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. 2020 Oct;29(10):1453-1464.
doi: 10.1007/s00787-019-01455-w. Epub 2020 Jan 24.

Characteristics of child psychiatric outpatients with slow processing speed and potential mechanisms of academic impact

Ellen B Braaten  1   2 , Amanda K Ward  1   2 , Gina Forchelli  1   2 , Pieter J Vuijk  3 , Nathan E Cook  1   2 , Patrick McGuinness  1 , B Andi Lee  3 , Anna Samkavitz  3 , Hannah Lind  3 , Sheila M O'Keefe  1   2 , Alysa E Doyle  4   5   6
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Characteristics of child psychiatric outpatients with slow processing speed and potential mechanisms of academic impact

Ellen B Braaten et al. Eur Child Adolesc Psychiatry. 2020 Oct.

Abstract

While slow processing speed (PS) is well documented in youth with ADHD, growing evidence suggests that this difficulty affects children with other neuropsychiatric conditions. Clarifying the relationship between slow PS and different forms of psychopathology is important clinically, given the potential impact of PS on academic functioning, and conceptually. In 751 youth, ages 6-21, consecutively referred for neuropsychiatric evaluation, we examined the association between slow PS (i.e., Wechsler PS Index < 85) and seven neuropsychiatric diagnostic groups. In 492 of these youth, we also related slow PS to eight psychopathology symptom dimensions. Finally, we modeled the relationship between PS, other cognitive functions and academic achievement. Data are from the Longitudinal Study of Genetic Influences on Cognition. Analyses included one-sample t tests, ANOVA, logistic regression, mixed modeling, and structural equation modeling (SEM), controlling for age, sex, and medication. Compared to normative data, all clinical groups showed PS decrements. Compared to referred youth without full diagnoses and accounting for other psychopathology, risk for slow PS was elevated in youth with autism spectrum disorder (OR = 1.8), psychotic disorders (OR = 3.4) and ADHD-inattentive type (OR = 1.6). Having multiple comorbidities also increased risk for slow PS. Among dimensions, inattention (OR = 1.5) associated with slow PS but did not fully explain the association with autism or psychosis. In SEM, PS had direct effects on academic achievement and indirect effects through working memory. Findings extend evidence that PS relates to multiple aspects of child psychopathology and associates with academic achievement in child psychiatric outpatients.

Keywords: Academic achievement; Child psychiatry; Cross-disorder; Outpatients; Processing speed; Working memory.

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Figures

Figure 1
Figure 1
Performance of youth referred for neuropsychiatric evaluation on Wechsler indices
Figure 2a
Figure 2a
PS shows indirect effects on word reading via working memory
Figure 2b
Figure 2b
PS shows both direct effects on numerical operations and indirect effects via working memory
See this image and copyright information in PMC

Comment in

References

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