Abstract
We administered a neuropsychological battery to boys aged 6 to 12 years old diagnosed with attention-deficit hyperactivity disorder (ADHD; n= 51) and to comparison boys of the same age range (n= 31). Boys with ADHD had greater difficulty than comparison youngsters on nonautomated language and motor tasks administered with a fast instructional set and on one of two traditional frontal executive measures (Porteus mazes). When tasks requiring automatic processing were paired with similar tasks requiring greater use of selective attention processes, the latter, controlled processing tasks differentiated groups better than did automated tasks. This differential effect of otherwise similar tasks is interpreted in terms of an output deficit mediated by response organization as detailed in the information processing literature. The ADHD group also exhibited slow gross motor output, measured independently of verbal output. The findings are evaluated in terms of both Luria's (1973) tripartite model of neurocognitive organization and frontal striatal models, with an emphasis on output processes. The observed language deficits could represent frontal lobe processes intricately related to self-monitoring and planning. The utility of controlled processing, self-paced tasks with fast instructional sets in assessing language and motor skills in ADHD is highlighted.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Achenbach, T. M. (1991).Manual for the Child Behavior Checklist/4–18 and 1991 Profile. Burlington: University of Vermont, Department of Psychiatry.
American Psychiatric Associaton. (1987).Diagnostic and statistical manual of mental disorders (3rd ed., rev.) Washington, DC: Author.
Barkley, R. A. (1990).Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford Press.
Barkley, R. A., Grodzinsky, G., & DuPaul, G. J. (1992). Frontal lobe functions in attention deficit disorder with and without hyperactivity: A review and research report.Journal of Abnormal Child Psychology, 20, 163–188.
Boder, E., & Jarrico S. (1982).The Boder Test of Reading-Spelling Patterns. New York: Grune & Stratton.
Chuinard, M. J., & Braun, C. M. J. (1993). A meta-analysis of the relative sensitivity of neuropsychological screening tests.Journal of Clinical and Experimental Neuropsychology, 15, 591–607.
Cohen, J. (1988).Statistical power analysis for the behavioral sciences. New York: Erlbaum.
Cooley, E. L., & Morris, R. D. (1990). Attention in children: A neuropsychologically based model for assessment.Developmental Neuropsychology, 6, 239–274.
Cornwall, A. (1992). The relationship of phonological awareness, rapid naming, and verbal memory to severe reading and spelling disability.Journal of Learning Disabilities, 25, 532–538.
de Sonneville, L. M. J., Njiokiktjien, C., & Bos, H. (1994). Methylphenidate and information processing. Part I: Differentiation between responders and non responders; Part II: Efficacy in responders.Journal of Clinical and Experimental Neuropsychology, 16, 877–897.
Denckla, M. B. (1983). Learning for language and language for learning. In U. Kirk (Ed.),Neuropsychology of language, reading, and spelling (pp.33–43). New York: Academic Press.
Denckla, M. B. (1985). Revised neurological examination for subtle signs.Psychopharmacological Bulletin, 21, 773–800.
Denckla, M. B. (1974). Motor co-ordination in normal children.Developmental Medicine and Child Neurology, 16, 729–741.
Denckla, M. B., & Rudel, R. (1974). Rapid “automatized” naming of pictured objects, colors, letters, and numbers by normal children.Cortex, 10, 186–202.
Denckla, M. B., & Rudel, R. (1978). Anomalies of motor development in hyperactive boys.Annals of Neurology, 3, 231–233.
Denckla, M. B., Rudel, R. G., Chapman, C., & Krieger, J. (1985). Motor proficiency in dyslexic children with and without attention disorders.Archives of Neurology, 42, 228–231.
Grodzinsky, G. M., & Diamond, R. (1992). Frontal lobe functioning in boys with attention-deficit hyperactivity disorder.Developmental Neuropsychology, 8, 427–445.
Goyette, C. H., Conners, C. K., & Ulrich, R. F. (1978). Normative data on Revised Conners Parent and Teacher Rating Scales.Journal of Abnormal Child Psychology, 6, 221–236.
Halperin, J. M., McKay, K. E., Matier, K., Sharma, V. (1994). Attention, response inhibition, and activity level in children: Developmental neuropsychological perspectives. In M. Treamontana & S. Hooper (Eds.),Advances in child neuropsychology (Vol. 2, pp. 1–54). New York: Springer.
Heilman, K. M., Voeller, K. K. S., & Nadeau, S. E. (1991). A possible pathophysiologic substrate of attention-deficit hyperactivity disorder.Journal of Child Neurology, 6, S76-S81.
Hinshaw, S. P. (1992). Externalizing behavior problems and academic underachievement in childhood and adolescence: Causal relationships and underlying mechanisms.Psychological Bulletin, 111, 127–155.
Hinshaw, S. P. (1994).Attention deficits and hyperactivity in children. Thousand Oaks, CA: Sage.
Hollingshead, A. B. (1975).Four-factor index of social status. Unpublished manuscript. Department of Sociology, Yale University.
Levin, B. E. (1990). Organizational deficits in dyslexia: Possible frontal lobe dysfunction.Developmental Neuropsychology, 6, 95–110.
Lezak, M. D. (1983).Neuropsychological assessment (2nd ed.). New York: Oxford University Press.
Loge, D. V., Staton, R. D., & Beatty, W. W. (1990). Performance of children with ADHD on tests sensitive to frontal lobe dysfunction.Journal of the American Academy of Child and Adolescent Psychiatry, 29, 540–545.
Loney, J. (1987). Hyperactivity and aggression in the diagnosis of attention deficit disorder. In B. B. Lahey & A. E. Kazdin (Eds.),Advances in clinical child psychology (Vol. 10, pp. 99–135). New York: Plenum Press.
Luria, A. R. (1973).The working brain. New York: Basic Books.
McKay, K. E., Halperin, J. M., Schwartz, S. T., & Sharma, V. (1994). Developmental analysis of three aspects of information processing: Sustained attention, selective attention, and response organization.Developmental Neuropsychology, 10, 121–132.
Osterreith, P. (1946). Le test de copie d'une figure complexe.Les Archives de Psychologie, 31, 206–356.
Pelham, W. E., Gnagy, E. M., Greenslade, K. E., & Milich, R. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders.Journal of the American Academy of Child and Adolescent Psychiatry, 31, 210–218.
Porteus, S. D. (1973).Porteus maze test: Fifty years application. Palo Alto: Pacific Books.
Posner, M. I. (1988). Structures and functions of selective attention. In T. Boll & D. K. Bryant (Eds.),Clinical neuropsychology and brain function: Research, assessment, and practice (pp. 173–203). Washington, DC: American Psychiatric Association.
Rourke, B. P., & Orr, R. R. (1977). Prediction of reading and spelling performance of normal and retarded readers: A four year follow-up.Journal of Abnormal Child Psychology, 5, 9–20.
Rourke, B. P., & Gates, R. D. (1980).The Underlining Test (preliminary norms). Windsor, Ontario, Canada: Department of Psychology, University of Windsor.
Sattler, J. M. (1992).Assessment of children (3rd ed.). San Diego: Jerome M. Sattler Publisher, Inc.
Schuerholz, L. J., Harris, E. L., Baumgardner, T. L., Reiss, A. L., Freund, L., Church, R. P., Mohr, J., & Denckla, M. B. (1995). An analysis of two discrepancy-based models and a processing-deficit approach in identifying learning disabilities.Journal of Learning Disabilities, 28, 18–29.
Sergeant, J., & Scholten, C. A. (1985). On resource strategy limitations in hyperactivity: Cognitive impulsivity reconsidered.Journal of Child Psychology and Psychiatry, 26, 97–109.
Smith, A. (1960). Changes in Porteus maze scores of brain-operated schizophrenics after an eight-year interval.Journal of Mental Science, 106, 967–968.
Sprague, R. L., & Sleator, E. K. (1976). Drugs and dosages: Implications for learning disabilities. In R. M. Knights & D. J. Bakker (Eds.),Neuropsychology of learning disorders: Theoretical approaches (pp. 351–366). Baltimore: University Park Press.
Sykes, D. H., Douglas, V. I., & Morganstern, G. (1973). Sustained attention in hyperactive children.Journal of Child Psychiatry and Psychology, 14, 213–220.
Van der Meere, J., van Baal, M., & Sergeant, J. A. (1989). The additive factor method: A differential diagnostic tool in hyperactivity and learning disability.Journal of Abnormal Child Psychology, 17, 409–422.
Van der Meere, J., Vreeling, H. J., & Sergeant, J. (1992). A motor preset study in hyperactivity, learning disabled, and control children.Journal of Child Psychology and Psychiatry, 8, 1347–1354.
Van der Meere, J., Wekking, E., & Sergeant, J. A. (1991). Sustained attention and pervasive hyperactivity.Journal of Child Psychology and Psychiatry, 32, 275–284.
Vitiello, B., Ricciuti, A., Stoff, D. M., Behar, D., & Denckla, M. B. (1989). Reliability of subtle (soft) neurological signs in children.Journal of the American Academy of Child and Adolescent Psychiatry, 28, 749–753.
Waber, D. P., & Holmes, J. M. (1985). Assessing children's copy productions of the Rey-Osterreith complex figure.Journal of Clinical and Experimental Neuropsychology, 7, 264–280.
Wechsler, D. (1974).Wechsler Intelligence Scale for Children—Revised. New York: The Psychological Corporation.
Wechsler, D. (1991).Wechsler Intelligence Scale for Children (3rd ed.). New York: The Psychological Corporation.
Werry, J. S., Elkin, G. S., & Reeves, J.C. (1987). Attention deficit, conduct, oppositional, and anxiety disorders in children: III. Laboratory differences.Journal of Abnormal Child Psychology, 15, 409–428.
Werry, J. S., Minde, K., Guzman, A., Weiss, G., Dogan, K., & Hoy, E. (1972). Studies on the hyperactive child VII: Neurological status compared with neurotic and normal children.American Journal of Orthopsychiatry, 42, 441–451.
Wolf, M., Bailey, H., & Morris, R. (1986). Automaticity, retrieval process, and reading: A longitudinal study in average and impaired readers.Child Development, 57, 988–1000.
Woodcock, R. W., & Johnson M. B. (1989, 1990).Woodcock-Johnson Psychoeducational Battery—revised. Denton, TX: DLM Resources.
Yap, R. L., & van der Leij, A. (1994). Testing the automatization deficit hypothesis of dyslexia via a dual-task paradigm.Journal of Learning Disabilities, 27, 660–665.
Author information
Authors and Affiliations
Additional information
This research was supported primarily by National Institute of Mental Health Grant R01 MH45064 awarded to Stephen P. Hinshaw. Joel T. Nigg was partially supported by NIH Research Service Award F31 MH10462-01. The authors wish to thank Deborah P. Waber, Ph.D., of Harvard University for her assistance in scoring the Rey-Osterreith complex design, and Jennifer Ablow, Margaret Kuklinsksi, Jeff Measelle, Teron Park, Cassandra Simmel, and Jennifer Treuting for helping to administer the measures, code the results, and discuss the study. We also acknowledge the enthusiastic participation of the children and families in the summer programs.
Rights and permissions
About this article
Cite this article
Carte, E.T., Nigg, J.T. & Hinshaw, S.P. Neuropsychological functioning, motor speed, and language processing in boys with and without ADHD. J Abnorm Child Psychol 24, 481–498 (1996). https://doi.org/10.1007/BF01441570
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF01441570