Age-Related Variance in Performance versus Ratings of Attention and Impulse Regulation in Children: Implications for the Assessment of ADHD

Abstract

Executive function task (EF) deficits are hypothesized to underlie difficulties with self-regulation. However, tasks assessing EF impairments have only been weakly correlated with rating scales that index self-regulation difficulties. A community sample of children and youth aged between 8 and 20 years old were assessed longitudinally. Growth curve analyses and correlations were conducted to better understand how these two types of measures relate to one another across development, as well as the impact of age-related variance. EF was assessed using the Stroop Task and Trail Making test and behavioral ratings of self-regulation were captured using the SWAN scale. EF task performance improved steeply until age 14-15, whereas the SWAN Scale showed small age-related decreases. EF task performance was moderately correlated with age among 8-13-year-olds and to a lesser extent among 14-20-year-olds. SWAN scores were not significantly related to age in either group. Correlations were similar in an ADHD "at-risk" subgroup. EF task performance and parent ratings of attention regulation have different developmental trajectories, which may partly explain why correlations are low to modest in these samples. In particular, age-related variance is an important methodological consideration with significant implications for the assessment of self-regulation in children and youth with ADHD.

Keywords: attention-deficit hyperactivity disorder (ADHD); behavior ratings; executive function; longitudinal; self-regulation; strengths and weaknesses of ADHD symptoms and normal behaviors rating scale (SWAN).

Figure 1

Developmental trajectory of SWAN total score. Closed circles represent observed means; open circles represent model-implied means.

Figure 2

Developmental trajectories of SWAN subscale scores. (a) Trajectory of inattention scores; (b) Trajectory of hyperactivity scores; (c) Trajectory of impulsivity scores. Closed circles represent observed means; open circles represent model-implied means.

Figure 3

Mean trajectories for executive function task performance (a) Trajectory of Trail Making Task Part B minus Part A time; (b) Trajectory of Stroop Task interference time. Closed circles represent observed means; open circles represent model-implied means. Score reflects time (in seconds), where less time indicates better performance.

Figure 3

Mean trajectories for executive function task performance (a) Trajectory of Trail Making Task Part B minus Part A time; (b) Trajectory of Stroop Task interference time. Closed circles represent observed means; open circles represent model-implied means. Score reflects time (in seconds), where less time indicates better performance.