Are “cool” executive function impairments more salient in ADHD symptoms than in reading disability?

Koltermann, Gabriella; Becker, Natália; Lopes-Silva, Júlia Beatriz; Gomides, Mariuche Rodrigues de Almeida; Paiva, Giulia Moreira; Haase, Vitor Geraldi; Salles, Jerusa Fumagalli de

doi:10.1590/1980-57642020dn14-010008

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Dementia & Neuropsychologia

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Original Article • Dement. neuropsychol. 14 (1) • Jan-Mar 2020 • https://doi.org/10.1590/1980-57642020dn14-010008 copy

Are “cool” executive function impairments more salient in ADHD symptoms than in reading disability?

DÉFICITS EM FUNÇÕES EXECUTIVAS “FRIAS” SÃO MAIS SALIENTES NOS SINTOMAS DE TDAH QUE NA DIFICULDADE DE LEITURA?

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Introduction:

Reading disability (RD) and Attention Deficit Hyperactivity Disorder (ADHD) symptoms often co-occur in school-age children.

Methods:

The present study evaluated the performance of 216 Brazilian children from 3^rd and 4^th grades on “cool” executive function (EF) abilities and phonological processing. The children were divided into three groups: those with ADHD symptoms only, those with RD only, and controls.

Results:

MANOVA analyses, controlling for age and nonverbal intelligence, showed worse performance for the RD group, compared to the ADHD symptoms group, on measures of phonological processing (phonemic awareness, phonological short-term memory, and lexical access) and “cool” EF components (orthographic verbal fluency and processing speed). The ADHD symptoms group did not differ from the control group on the majority of the “cool” EF tasks. Compared to the control group, the ADHD symptoms group and the RD group both showed significantly more errors in rapid automatized naming of figures, which evaluates the inhibition component of EF; performance on this task was similar for these groups.

Conclusion:

We conclude that children with RD have greater impairment in phonological processing and “cool” EF compared to those with ADHD symptoms. Furthermore, deficits in inhibitory control may be shared among children with both conditions.

Key words:
attention deficit hyperactivity disorder; reading disability; cognition; child; neuropsychology

	Controls (N = 159)	ADHD symptoms (N = 20)	RD (N = 37)	F	p
Sex (%) M/F	46.5% / 53.5%	50% / 50%	35.1% / 64.9%	1.80^I	.40
Age (M ± SD)	8.96 ± 0,70	8.70 ± .65	9.03 ± .76	1.45	.23
School grade (%) 3º/4º	27% / 73%^a	55% / 45% ^a	21.6% / 78.4%^b	7.87 ^I	.01^* ADHD: attention deficit hyperactivity disorder. RD: reading disability. M: male. F: female. BH: Belo Horizonte. POA: Porto Alegre. RCPM: Raven Colored Progressive Matrices. LPI: Oral Single-Word and Pseudoword Reading Task. + F: analysis of variance. +a,b: Bonferroni post-hoc analysis. § I: Chi-square test. \|\| 1= Indicator of school quality in Brazil. This index is calculated based on a combination of school progression rates and performance on government mandatory standardized tests, such as the Brazil Exam and the SAEB. When results were last published, in 2013, the national IDEB for Brazil was calculated at 5.2, well below the value of 6.0 recommended by the Organization for Economic Cooperation and Development.26
City (%) BH/POA	69.2% / 30.8%	80% / 20%	64.9% / 35.1%	1.42 ^I	.49
Schools' IDEB¹ (M ± SD)	6.67 ± .55	6.65 ± .82	6.57 ± .90	.30	.73
RCPM Percentile (M ± SD)	82.79 ± 14.70 ^a	82.40 ± 16.87^a,b	73.81 ± 20.89 ^b	4.71	.01^* ADHD: attention deficit hyperactivity disorder. RD: reading disability. M: male. F: female. BH: Belo Horizonte. POA: Porto Alegre. RCPM: Raven Colored Progressive Matrices. LPI: Oral Single-Word and Pseudoword Reading Task. + F: analysis of variance. +a,b: Bonferroni post-hoc analysis. § I: Chi-square test. \|\| 1= Indicator of school quality in Brazil. This index is calculated based on a combination of school progression rates and performance on government mandatory standardized tests, such as the Brazil Exam and the SAEB. When results were last published, in 2013, the national IDEB for Brazil was calculated at 5.2, well below the value of 6.0 recommended by the Organization for Economic Cooperation and Development.26
Inattention score (M ± SD)	5.88 ± 3.97 ^a	14.68 ± 4.86^b	6.19 ± 4.12^a	39.74	< .001^** * p = .02.
Hyperactivity score (M ± SD)	5.66 ± 3.83 ^a	15.40 ± 4.41 ^b	5.08 ± 4.32^a	55.96	< .001^** * p = .02.
Combined inattention and hyperactivity/impulsivity score (M ± SD)	11.54 ± 6.74 ^a	29.74 ± 6.37 ^b	11.27 ± 6.74 ^b	63.99	< .001^** * p = .02.
LPI percentile (M ± SD)	52.86 ± 27.80 ^a	48.50 ± 21.58 ^a	7.04 ± 3.23 ^b	51.36	< .001^** * p = .02.

	Control group (M ± SD) (N = 159)	ADHD symptoms group (M ± SD) (N = 20)	RD group (M ± SD) (N = 37)	F	p
Phonemic elision (correct responses)	23.07 ± 4.65^a	23.13 ± 4.65^a	19.12 ± 4.92^b	11.309	< .001^ p ≤ .001.
Letter span - forward order	5.5 ± 1.10	5.43 ± 1.04	5.00 ± 1.10	2.629	.075
Letter span - backward order	5.37 ± 1.18	5.05 ± 1.00	4.99 ± 1.11	1.590	.207
Digit span - forward order	6.70 ± 1.31^a,b	7.30 ± 0.96^a	6.32 ± 1.07^b	3.608	.029^* * p < .05.
Digit span - backward order	3.74 ± 1.22	3.37 ± .81	3.58 ± 1.31	1.143	.321
Corsi Blocks - forward order	35.26 ± 11.65	37.82 ± 11.57	32.28 ± 12.29	1.379	.255
Corsi Blocks - backward order	26.45 ± 12.32	29.77 ± 13.62	26.56 ± 10.62	.504	.60
Orthographic verbal fluency (correct words)	7.88 ± 3.06^a	8.20 ± 2.46^a	5.68 ± 2.72^b	9.088	< .001^ p ≤ .001.
Semantic verbal fluency (correct words)	13.71 ± 3.56^b	12.42 ± 2.73^a,b	11.93 ± 4.22^a	7.256	.001^ p ≤ .001.
FDT - reading - errors	.069 ± 0.30	.096 ± 0.44	.084 ± 0.27	.088	.916
FDT - reading - RT (ms)	29784.28 ± 5651.29^b	30684.01 ± 4808.81^a,b	32637.81 ± 5477.81^a	4.095	.018^* * p < .05.
FDT - counting - errors	.47 ± 1.02^b	.65 ± 1.18^a,b	1.14 ± 2.98^a	2.765	.065^* * p < .05.
FDT - counting - RT (ms)	41766.76 ± 8621.66^b	43197.92 ± 10282.93^a,b	45966.71 ± 14481.08^a	2.867	.059
FDT - choosing - errors	2.46 ± 2.65^b	4.23 ± 4.96^a,b	3.69 ± 4.32^a	4.113	.018^* * p < .05.
FDT - choosing - RT (ms)	68833.25 ± 14400.80	73480.98 ± 15313.97	72482.35 ± 14138.48	1.766	.174
FDT - switching - errors	2.98 ± 2.89^b	4.71 ± 6.10^a,b	4.77 ± 5.78^a	4.417	.013^* * p < .05.
FDT - switching - RT (ms)	79662.66 ± 18461.58	80416.20 ± 27576.06	77309.51 ± 28950.41	.231	.794
CNT - letters - errors	.10 ± .40^b	.10 ± .44^a,b	.32 ± .62^a	3.443	.034^* * p < .05.
CNT - letters - RT (ms)	20869.28 ± 4355.49^b	22294.60 ± 5079.37^a,b	24907.25 ± 6626.67^a	11.779	< .001^ p ≤ .001.
CNT - numbers - errors	.12 ± .52	.21 ± .41	.23 ± .68	0.750	.474
CNT - numbers - RT (ms)	22736.82 ± 5666.98^b	23512.91 ± 6089.46^a,b	26181.44 ± 5833.22^a	5.393	.005^* * p < .05.
CNT - figures - errors	.69 ± 1.69^a	.58 ± 1.12^a	1.82 ± 2.64^b	5.940	.003^ p ≤ .001.
CNT - figures - RT (ms)	53183.96 ± 17813.67^b	54788.92 ± 19935.23^a,b	63989.07 ± 17717.10^a	5.518	.005^* * p < .05.
CNT - figures/inhibition - errors	.53 ± 1.06^a	1.87 ± 2.61^b	2.12 ± 3.14^b	14.950	< .001^ p ≤ .001.
CNT - figures/ inhibition - RT (ms)	55593.30 ± 16786.00^a	59277.15 ± 20476.31^a	71572.31 ± 24749.91^b	11.594	< .001^ p ≤ .001.
CNT - figures/switching - errors	1.77 ± 2.84^b	2.07 ± 2.06^a,b	3.66 ± 5.47^a	4.673	.010^* * p < .05.
CNT - figures/ switching - RT (ms)	80696.08 ± 97619.91	71191.08 ± 22977.80	93043.38 ± 34444.98	.488	.614

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E-mail: revistadementia@abneuro.org.br | demneuropsy@uol.com.br

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[1] Gabriella Koltermann. Psychology Institute UFRGS – Ramiro Barcelos, 2600, room 114 – Bairro Santa Cecília – 90035-003 Porto Alegre RS – Brazil. E-mail: gabikoltermann@gmail.com