Application of ADHD theory outside the laboratory : children's cognitive performance in real-life contexts

[Truncated] One current theory of Attention-Deficit/Hyperactivity Disorder (ADHD) proposes that a primary deficit in behavioral inhibition gives rise to secondary deficits in four executive functions (EF) and motor control. This theory is purported to account for the cognitive and behavioral problems associated with the Combined subtype of ADHD but not those of the Predominantly Inattentive subtype. To date, empirical support for this theory is primarily from laboratory-based cognitive methods. It is not known whether children with ADHD also exhibit deficient inhibition or executive dysfunction in real-life activities. The purpose of the present research was to test current theory by examining behavioral inhibition and EF in children with a diagnosis of ADHD (Combined Type or Predominantly Inattentive Type) in two real-life contexts (videogame play and route tasks at the zoo) as well as during traditional laboratory tasks (Stroop, Wisconsin Card Sorting Task).

Participants included a community sample of 57 boys diagnosed with ADHD (20 Inattentive Type, 37 Combined Type, no diagnosed comorbidity, unmedicated) and 57 non-disordered control boys (matched on age and IQ). Operationally defined measures of behavioral inhibition, specific EF and motor control were derived from real-life indoor and outdoor activities, and assessed under contrasting conditions of low/high working memory and distractor loads.