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Investigação em PHDA

Executive functions in children with Attention-Deficit/Hyperactivity Disorder: Performance based measures versus questionnaires

Andreia Veloso1, Selene G. Vicente1, Marisa G. Filipe1.


Center for Psychology, Faculty of Psychology and Education Sciences, University of Porto

Objectives: Theoretical explanations about Attention-Deficit/Hyperactivity Disorder (ADHD) increasingly highlight the role of executive function (EF) impairments. EFs can be viewed as a multidimensional construct that encapsulates higher-order cognitive processes responsible for guiding, directing, and managing cognitive, emotional, and behavioral functions. Although EFs have been broadly investigated in individuals with ADHD, results have been incongruous perhaps due to the diversity of tasks used to assess these functions. Thus, this study aimed to assess EFs in children with ADHD through different types of measures: performance-based neuropsychological measures and questionnaires.

Method: Eighteen children with ADHD (Mage= 8.60), were matched to a typically developing (TD) group by age, gender, and non-verbal intelligence. Performance-based measures were used to assess working memory, mental flexibility, inhibition, planning, problem solving, and affective decision-making: Digit Span, Verbal Fluency, Tower of London, Trails, and Delay Gratification Task. The Behavior Rating Inventory of Executive Function (BRIEF) – Teacher and Parental Versions evaluated inhibition, shifting, emotional control, initiative, working memory, planning/organization, organization of materials, and monitoring skills in daily life.

Results: In performance-based measures, compared to TD children, the ADHD group demonstrated significant difficulties in measures of working memory, planning, and affective decision-making. In behavioral ratings, the ADHD group displayed greater difficulties in inhibition, emotional control, initiative, working memory, planning/organization, organization of materials, and monitoring.

Conclusion: Performance-based measures detected differences between groups in working memory, planning, and affective decision-making. Questionnaires pinpointed a larger spectrum of difficulties. Concordantly, ecological measures may be considered of greater clinical value as they are representative of children difficulties in everyday life. Performance-based tasks, contrarily, hold low ecological validity, what may account for the different results between measures. As such, it is paramount to devise performance-based measures with ecological validity to increase their efficacy in pinpointing executive difficulties.