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Research on Child and Adolescent Psychopathology

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03-03-2016

Preschool Neuropsychological Measures as Predictors of Later Attention Deficit Hyperactivity Disorder

Auteurs: Rosanna P. Breaux, Shayl F. Griffith, Elizabeth A. Harvey

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 8/2016

Abstract

The present study examined preschool neuropsychological measures as predictors of school-age attention deficit hyperactivity disorder (ADHD). Participants included 168 children (91 males) who completed neuropsychological measures at ages 3 and 4, and who were evaluated for ADHD and oppositional defiant disorder at age 6. The Conners’ Kiddie Continuous Performance Test (K-CPT), NEPSY Statue subtest, and a delay aversion task significantly distinguished at-risk children who later did and did not meet criteria for ADHD, with poor to fair overall predictive power, specificity, and sensitivity. However, only the K-CPT ADHD Confidence Index and battery added incremental predictive validity beyond early ADHD symptoms. This battery approach, which required impairment on at least 2 of the 3 significant measures, yielded fair overall predictive power, specificity, and sensitivity, and correctly classified 67 % of children. In addition, there was some support for the specificity hypothesis, with evidence that cool executive function measures (K-CPT and Statue subtest) tended to predict inattentive symptoms. These findings suggest that neuropsychological deficits are evident by preschool-age in children with ADHD, but neuropsychological tests may still misclassify approximately one-third of children if used alone. Thus, neuropsychological measures may be a useful component of early ADHD assessments, but should be used with caution and in combination with other assessment methods.

vorige artikel Associations between Infant Behaviors during the Face-To-Face Still-Face Paradigm and Oppositional Defiant and Callous-Unemotional Behaviors in Early Childhood

volgende artikel Pre- and Perinatal Risk for Attention-Deficit Hyperactivity Disorder: Does Neuropsychological Weakness Explain the Link?

Numerical Memory II which involves repeating digits backwards was administered to children; however, the majority of children were not able to successfully complete any items, so only part 1 was used.

We chose these cutoffs as they balanced specificity and sensitivity. However, we also explored clinical cutoffs (scaled score of 7) for the four subtests (three NEPSY subtests and K-ABC Hand Movement) that have them. In each case even though OPP was similar to the OPP for the cutoffs we used, there was an imbalance between specificity (0.89–0.97) and sensitivity (0.08–0.18).

The group of children who were not able to complete each measure was compared to the group of children who successfully completed the measure on T4 inattentive and hyperactive/impulsive symptoms. Children who completed the KABC Hand Movement subtest had significantly higher hyperactive/impulsive symptoms (4.02) than children who did not complete this subtest (3.00), t(161) = 2.14, p = 0.03. For all other measures, children who did and did not complete the measure did not differ on ADHD symptoms, all ps > 0.07.

None of the individual indicators that comprise the K-CPT ADHD Confidence Index significantly predicted whether at-risk children later met criteria for ADHD. Additionally, each indicator alone displayed poor sensitivity, specificity, NPP, PPP, and OPP (values range from 0.39 to 0.57). This is likely because aggregating measures (e.g., combining measures to create the Confidence Index) often increases reliability and validity.

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Titel: Preschool Neuropsychological Measures as Predictors of Later Attention Deficit Hyperactivity Disorder
Auteurs: Rosanna P. Breaux
Shayl F. Griffith
Elizabeth A. Harvey
Publicatiedatum: 03-03-2016
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 8/2016
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-016-0140-1

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