Neurocognitive Correlates of Attention-Deficit Hyperactivity Disorder Symptoms in Children Born at Extremely Low Gestational Age.
Megan N Scott, Scott J Hunter, Robert M Joseph and 5 others
PMID 28410255WHAT IT FOUND
In 10-year-olds born before 28 weeks, significant ADHD symptoms were associated with lower language, working memory, attention, visual-motor, and school scores.
These links persisted for reading, spelling, and working memory after excluding children with IQ below 85.
Key findings
01Children classified as having significant ADHD symptoms had median test Z-scores about -1.0 and were .25 to .75 standard deviations below children without that classification across all tests.
02After adjustment for maternal and newborn characteristics, ADHD symptom classification was significantly associated with Z-scores of -1 or lower on all DAS-II, OWLS, and WIAT-III subtests, all but two NEPSY-II subtests, and the LPA-based executive impairment groups.
03After excluding children with IQ below 85, ADHD symptom classification remained associated with low word reading, pseudoword decoding, spelling, working memory and auditory response scores.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study did not use a conventional diagnostic interview for ADHD, so children were grouped by research classification of significant symptoms, not a clinical diagnosis. Teacher ratings were missing for 237 of the 871 children, and the authors were uncertain about potential bias. ADHD symptom severity and functional impairment were not assessed, so the paper cannot say how much these findings affect daily life. The comparison used national normative data rather than matched full-term controls, so group differences may reflect the extremely preterm cohort itself. The study cannot separate the effect of ADHD symptoms from the cognitive and motor difficulties being measured. After excluding children with IQ below 70, many subtests no longer showed a significant association. Subtype information could not be used because reporters often disagreed about subtype. Because this was an observational study, it cannot show that ADHD symptoms caused the lower scores.
The easy way to misread this
Do not conclude that ADHD symptoms caused the lower scores or that these children meet a clinical diagnosis. The study used a research symptom classification, not a conventional diagnostic instrument, and many associations were weaker or absent when children with lower IQ were excluded.