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Neurocognitive and Symptom Trajectories of ADHD from Childhood to Early Adolescence

Murray, Andrea L. PhD*; Robinson, Thomas PhD; Tripp, Gail PhD*

Journal of Developmental & Behavioral Pediatrics: September 2017 - Volume 38 - Issue 7 - p 465–475
doi: 10.1097/DBP.0000000000000476
Original Articles
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Objective: This longitudinal study investigated changes in neurocognitive functioning from childhood to early adolescence in a sample of children diagnosed with DSM-IV attention-deficit hyperactivity disorder (ADHD). It also compared the neurocognitive trajectories of children who continued to meet the diagnostic criteria for ADHD at follow-up and those in partial remission.

Methods: Children diagnosed with ADHD (N = 55) were tested at baseline (M = 7.7 years, SD = 1.5) and 4 years later (M = 11.7 years, SD = 1.5) on measures of intellectual, academic, and executive functioning. Group and individual analyses were used to examine neurocognitive functioning over this period.

Results: Intellectual function was stable over the 4-year interval. Reliable change analyses highlighted variability in academic performance. Approximately half the sample showed a reliable decline in at least 1 academic subject with almost a third showing reliable improvement. Executive functions generally followed a stable or improving course, with significant improvements on measures of information processing, attentional control, cognitive flexibility, and goal setting. There was some evidence of better neurocognitive performance in those with partial symptom remission at follow-up.

Conclusion: Study findings emphasize the importance of monitoring academic performance in children with ADHD, including examination of change at the individual level. Declines in academic performance were observed, despite stable intellectual and improving executive function. Early cognitive functioning did not predict symptom remission; however, reduced symptoms at follow-up were associated with better executive function.

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*Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, Okinawa, Japan;

Department of Psychology, University of Otago, Dunedin, New Zealand.

Address for reprints: Gail Tripp, PhD, Human Developmental Neurobiology Unit, Okinawa Institute of Science and Technology Graduate University, Onna, Onna-son, Kunigami-gun, Okinawa 904-0411, Japan; e-mail:

Data collection for this study was supported by funding from the New Zealand Neurological Foundation and the University of Otago, manuscript preparation by internal subsidy funding from the Okinawa Institute of Science and Technology Graduate University. T. Robinson was supported by a University of Otago Postgraduate Scholarship.

Disclosure: The authors declare no conflict of interest.

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Received September , 2015

Accepted May , 2017

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