Impact of executive function deficits and attention deficit/hyperactivity disorder

The association between executive function deficits (EFDs) and functional outcomes were examined among children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Participants were children and adolescents with (n 259) and without (n 222) ADHD, as ascertained from pediatric and psychiatric clinics. The authors defined EFD as at least 2 executive function measures impaired. Significantly more children and adolescents with ADHD had EFDs than did control participants. ADHD with EFDs was associated with an increased risk for grade retention and a decrease in academic achievement relative to (a) ADHD alone, (b) controlled socioeconomic status, (c) learning disabilities, and (d) IQ. No differences were noted in social functioning or psychiatric comorbidity. Children and adolescents with ADHD and EFDs were found to be at high risk for significant impairments in academic functioning. These results support screening children with ADHD for EFDs to prevent academic failure. Among the family of mental processes that comprise neuropsy-chological functioning is the set of higher cortical abilities referred to as executive functions (EFs). This construct has been defined as “the ability to maintain an appropriate problem set for attainment of future goals ” (Welsh & Pennington, 1989, p. 201) and includes such abilities as components of attention, reasoning, planning, inhibition, set-shifting, interference control, and working memory (Pennington & Ozonoff, 1996). EFs are considered to be critically important for complex human behavior, and their breakdown is thought to commonly result in behavioral or psychiatric impair-ment (Goldberg & Seidman, 1991). Studies of Alzheimer’s diseas