Cognitive Dimensions of Learning in Children With Problems in Attention, Learning, and Memory

Abstract

A data-driven, transdiagnostic approach was used to identify the cognitive dimensions linked with learning in a mixed group of 805 children aged 5 to 18 years recognised as having problems in attention, learning and memory by a health or education practitioner. Assessments included phonological processing, information processing speed, short-term and working memory, and executive functions, and attainments in word reading, spelling, and maths. Data reduction methods identified three dimensions of phonological processing, processing speed and executive function for the sample as a whole. This model was comparable for children with and without ADHD. The severity of learning difficulties in literacy was linked with phonological processing skills, and in maths with executive control. Associations between cognition and learning were similar across younger and older children and individuals with and without ADHD, although stronger links between learning-related problems and both executive skills and processing speed were observed in children with ADHD. The results establish clear domain-specific cognitive pathways to learning that distinguish individuals in the heterogeneous population of children struggling to learn.

Keywords: ADHD; cognition; learning difficulties; maths; reading; transdiagnostic.

Figure 1. Consort Diagram Showing CALM Study Referral Routes

Note. n (female). M and SD are ages in years. CAMHS = Child and Adolescent Mental Health Services. SLT = Speech and Language Therapists.

Figure 2. Three-Factor Confirmatory Factor Analysis Model for the Whole CALM sample (All Ages)

Note. Latent variables phonological processing (phono), speed, and executive functions (exec) are represented in ovals. Cognitive measures are shown as observed variables in squares. Variable names are: CNrep = Nonword Repetition, DR = Digit Recall, CMS = Delayed Recall, SRT = Simple Reaction Time, Allit = Alliteration, RAN = Rapid Automatic Naming, FI = Following Instructions, Can= Cancellation, MR= Matrix Reasoning, DM = Dot Matrix, BDR = Backward Digit Recall, MrX = Mr X. Parameter estimates are fully standardized. Residual variances are freely estimated but not shown for visual clarity.

Figure 3. Path Models Predicting Learning from Cognitive Factors for the Whole Sample, All Ages

Note. N=805; Learning outcomes (reading, spelling, and maths) are regressed on phonological processing, speed, and executive factors. Parameter estimates are fully standardized. Factor loadings and covariances are not shown for simplicity. Variable names are: CNrep = Nonword Repetition, DR = Digit Recall, CMS = Delayed Recall, SRT = Simple Reaction Time, Allit = Alliteration, RAN = Rapid Automatic Naming, FI = Following Instructions, Can= Cancellation, MR= Matrix Reasoning, DM = Dot Matrix, BDR = Backward Digit Recall, MrX = Mr X. Residual variances are freely estimated but not shown for visual clarity.

Figure 4. Three-Factor Confirmatory Factor Analysis for Children Aged 8 Years and Older

Note. Latent variables executive functions (exec), processing speed (speed), and phonological processing (phono) are represented in ovals. Cognitive measures are shown as observed variables in squares. DM = Dot matrix, BDR = Backward Digit Recall, MrX = Mr X, FI = Following Instructions, CMS = Delayed Recall, Plan = planning, MR= Matrix Reasoning, RAN = Rapid Automatic Naming,VS = Visual Scanning, Spd = Motor Speed, SWT = Number-Letter Switching, Can= Cancellation, RBBS= Reds, Blues, Bags and Shoes Switching, Allit = Alliteration, CNrep = Nonword Repetition, DR = Digit Recall. Parameter estimates are fully standardized. Residual variances are freely estimated but not shown for visual clarity.

Figure 5. Path Models Predicting Learning from Cognitive Factors for Children 8 Years and Older

Note. N=566; Learning outcomes (reading, spelling, and maths) are regressed on phonological processing, speed, and executive factors. Parameter estimates are fully standardized. Factor loadings are not shown for simplicity.