Attention Deficit Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed of child clinical syndromes and is associated with poor academic achievement, poor peer and family relations, and an elevated risk for anxiety, depression, and conduct disorder (Barkley ,1990; Barkley, Guevremont, Anastopoulos, DuPaul, & Shelton, 1993; Barkley, Murphy, & Kwasnik, 1996; Beiderman, Faraone, & Lapey, 1992; Fischer, Fischer, et al., 1990; Hinshaw, 1994; Nadeau 1995; Weiss & Hechtman, 1993). Although ADHD is one of the most commonly diagnosed and widely researched disorders, the diagnostic criteria and defining characteristics of ADHD remain controversial (Wolraich, 1999). The current diagnostic formulation, as specified by the DSM-IV-TR, includes three distinct subtypes: Attention Deficit Hyperactivity Disorder- Predominantly Hyperactive Impulsive Type (ADHD-H), Attention Deficit Hyperactivity Predominantly Inattentive Type (ADHD-PI) and Attention Deficit Hyperactivity Disorder- Combined Typed (ADHD-C). Perhaps the most controversial aspect of the current nosology is the inclusion of the inattention symptoms within the family of ADHD diagnoses (Milich, Balentine, Lynam, 2001). Researchers and clinicians have further posited that ADHD-PI represents a distinct disorder with two subtypes: inattentive-disorganized and sluggish cognitive tempo. This study explored the relation between reading fluency, sluggish cognitive tempo symptoms, disorganized symptoms, processing speed and ADHD diagnosis. This study examined performance of children diagnosed 77 children diagnosed with ADHD (i.e. 53 participants met criteria for ADHD-PI and 24 participants met criteria for ADHD-C) on measures of cognitive functioning, processing speed, behavioral reports, sluggish cognitive tempo, disorganization and reading fluency. Significant group differences did not emerge on measures of processing speed, sluggish cognitive tempo symptoms or disorganized symptoms. Path analysis was employed to examine the simultaneous effects of processing speed on inattention symptoms, hyperactive/impulsive symptoms, SCT symptoms, DO symptoms, reading fluency, and internalizing symptoms. In addition, the paths from SCT symptoms, DO symptoms, inattention symptoms, and hyperactive/impulsive symptoms to reading fluency and internalizing symptoms were also be examined. Processing speed had a significant direct effect on SCT symptoms, Inattention Symptoms and Reading Fluency. In addition, SCT symptoms had a significant direct effect on anxiety symptoms. In summary, findings from the study provide important information about the link between processing speed, attention written, and reading fluency. Limitations of the study and implications for future research and practice are discussed. / text

Adolescents with Sluggish Cognitive Tempo (SCT) show symptoms of slowness, mental confusion, excessive daydreaming, low motivation, and drowsiness/sleepiness. Although many symptoms of SCT reflect internalizing states, no study has evaluated the utility of self-report of SCT in an ADHD sample. Further, it remains unclear whether SCT is best conceptualized as a unidimensional or multidimensional construct. In a sample of 262 adolescents comprehensively diagnosed with ADHD, the present study evaluated the dimensionality of a SCT scale and compared CFA and bifactor model fits for parent- and self-report versions. Analyses revealed the three-factor bifactor model to be the best fitting model. In addition, SCT factors predicted social and academic impairment and internalizing symptoms. Therefore, SCT as a multidimensional construct appears to have clinical utility in predicting impairment. Also, multiple reporters should be used, as they predicted different areas of functioning and were not invariant, suggesting that each rater adds unique information.

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Sluggish cognitive tempo (SCT) is a construct that includes symptoms of slowness, mental confusion, excessive daydreaming, low motivation, and drowsiness/sleepiness. SCT is often co-morbid with attention-deficit/hyperactivity disorder (ADHD), and SCT symptoms are associated with significant academic and interpersonal impairment above and beyond the influence of ADHD symptoms. Despite the overlap between ADHD and SCT and associated impairments, no studies have evaluated how evidence-based psychosocial interventions for adolescents with ADHD impact symptoms of SCT. This study examined whether SCT symptoms improved in a sample of 274 young adolescents with ADHD who received either an organizational skills or a homework completion intervention. SCT intervention response was evaluated broadly in all participants, and specifically, for participants in the clinical range for SCT symptom severity at baseline. Change in ADHD symptoms of inattention, executive functioning, and motivation was examined as potential predictors of improvement in SCT. Multilevel modeling analyses indicated that SCT symptoms decreased at the same rate for adolescents in both the organizational skills and homework completion interventions when compared to the waitlist group (d = .410). For adolescents with parent-reported clinical levels of SCT, the decrease in symptoms was more pronounced (d = .517), with the interventions decreasing the total score of SCT by 2.91 (one symptom). Additionally, in the high SCT group, behavior regulation executive functioning, metacognitive executive functioning, and inattention predicted change. Clinical implications and future directions are discussed, including development of interventions for adolescents with high levels of SCT.

<p>Årligen slutar 30 procent av eleverna gymnasieskolan utan betygsbehörighet. På individuella program (IV) är siffran 85 procent. För att kartlägga skolsituationen för en elevgrupp på IV-programmet intervjuades 24 elever. Utöver detta gjordes en kognitiv bedömning samt en självskattning av upplevd psykisk hälsa. Huvuddelen av eleverna presterade på en ojämn kognitiv nivå, inom normalvariationen. Arton elever bearbetade information långsamt. Eleverna skattade att de mådde psykiskt sämre än normgruppen. De rapporterade tidiga skolsvårigheter som i vissa fall uppmärksammats,men lämnats utan adekvat åtgärd. Elever med långvariga skolproblem,försvårande additiva faktorer kombinerat med ett begåvningsvärde i normalvariationens nedre spann samt långsamhet vid informationsbearbetning upplever negativa individuella konsekvenser. De negativa effekterna kan mildras med tidiga interventioner på en för eleverna adekvat nivå och beaktat elevernas relativa kognitiva styrkor.</p>

Årligen slutar 30 procent av eleverna gymnasieskolan utan betygsbehörighet. På individuella program (IV) är siffran 85 procent. För att kartlägga skolsituationen för en elevgrupp på IV-programmet intervjuades 24 elever. Utöver detta gjordes en kognitiv bedömning samt en självskattning av upplevd psykisk hälsa. Huvuddelen av eleverna presterade på en ojämn kognitiv nivå, inom normalvariationen. Arton elever bearbetade information långsamt. Eleverna skattade att de mådde psykiskt sämre än normgruppen. De rapporterade tidiga skolsvårigheter som i vissa fall uppmärksammats,men lämnats utan adekvat åtgärd. Elever med långvariga skolproblem,försvårande additiva faktorer kombinerat med ett begåvningsvärde i normalvariationens nedre spann samt långsamhet vid informationsbearbetning upplever negativa individuella konsekvenser. De negativa effekterna kan mildras med tidiga interventioner på en för eleverna adekvat nivå och beaktat elevernas relativa kognitiva styrkor.