Effects of Attention-Deficit/Hyperactivity Disorder and Anxiety on Attention, Working Memory, and Academic Achievement in Children and Adolescents: A Structural Equation Modeling Approach

Attention and working memory, two constructs that affect youth who have ADHD and anxiety, are essential in establishing automaticity and success in academic achievement. Using data from a large study involving 502 children and adolescents (332 diagnosed with ADHD, 145 diagnosed with anxiety disorder, and 126 diagnosed with neither), ages 7 to 15 years, this paper applies structural equation modeling to test the sequential relationship between the latent constructs of attention, working memory, and academic achievement, and the effects of symptoms of ADHD and anxiety on each construct, and also to assess consistency in measurement techniques of each underlying construct. The study establishes that the structural equation model created to replicate a theory of automaticity fit the data from this sample well, and there was significant sequential prediction between attention, working memory, and academic achievement. In addition, better performance on measures of attention and working memory predicts higher academic achievement, as relative weaknesses in academic achievement seen in children and adolescents with ADHD can be explained largely by deficits in attention and working memory. Anxiety symptoms were unrelated to attention, working memory, and academic achievement, when controlling for ADHD. However, a significant negative correlation between harm avoidance, a trait of anxiety, and ADHD symptoms suggest that it may be of value to explore the theoretical underpinnings of the relationship between harm avoidance, ADHD, and academic achievement