Optimal Items for Assessing Sluggish Cognitive Tempo in Children Across Mother, Father, and Teacher Ratings

Abstract

A recent meta-analysis identified optimal items for assessing sluggish cognitive tempo (SCT) as distinct from attention deficit/hyperactivity disorder inattention (ADHD-IN), and a preliminary study with teacher ratings of children in the United States found strong support for the convergent and discriminant validity of 15 SCT items. The current study evaluated whether the same 15 SCT items demonstrated convergent and discriminant validity from ADHD-IN in a large, community-based sample of children in Spain, and whether validity results were replicated across mother, father, and teacher ratings. Mothers, fathers, and teachers completed measures of SCT, ADHD-IN, ADHD-hyperactivity/impulsivity, oppositional defiant disorder, limited prosocial emotions, anxiety, depression, shyness, peer rejection, social impairment, and academic impairment on 2,142 Spanish children (49.49% girls; ages 8-13). The 15 SCT symptoms demonstrated convergent validity along with discriminant validity with ADHD-IN across all three informants. The SCT symptom ratings also showed measurement invariance across the informants. In addition, SCT and ADHD-IN factors had different and unique associations with the other symptom and impairment factors. The 15 SCT symptoms identified in this study-consistent across mother, father, and teacher ratings-appear appropriate to serve as a standard symptom set for assessing SCT in children. Use of a common set of symptoms in future studies will advance our understanding of the SCT construct, including its etiology and developmental progression, associations with ADHD and other psychopathologies, links to impairment, and implications for clinical intervention.

Figure 1.

Exploratory structural regression analysis. The SCT manifest variables (items) were allowed to cross-load on ADHD-IN and the ADHD-IN manifest variables were allowed to cross-load on SCT. None of the other manifest variables were allowed to cross-load on the other factors. Manifest variables are not shown to simply the figure. Predictors and outcomes were regressed on the covariate, child sex. SCT = sluggish cognitive tempo; IN = ADHD-inattention; HI = ADHD-hyperactivity/impulsivity; ODD = oppositional defiant disorder; LPE = limited prosocial emotions; ANX = anxiety; DEP = depression; SHY = shyness; PR = peer rejection; SI = global social impairment; AI = global academic impairment; D = disturbance.