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. 2014 Jan;42(1):77-90.
doi: 10.1007/s10802-013-9758-4.

Social and academic impairment in youth with ADHD, predominately inattentive type and sluggish cognitive tempo

Stephen A Marshall  1 , Steven W Evans, Ricardo B Eiraldi, Stephen P Becker, Thomas J Power
Affiliations

Social and academic impairment in youth with ADHD, predominately inattentive type and sluggish cognitive tempo

Stephen A Marshall et al. J Abnorm Child Psychol. 2014 Jan.

Abstract

Sluggish cognitive tempo (SCT) was originally identified as a construct that characterized the inattention problems of some children with attention deficit disorder (ADD). Research has indicated that using SCT symptoms to identify a subset of youth with attention-deficit/hyperactivity disorder, predominately inattentive type (ADHD-IT) may elucidate distinct patterns of impairment and thereby improve the external validity of ADHD subtypes. The objective of the current study was to investigate whether youth with clinically-assessed ADHD-IT and high levels of SCT exhibit unique social and academic impairments. In a clinic-referred sample of youth (N = 209; 23 % female) aged 6 to 17 years, participants who met criteria for three different groups were identified: ADHD, Combined Type (ADHD-CT; n = 80), ADHD-IT with low SCT symptoms (n = 74), and ADHD-IT with high SCT symptoms (n = 55). These groups were compared on indicators of social and academic functioning while considering the effects of co-occurring internalizing and disruptive behavior disorders. Youth with ADHD-IT high in SCT exhibited uniquely elevated withdrawal, as well as low leadership and low peer-directed relational and overt aggression, which were not accounted for by co-occurring disorders. This high-SCT group was also the only group to have more homework problems than the ADHD-CT group, but only when other disruptive behavior disorders were absent. The distinctiveness of the high-SCT group, which was primarily evident in social as opposed to academic functioning, provides partial support for the external validity and clinical utility of SCT.

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Figures

Fig. 1
Fig. 1
Depiction of the interaction between ADHD subgroup and ODD/CD status in analyses of teacher ratings of classroom performance on the Academic Performance Questionnaire (APQ) and parent ratings of homework difficulties on the Homework Problems Checklist (HPC). Higher scores on both measures indicate greater impairment. The top of each bar represents estimated group means after adjusting for internalizing disorder status, age, gender, and full scale IQ. ADHD-CT = ADHD, Combined Type; LSCT = ADHD, Inattentive Type with low SCT; HSCT = ADHD, Inattentive Type with high SCT; ODD/CD = Oppositional Defiant Disorder or Conduct Disorder
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