neuropsychological measures for attention deficit/hyperactivity disorder in children

Date of Completion

January 1999

Keywords

Psychology, Psychobiology|Psychology, Developmental|Psychology, Clinical|Psychology, Psychometrics

Degree

Ph.D.

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a developmental disorder which is characterized by inattention, hyperactivity, and impulsivity. The current method of diagnosis involves extensive interview and behavior rating scales in order to determine whether an individual displays certain characteristics of ADHD. Researchers have long sought a more objective measure of ADHD, with limited success. The present study explores the predictive power of several neuropsychological assessment tools used in combination in classifying children with ADHD. These tests of frontal/executive functioning included the Hand Movements Scale from the Kaufman Assessment Battery for Children (K-ABC), the Stroop Color-Word Association Test, the Controlled Oral Word Association Test (COWAT, or F-A-S), the Trail Making Test, the Arithmetic and Digit Span subtests of the Wechsler Intelligence Scale for Children, Third Edition (WISC-III), and Conners' Continuous Performance Test (CPT). ^ Twenty-one ADHD boys and 22 community control children completed the one-hour battery which was administered in the home. Group differences were significant on the Digit Span and CPT tests only, and battery analysis did little to increase overall predictive power. For a battery of seven neuropsychological tests, an impaired score on at least two of seven tests provided the strongest prediction, but it was modest, offering limited diagnostic utility. Similar classification rates were obtained with a battery comprised of the three strongest tests. The present study highlights the difficulty in identifying consistent mean differences on tests of frontal/executive functioning across studies, as well as the need to assess the predictive validity of these tests in classifying children with ADHD. Continued study is needed to better understand the variability in previous findings and to explore further the utility of a battery approach. Inconsistencies in the literature are discussed, with consideration of research methodology, developmental obstacles, the heterogeneity of the ADHD population, and comorbid diagnoses. ^