ABSTRACT

Our study is one of the few to analyze executive functioning (EF) in a comprehensive, multi-modal fashion as a potential contributor to the comorbidity between attention-deficit/hyperactivity disorder (ADHD) and basic reading disability (RD). We included multiple, traditional, neuropsychological measures of EF, along with the Behavior Rating Inventory of Executive Function (BRIEF) questionnaire, to assess inhibit, shift, working memory (WM), planning, generation fluency, and problem-solving. Participants included 263 children, ages 8–12 years, with RD, ADHD, RD/ADHD, and typically developing controls. When using the traditional measures in a 2 × 2 MANCOVA, we found both RD and ADHD had poor cognitive EF in most areas at the group level, with phonological loop deficits being more specific to RD and behavioral regulation deficits being more specific to ADHD. Children with RD/ADHD performed comparably to those with RD and ADHD alone. Results were similar on the BRIEF. In contrast, only WM predicted both basic reading and inattention when the data were assessed in a continuous fashion. It also explained the correlations between basic reading and inattention, being worthy of longitudinal research to determine if it is a shared contributor to RD/ADHD. When comparing hypotheses as to the nature of RD/ADHD, we found the multiple deficit hypothesis was better supported by our EF data than the phenocopy hypothesis or the cognitive subtype hypothesis.

摘要

我们的研究是少数以全面、多模式的方式分析执行功能 (EF) 的研究之一作为注意缺陷/多动障碍（ADHD）和基本阅读障碍（RD）之间合并症的潜在因素。我们纳入了多种传统的 EF 神经心理学测量方法以及执行功能行为评定量表 (BRIEF) 问卷，以评估抑制、转变、工作记忆 (WM)、计划、生成流畅性和解决问题的能力。参与者包括 263 名 8-12 岁的儿童，他们患有 RD、ADHD、RD/ADHD，并且通常处于发育控制阶段。当在 2 × 2 MANCOVA 中使用传统测量时，我们发现 RD 和 ADHD 在组水平的大多数区域的认知 EF 都很差，语音循环缺陷对 RD 更具体，行为调节缺陷对 ADHD 更具体。患有 RD/ADHD 的儿童的表现与单独患有 RD 和 ADHD 的儿童相当。简报上的结果相似。相比之下，当以连续方式评估数据时，只有 WM 预测基本阅读和注意力不集中。它还解释了基本阅读和注意力不集中之间的相关性，值得纵向研究以确定它是否是 RD/ADHD 的共同贡献者。在比较关于 RD/ADHD 的性质的假设时，我们发现我们的 EF 数据比表型假设或认知亚型假设更好地支持了多重缺陷假设。