ADHD Type and Comorbid Conditions Significantly Impact Information Processing
Children with combined-type ADHD are able to achieve faster, more accurate processing when given information visually, partially overcoming a relative weakness revealed in a recent study exploring cognitive distinctions between patients with combined-type vs. inattentive-type ADHD, plus those with comorbid anxiety and oppositional defiant disorder (ODD).
June 9, 2021
Visual and auditory information are processed differently by children with ADHD, depending on their diagnosed ADHD subtype and the presence of comorbid conditions, according to a new Journal of Attention Disorders study exploring cognitive distinctions between the ADHD sub-types and between children with and without ADHD comorbidities.1 Notably, the research found that children with combined-type ADHD respond best to visual information, though children without ADHD outperform those with inattentive- or combined-type ADHD on Continuous Performance Tests measuring attention, inhibition, and working memory.
One hundred fifty participants, aged 7 to 10, were grouped according to ADHD presentation (combined or inattentive) or comorbid diagnosis (anxiety, ODD, both, or neither). Their performance on the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) was compared to a control group of 60 children without ADHD. Diffusion decision modelling was used to break down performance into cognitive components.
Children with combined- or inattentive-type ADHD had slower and less accurate visual and auditory processing than did controls. Those with combined-type ADHD were more sensitive to changes in presentation modality than those with inattentive-type and controls; they reacted more favorably to visual information than they did to auditory information, overall. “These results could be important for educational strategies regarding the most useful modality for presentation of educational materials: in a context with frequent targets (go stimuli), presenting them visually rather than auditorily helped particularly children with ADHD-C to achieve faster and more accurate processing,” the study reported.
Children with comorbid ADHD, ODD, and anxiety disorders demonstrated an increased tendency toward making premature decisions than did the children with ADHD and anxiety only, ODD only, or no comorbidity. Researchers suggest that additional biases may occur in cognitive processing with double comorbidity due to the confounding effect of “comorbidity load.”
These findings highlight the need for cognitive tests with multiple conditions because clinical associations appear when changes in cognitive components are examined across conditions. Identifying underlying cognitive components of types of ADHD and co-morbid diagnoses could help tailor treatments to the needs of different individuals with ADHD, and improve educational interventions.
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1 Ging-Jehli NR, Arnold LE, Roley-Roberts ME, deBeus R. Characterizing Underlying Cognitive Components of ADHD Presentations and Co-morbid Diagnoses: A Diffusion Decision Model Analysis. Journal of Attention Disorders. June 2021. doi:10.1177/10870547211020087