The Cambridge Cognitive Examination for Down's Syndrome (CAMCOG-DS) was developed to assess cognitive functioning and dementia-related cognitive decline in people with Down's Syndrome (DS). It has been translated into different languages and is often used in international studies. Although adapted for people with intellectual disabilities (ID), many tasks involve verbal responses and instructions are presented orally. Therefore, the administration for people with severe language deficits can be challenging. The aim of this retrospective data analysis is to examine the influence of language ability and reasoning on CAMCOG-DS performance. Study 1 examined the relationship between CAMCOG-DS, picture naming, single word comprehension and reasoning in adults with DS. Study 2 replicates and broadens the findings in a sample of children and adults with DS.

Study 1 included 40 adults with DS between 18 and 51 years (M = 28.6, SD = 8.4). 25 had a mild and 15 a moderate ID. CAMCOG-DS, the short form of the Boston Naming test (BNT), a test for single word comprehension from the Werdenfelser Testbatterie (WTB) and the Colored Progressive Matrices (CPM) were administered. Study 2 included 38 participants between 8 and 59 years (23 children, M = 11.4; 15 adults; M = 31.3). 3 had a borderline, 23 a mild, and 12 a moderate ID. The same tasks as in Study 1 were applied, but the CPM was replaced by its successor, the Raven's 2.

In Study 1, participants with mild ID performed better in all tasks than those with moderate ID (p < .05). Moderate relationships were found between CAMCOG-DS total score and the language tasks (r = .56 and r = .46), which remained significant when level of ID was controlled for. There was also a moderate relationship between CAMCOG-DS and reasoning (r = .46). Regression analysis showed that BNT performance predicted CAMCOG-DS performance (R2 = .31). In Study 2, those with mild ID, compared to those with moderate ID, performed better in all tasks (p < .05), however, regarding the CAMCOG-DS and language tasks, this effect was larger in adults than in children. Adults performed better than children in the CAMCOG-DS and BNT (p < .05), but not in single word comprehension or reasoning. As in Study 1, moderate to large correlations were revealed between CAMCOG-DS and language tasks and between CAMCOG-DS and reasoning (r > .52), remaining significant when age and ID level were controlled for. Regression analysis showed that both naming and reasoning but not single word comprehension or age predicted CAMCOG-DS performance (R2 = .69), however, performance was best predicted by naming (R2 = .65).

Our results suggest that language ability and reasoning relate to CAMCOG-DS performance, which is best predicted by BNT picture naming. This should be considered in CAMCOG-DS interpretation, as the capabilities of patients with lesser language ability might be underestimated. Future developments of dementia assessments for people with ID should include more nonverbal tasks.

An effective support system for families with children with an Autism Spectrum Disorder (ASD) consists of multiple methods of educational and therapeutic delivery. Such methods are adapted to meet a family’s needs and needs of the time, like the COVID-19 pandemic. Individualized Educational Plan (IEP) are established by schools to support success in academics for children with ASD. IEPs can vary depending on the district and accessibility, thus, the effective implementation and communication between this support system is important for its success. The current case study examines academic and therapeutic outcomes of an IEP implementation during hybrid learning of a child with ASD and their family.

Purposeful sampling identified a participant from a previous IRB approved study through the UNLV Educational Psychology program that interviewed parents on their remote learning experience. A qualitative case study was applied to further investigate student outcomes. Parent interview and the child’s progress report were coded and analyzed systematically. The identified family included correspondence from the mother (Lisa, 37) and her son (Noah, 9). Noah attended third grade at a Charter School and was diagnosed with ASD in 2019. His IEP included 80% in General Education (online) with Special Education assistance (in person; reading, writing, and mathematics) and Occupational (OT), Speech/Language (SLP), and Physical Therapy (PT) (hybrid).

Noah began hybrid learning in October 2020, with in-person learning two days a week and remote learning everyday for two to three hours each day. Progress report and interview were collected in April 2021 at the halfway point of his IEP implementation which described Noah’s current special education and therapy services goals/outcomes in March 2021. This included 11 goals that were observed and assessed in OT (2), PT(2), Reading (2), Writing (1), Math (2), and SLP (2). Noah progressed in 9 of 11 goals, with 1 being met and 8 classified as satisfactory by displaying some improvement in respective skills mid year. The remaining OT (2) goals showed no definitive conclusion. Lisa mentioned that lack of direct observation of particular skills and too many online classes to attend led to inconclusive outcomes. Lisa and Noah came across difficulties while engaging in OT online sessions encountering emotional stress when adjusting to the mode of delivery. Lisa expressed positive emotions when referring to the support system and described it as collaborative with adequate attention to multiple aspects of his development. She voiced understanding of her’s and other professionals’ role and the extent of their abilities in the context of the pandemic.

Of the 11 IEP goals, there was adequate progress for the child amid hybrid learning. The parent preferred that OT be delivered in person as certain procedures require direct contact and affected outcomes. Hybrid learning has allowed for parents to directly access their children’s endeavors and heighten communication with professionals. This suggests that maintenance of IEP standards can be satisfactory in a hybrid learning model with adequate monitoring from parents and treatment teams for children with ASD.

Attention plays a key role in auditory processing of information by shifting cognitive resources to focus on incoming stimuli (Riccio, Cohen, Garrison, & Smith, 2005). Mood symptoms are known to affect the efficiency with which this processing occurs, especially when consolidation of memory is required (Massey, Meares, Batchelor, & Bryant, 2015). Without proper focus on relevant task information, improper encoding occurs, resulting in negatively affected performances. This study examines how depression, anxiety, and stress moderate the relationship between auditory attention and verbal list-learning.

Archival data from 373 adults (Mage= 56.46, SD=17.75; Medu = 15.45, SD=2.2; 54% female; 74% white*) were collected at an outpatient clinic. Race was not available in a small percentage of cases included in analyses. Auditory attention was assessed via the Brief Test of Attention (BTA). Learning was assessed via the California Verbal Learning Test (CVLT-II) total T-Score (Trials 15). Mood was assessed via the Depression Anxiety and Stress Scales (DASS-42). A moderation analysis was conducted utilizing the DASS-42 as the moderator between the relationship of BTA and CVLT-II.

Block 1 of the hierarchical regression was significant in that BTA contributed significantly toward verbal learning on the CVLT-II (F(1, 378)=30.141, p =<.001 , AR2=.074). The standardized beta weight and p-value for BTA were (ß=.272, p<.001). When DASS variables were introduced into Block 2, the model remained significant F(3, 375)=4.227, p =.006 , AR2=.030). The DASS Anxiety subscale had significant beta weights in the model (ß=-.210 p=.004), whereas Depression and Stress were not significant (ß=.039, p=.563) and (ß=.021, p=.765), respectively.

The current study examined whether mood symptoms affect the relationship between auditory attention and verbal learning. Present results confirm previous research that auditory attention has a significant impact on verbal learning (Massey, Meares, Batchelor, & Bryant, 2015; Weiser, 2004). Building upon prior research, these results indicate that when accounting for auditory attention, clinicians should be aware of possible confounds of anxiety, which may artificially suppress auditory attention. In some circumstances, a differential diagnosis may require consideration that absent anxiety auditory attention may be within normal range. Continued assessment and evaluation regarding the impact of anxiety is crucial for neuropsychologists when examining performances on verbal learning.

Continuous performance tests (CPT) are often considered the gold standard for the diagnosis attention-deficit/hyperactivity disorder (ADHD), particularly when parent and teacher rating scales are inconclusive. Prior work has indicated that CPT can also help differentiate between ADHD subtypes. However, the ability of CPT to differentiate ADHD subtype has not been examined among youth with comorbid ADHD and anxiety (ADHD+A). This is particularly concerning as the extant literature suggests that anxiety symptoms may exacerbate deficits associated with ADHD (e.g.. , working memory, attention) and attenuate others (e.g., inhibition); thus, anxiety may influence expected patterns on the CPT. This study therefore seeks to examine the role of ADHD subtype on the relationship between ADHD+A and performance on a CPT among youth with ADHD+A.

Participants included 54 children ranging from 6 to 20 years old (Mage=11.83, 54% female) who were diagnosed with ADHD+A via neuropsychological evaluation. In terms of ADHD subtype, 51.9% (n=28) were diagnosed with ADHD combined or ADHD primarily hyperactive and 48.1% (n=26) were diagnosed with ADHD primarily inattentive. Approximately 46.30% (N=25) of participants were medication naive. Analyses were conducted using data from the Conners Kiddie Continuous Performance Test -Second Edition (KCPT-2), Conners Continuous Performance - Second Edition (CPT-2) and the Conners Continuous Performance - Third Edition (CPT-3), which are part of the same family of performance-based attention measures. Independent samples t-tests were conducted to examine performance differences in aspects of attention (e.g., inattentiveness, sustained attention) and hyperactivity (e.g., impulsivity, inhibition).

ADHD subtype was not significantly related to measures of inattentiveness. This includes the number of targets missed (omissions; (t(39)=-.532, p=.59)) and variability in response time (variability; (t(39)=-0.30, p=.77)). In terms of sustained attention, ADHD subtype was not related to variability in response speed across blocks (Hit SEBC/HRT Block Change; (t(39)=-0.26, p=.79)). Importantly, these results were consistent regardless of ADHD medication status. ADHD subtype was also not significantly related to impulsivity. This includes responses to nontargets (commissions; (t(39)=-1.05, p=.30)), random or anticipatory responding (perseverations; (t(39)=-0.19, p=.85)), and mean response speed of correct responses (HR; (t(39)=-0.72, p=.48)).

The extant literature suggests that CPT can help clinicians differentiate between ADHD subtypes. However, the results of this study indicate that there are no performance differences on the CPT among youth with comorbid ADHD and anxiety. There are several limitations to consider. First, this study had a relatively small sample size, which also limited the ability to examine ADHD primarily hyperactive/impulsive as a distinct subtype. Additionally, this study did not examine the effect of individual anxiety disorders (i.e., generalized anxiety disorder, specific phobias). Finally, these findings may not generalize to other standardized measures of attention or more ecologically valid measures. Despite these limitations, this study is an important step in understanding the relationship between ADHD+A and performance on attention measures. Clinicians should be cautious in using results from CPT to distinguish between ADHD subtype among children with comorbid anxiety.

Sluggish cognitive tempo (SCT) is an attentional disorder characterized by excessive daydreaming, reduced alertness, slowed motor behavior, and mental fogginess. The purpose of the present study was to examine potential executive functioning group differences between children with high SCT symptoms versus those with low SCT symptoms. It was hypothesized that children with high SCT symptoms would have greater executive functioning deficits than children with low SCT symptoms, as reported by their teachers.

There were 32 children in this study, between the ages of 6 to 13 (M = 8.94; SD = 1.97). To measure the level of SCT symptomology, an average rating on four items from the Child Behavior Checklist (CBCL; Items 13, 17, 80, 102) and an average rating from five items from the Teacher's Report Form (TRF; Items 13, 17, 60, 80, 102) were acquired and averaged to produce a combined measure of SCT. The present study had fair to good reliability for CBCL and TRF with Cronbach alpha values of .71 and .82 respectively. Eighteen participants had SCT scores above the Garner et al. (2010) cutoff criteria for the CBCL (SCT over 0.67) or the TRF (SCT over 0.75) which placed them in the high SCT group. The 13 participants who did not meet criteria for high SCT were considered the low SCT group. To measure executive function, Behavior Rating Inventory of Executive Function (BRIEF) teacher ratings were used. A general linear model multivariate analysis was conducted on each measure of the BRIEF teacher reports with ADHD-Inattentive (ADHD-IN) and Verbal Comprehension Index (VCI) scores as covariates.

There were significant group differences between the BRIEF Teacher Global Executive Composite scores of the high SCT group (M = 60.81, SD = 7.78) versus the low SCT group (M = 50.31, SD = 6.87), F(1, 30) = 11.73, p < .001, np2 = .59. The high SCT group scored significantly higher than the low SCT group on the Initiate (p < .001), Working Memory (p < .001), Plan/Organize (p < .001), Monitor (p < .01), and Organization of Materials (p < .05) subscales. These findings indicate that the children in the high SCT group had greater executive functioning difficulties overall than the low SCT group.

Children with high SCT symptoms demonstrated greater executive functioning deficits than children with low SCT symptoms regarding metacognition but not behavioral regulation. This means that children with SCT likely struggle more with initiating tasks, planning, organization, memory, and monitoring their thinking and behaviors than children without SCT. These skills are important for learning, which may at least partially help explain why children with SCT experience problems in school.

Accumulating evidence from case-control and population studies suggests attention-deficit/hyperactivity disorder (ADHD) confers a 2- to 5-fold risk of all-cause dementia later in life. Here, we investigate vascular burden as a potential mediator of this relationship, because vascular integrity is well known to be compromised in ADHD (due to chronic obesity, diabetes, and hypertension) and is also a robust risk factor for neurodegeneration (due to reduced cerebral blood flow). We use brain white matter hyperintensities (WMH) as a measure of vascular burden.

Thirty-nine adults aged 48-81 years with clinical ADHD, and 37 matched controls, completed neuropsychological testing and 1.5 T structural neuroimaging. None had stroke. Cognitive tests were demographically-adjusted to Z scores using regression-based norms generated from the control group, and averaged across tests within domains of short- and long-term verbal memory (forward digit span, California Verbal Learning Test, Logical Memory), visual memory (Visual Recognition, Rey Complex Figure), processing speed (coding, trails A, Stroop word-reading and color-naming), language (Boston Naming Test, semantic fluency), visuoconstruction (clock drawing, Rey Complex Figure copy), and executive function (backward digit span, trails B, phonemic fluency, Stroop inhibition, Wisconsin Card Sorting Test). Total WMH volumes (i.e., combined periventricular and deep) within subcortical, temporal, frontal, parietal, and occipital regions were individually divided by regional volumes to produce a proportion of each region representing WMH, then log-transformed to correct for skew. Age-corrected linear regression quantified total effects of ADHD on cognition; when these were significant, mediation models quantified the direct effects of ADHD on WMH volumes and the direct effect of WMH volumes on cognition. Sobel’s test estimated indirect effects of ADHD on cognition via WMH.

Group had a significant total effect on Processing Speed (ß=-1.154, p<.001) and on Executive Functioning (ß=-0.587, p=.004), where ADHD participants had lower composite scores (M=-1.10, SD=1.76 and M=-0.54, SD=1.14 respectively) than controls (M=0.02, SD=0.74; M=0.00, SD=0.49). Only frontal-lobe WMH had direct effects on Processing Speed (ß=-0.315, p=.012) and Executive Functioning (ß=-0.273, p<.001). The direct effect of ADHD on frontal WMH was significant (ß=-0.734, p=.016), and Sobel’s tests supported an indirect effect of ADHD on Executive Functioning (z=2.079, p=.038) but not Processing Speed (z=1.785, p=.074) via WMH. Because the effect of ADHD on WMH was negative (i.e., fewer WMH in ADHD) despite worse cognition than controls, we tested the a posteriori hypothesis that WMH burden may be relatively more deleterious for ADHD than controls. We found considerably stronger negative correlations between total WMH volumes and Processing Speed (r=-.423, p=.009) and Executive Functioning (r=-.528, p<.001) in the ADHD group than in controls (r=-.231, p=.175 and r=-.162, p=.346, respectively), even though total whole-brain proportion of WMH (M=0.15%, SD=0.27; Mann-Whitney l/=430.0, p=.002) and frontal-lobe proportion of WMH volumes (M=0.33%, SD=0.51; Mann-Whitney U=464.0, p=.007) were lower in ADHD than in controls (M=0.29%, SD=0.42 and M=0.66%, SD=0.88, respectively).

WMH burden contributes significantly to the relationship between ADHD and cognition, but ADHD remains an independent contributor to worse processing speed and executive functioning in older adults. Vascular burden may have relatively more deleterious effects on cognition in ADHD, potentially due to decades of accumulated allostatic load, whereas healthy controls can accumulate greater amounts of WMH before cognition is impacted.

Several studies have found a bilingualism advantage on executive functioning tasks like cognitive flexibility, inhibitory control, switching, and working memory in typically developing populations. (Grote et al., 2015, Foy & Mann, 2014). However, some studies have found deficits in inhibitory control and switching for bilingual individuals with Attention Deficit/Hyperactivity Disorder (ADHD) compared to monolingual individuals and control groups (Bialystok et al., 2017, Mor et al., 2015). They suggest that this disadvantage is due to the burden of managing two language systems which perpetuates the executive dysfunction seen in ADHD. The current study aims to examine if there is a bilingualism advantage in other aspects of executive function, including inhibitory control, planning, problem solving, switching, and working memory among children and adults diagnosed with ADHD.

The medical records of 170 patients evaluated in an outpatient neuropsychology clinic from 20182022 were reviewed. Sixty participants diagnosed with ADHD, between the ages of 6 and 46 (61.67% male), comprised the final sample. Forty-one were monolingual and 19 were bilingual or multilingual. Language status was based upon patient or parental report. Outcomes on various direct and indirect measures of executive function were examined.

Linear regression models, adjusting for age and sex, revealed a significant bilingual advantage on the following measures: Wechsler Intelligence Scale for Children- Fifth Edition (WISC-V) and Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) Digit Span Backwards and Digit Span Sequencing, WISC-V Picture Span, and Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF-2) Parent-Report Emotion Regulation Index (ERI). There were no significant differences in scores between monolinguals and bilinguals on the following measures: Delis-Kaplan Executive Function System (D-KEFS) Color-Word Interference Inhibition versus Combined Naming Contrast Score and Inhibition/Switching versus Inhibition Contrast Score, D-KEFS Trail Making Number-Letter Switching versus Combined Number Sequencing and Letter Sequencing Contrast Score, A Developmental Neuropsychological Assessment, 2nd Edition (NEPSY-2) Naming versus Inhibition Contrast Score and Switching versus Inhibition Contrast Score, Wisconsin Card Sort Task Learning to Learn Index, BRIEF-2 Parent-rated Behavioral Regulation Index (BRI), Cognitive Regulation Index(CRI), and Global Executive Composite(GEC), BRIEF-2 Self-rated BRI, ERI, CRI, and GEC, or BRIEF Adult Version BRI, Metacognitive Index, and GEC.

Bilingual status is associated with stronger auditory and visual working memory among people with ADHD, but not with stronger inhibitory control, switching, planning, or problem solving skills. At the same time, there were no significant differences between monolingual and bilingual ADHD patients on BRIEF parent- or self-rated behavioral or cognitive dysregulation. Our results suggest that bilingualism may confer an advantage in some aspects of executive function among a population with weak attention and executive function skills more broadly. Furthermore, we did not find any type of disadvantage for those who are bilingual. Future studies should examine whether lower parental ratings of emotion dysregulation among ADHD patients who are bilingual are due to bilingual children’s better ability to adapt to different situations or cultural differences in parenting practices.

Attention of the research community on childhood cancer has grown exponentially over the last 5 decades (Robinson & Hudson, 2014). With research attention growing rapidly, cure rates have increased just as dramatically, with survivorship well over 80% (Ward, et al., 2014). With survivorship on the rise, research has turned to the examination of late effects in survivors of childhood cancer, especially neuropsychological late effects (Krull, et al., 2018). Late effects, functional impairment, and the awareness of one’s own impairment can create several lasting issues in a survivor’s life (Oeffinger, et al., 2010). The objective of this study is to explore the feasibility and functionality of a group intervention for this population.

Participants were recruited from a pediatric cancer institute in southern California. To be considered for inclusion, participants must have completed curative treatment for childhood cancer, not be currently undergoing treatment for childhood cancer, be free of any severe and persistent mental illnesses, and have access to a stable internet connection (for Zoom sessions). This study examined the impact of an Acceptance and Commitment Therapy (ACT)-based group intervention protocol on survivors of childhood cancer. Specifically, this study explored a strategy to identify early neuropsychological late effects and a strategy to improve these impacts. The group intervention was conducted via Zoom (www.zoom.us) which provided an opportunity to continue to provide this service in the wake of COVID-19. Data was collected at baseline and at the completion of the group intervention. This data focused on the functional and perceived impacts of neuropsychological sequelae in these participants, as well as the changes as related to the group intervention.

Data did not show any significant changes from baseline to follow-up in this population. The lack of significance was likely due to a severely truncated sample size. Despite the lack of significant findings, data appears to trend negatively. Although these findings do not provide conclusive evidence for this ACT-based group as an intervention for neuropsychological late effects in survivors of childhood cancer, the data suggested some interesting trends which will be explored further in this presentation.

The results of this study help to further explore the importance of attention to neuropsychological symptoms and issues in survivors of childhood cancer, especially within the first few years following the completion of treatment. As survivorship continues to increase, it will be of utmost importance to continue to examine the impact of neuropsychological late effects and how the field of neuropsychology can best serve this population. This study was severely limited by a small sample size, a single clinician providing the protocol, and a truncated timeline. Further research will examine the impact of this study protocol in a larger sample size, which will likely increase the ability to reject the null hypothesis. In addition, future research must also be conducted to better explore strategies of early and consistent neuropsychological intervention in this population.

There has been relatively little research on the effect of childhood attention difficulties/weaknesses and learning disabilities/differences on cognitive aging. This study examined associations between self-reported symptoms and diagnoses/concerns of childhood attention deficit hyperactivity disorder (ADHD) and reading or math learning disabilities (LD) and cognitive abilities in older adulthood. We hypothesized that cognitive weaknesses in childhood would be associated with cognitive abilities later in life.

The 25 individuals with healthy cognition or MCI were recruited from the greater Philadelphia area (Mage= 74.4; SD= 5.34; 40% men; 84%white) and completed a self-report questionnaire of childhood ADHD and LD. Specifically, participants rated their experience of ADHD symptoms of inattention and hyperactivity/impulsivity and indicated whether they had a past diagnosis of (or concerns regarding past) ADHD, math LD or language/reading LD Participants also completed tests of language, attention, episodic memory, executive function, and processing speed. Pearson or point-biserial correlation coefficients (r-values) indicating a medium effect size (.30 or greater) were interpreted as meaningful.

On average, participants reported 3.48 symptoms of inattention and 2.56 symptoms of hyperactivity/impulsivity (i.e., at least six symptoms from either category are consistent with diagnostic criteria for ADHD). 16% of the sample reported childhood ADHD/attention difficulties, 48% reported childhood math LD/math difficulties, and 32% reported childhood language LD/difficulties. On cognitive tests, the sample performed in the average range, with considerable variability (i.e., norm-based, demographically adjusted T-scores ranged from 20-74). The relation between cognitive scores and report of childhood ADHD symptoms was weak and non-significant correlation (r<.18). By contrast, report of childhood ADHD/attention difficulties was associated with lower scores attention tests (r=.33). Report of childhood language LD/difficulties was associated with a worse overall cognitive composite (r=-.35) and executive function ability (r=-.35). Childhood math LD/difficulties was not meaningfully associated with lower scores on any of the cognitive tests administered. Unexpectedly, report of childhood cognitive difficulties also were associated with higher scores on cognitive tests, such that childhood ADHD/attention difficulties was associated with better performance on tests of episodic memory (r=.39), and childhood math LD/difficulties were associated with better performance on tests of language (r=-.37).

Current cognitive abilities in older adults may be influenced by lifelong cognitive weakness and academic difficulties. A history of ADHD and LD/difficulties should be considered in clinical neuropsychological assessment and future research on cognitive aging should consider ADHD/LD from a lifespan, developmental framework.

Neurobiological and cognitive theories implicate deficits in executive function (EF) as a core facet of both depressive disorders and attention-deficit/hyperactivity disorder (ADHD), but empirical investigations inconsistently support this conclusion. Despite recognition of the likely bi-directional relationship of EF deficits to depression and ADHD, respectively, the extent to which comorbid depression might impact EF in adults remains unclear, considering more of the literature has examined children and adolescents. This study examined performance differences on EF measures in clinically-referred adults diagnosed with ADHD or a non-ADHD primary psychopathological condition in the presence/absence of comorbid depression.

This cross-sectional study included data from 404 adults referred for neuropsychological evaluation at a Midwestern academic medical center. In total, 343 met DSM-5 diagnostic criteria for ADHD (ADHD-all group:164 Predominantly Inattentive presentation [ADHD-I] and 179 Combined presentation [ADHD-C]) and 61 met criteria for a non-ADHD primary psychopathological condition (psychopathology group: 31 mood disorder, 17 anxiety disorder, and 13 posttraumatic stress disorder) when assessed via semi-structured clinical interview. All patients completed the Beck Depression Inventory-Second Edition (BDI-II) and five EF tests: Letter Fluency, Trail Making Test-Part B (Trails-B), Stroop Color and Word Test Color-Word trial (SCWT CW); and WAIS-IV Working Memory Index (WMI). Oneway MANOVAs assessed for significant EF differences between groups with high (BDI-II greater than or equal to 20) or low (BDI-II less than or equal to 19) depressive symptoms.

When group diagnosis (ADHD-all vs. psychopathology) was examined in the context of high or low depression, a significant difference in EF performance emerged between groups, F(12, 1042.72)=2.44, p<.01, Wilk's A=.93, partial n2=.02, with univariate analyses indicating a significant difference in FAS-T between at least two of the groups (F(3, 397)=3.92 , p< .01, partial n2=.03). Tukey's HSD Test for multiple comparisons found that the mean value of FAS-T was significantly different between the ADHD-high depression and ADHD-low depression groups (p=.046 , 95% CI = [5.81, -.04]) as well as between the ADHD-low depression and psychopathology-high depression groups (p=.05, 95% CI = [-8.89, .00]). A one-way MANOVA examining differences between groups when distinguishing ADHD by subtype revealed a statistically significant difference in EF performance between groups, F(20, 1301)=1.85, p<.05, Wilk's A=.91, partial n2=.02, with univariate analyses indicating a statistically significant difference in FAS-T between at least two of the groups (F(5, 395) = 2.39 , p<.05, partial n2 = .03). However, Tukey's HSD Test for multiple comparisons found that the mean value of FAS-T was not significantly different between any of the groups.

Overall, results indicate that clinically-referred patients with ADHD perform comparably on tests of EF regardless of the presence or absence of comorbid depression. These findings have implications for conceptualizing EF weaknesses in neuropsychological profiles for individuals with ADHD and suggest examining factors beyond comorbid depression.

While attention-deficit/hyperactivity disorder (ADHD) symptoms, including inattention, hyperactivity, and impulsivity, are normally distributed within the population, features of ADHD have been associated with poor functional outcomes across various domains of life, such as academic achievement and occupational status. However, some individuals with even strong ADHD features show normal or above-average success within these functional domains. Executive dysfunction and emotion regulation abilities are associated with educational attainment and occupational status and may therefore explain some of the heterogeneity in functional outcomes in individuals with mild, moderate, and high levels of ADHD symptoms. In this study, we investigated whether emotion regulation strategy use (i.e., emotion suppression or cognitive reappraisal) and executive function abilities moderate the relationship between ADHD symptoms and occupational status and education attainment in adults.

Data were collected from 109 adults aged 18 - 85 (M = 38.08, SD = 15.54; 70.6% female) from the Nathan Kline Institute Rockland Sample. All participants completed measures of ADHD symptoms (Conners Adult ADHD Rating Scale), emotion regulation strategy use (Emotion Regulation Questionnaire), and executive functioning (composite scores of inhibition, shifting and fluency from the standardized Delis-Kaplan Executive Function System). In this study, executive function abilities and emotion regulation strategy use were tested as potential moderators of the relationship between ADHD symptoms and functional outcomes using hierarchical regression models.

Several two- and three-way interactions predicting occupational status and educational attainment were observed. Education attainment was predicted by hyperactivity and reappraisal (ß = -0.26, p = .006); inattention, shifting, and reappraisal (ß = -0.52, p = .029); inattention, shifting, and suppression (ß = -0.40, p = .049); inattention, fluency, and reappraisal (ß = 0.24, p = .038); hyperactivity, fluency, and reappraisal (ß = 0.27, p = .034); and impulsivity, fluency, and reappraisal (ß = 0.44, p = .004). Occupational status was predicted by inattention and reappraisal, (ß = -0.27, p = .032), hyperactivity and reappraisal (ß = -0.26, p = .004); and impulsivity, fluency, and reappraisal (ß = 0.35, p = .031). Fluency was positively associated with educational attainment when controlling for inattention and impulsivity.

Consistent with the hypothesis, the association between ADHD symptoms and both occupational status and educational attainment were moderated by the interaction between emotion regulation strategy use, executive function abilities domains. The observed interactions suggest that both occupational status and educational attainment may depend heavily on one’s intrinsic abilities and traits. Contrary to previous literature, we found no evidence that ADHD symptoms, emotional regulation strategies were independently associated with either educational attainment or occupational status, but this should be validated in a sample with greater representation of adults with clinically significant ADHD.

There has been a surge in individuals seeking neuropsychological assessment for attention-deficit/hyperactivity disorder (ADHD) after watching social media created by people claiming to have ADHD. While online content may promote destigmatization of ADHD, self-diagnoses derived from social media use may contribute to the development of inaccurate illness beliefs. Individuals who feel strongly connected to social media that mentions personal anecdotes of ADHD might be more likely to believe they also have ADHD. We examined associations between social media search for ADHD and beliefs about everyday experiences being diagnostic of ADHD among adults concerned about having ADHD, as compared to a control group.

A cross-sectional online study included 320 university students (Mage=19.56±2.92; 72% female; 81% White) without history of ADHD. Participants who reported concern about having ADHD, with (n=43) or without other psychological history (n=73) rated whether 100 experiences taken from social media were diagnostic of ADHD, and then rated the amount of time they spent on social media searching for ADHD content. They then rated how often they personally experienced the symptoms. Participants who reported no concern about having ADHD (n=184) only rated how often they personally experienced the symptoms.

Social media search for ADHD was related to total number of experiences believed to be diagnostic of ADHD among participants concerned about having ADHD without psychological history (r=.28, p=.03), but not for those with psychological history (r=.09, p=.57). For participants concerned about having ADHD (regardless of psychological history), social media search for ADHD was related to total number of symptoms personally experienced (rs=.48-.56, ps<.001) and to the number of symptoms endorsed at a clinical level (rs=.48, ps<.001). Total number of experiences believed to be diagnostic of ADHD was related to the number of symptoms personally experienced among participants concerned about having ADHD with psychological history (r=.53, p<.001; clinical level .47, p=.002), but not for those without psychological history (r=.14, p=.31; clinical level .19, p=.15). Of the 100 symptoms, 56 were believed to be diagnostic of ADHD by at least 50% of participants concerned about having ADHD. Of the 56, 43 were personally experienced at a clinical level by controls. For the 13 remaining symptoms not endorsed at a clinical level by controls, symptoms believed to be diagnostic of ADHD was related to symptoms personally experienced among participants concerned about having ADHD with psychological history (r=.53, p<.001; clinical level .52, p<.001), but not for those without psychological history (r=.14, p=.30; clinical level .19, p=.15).

Greater social media search for ADHD is related to higher symptom report among individuals concerned about having ADHD regardless of psychological history. However, individuals concerned about having ADHD without psychological history who engage in greater social media use appear to be more likely to believe that general symptoms are specifically due to ADHD. These individuals may be more prone to misattribute symptoms to ADHD. Nearly 77% of symptoms rated as diagnostic of ADHD were frequently experienced by individuals without concern about having ADHD, which demonstrates the high base rate of ADHD-like symptoms in the general population.

Individuals with attention-deficit/hyperactivity disorder (ADHD) exhibit deficits in reward-based learning, which have important implications for behavioral regulation. Prior research has shown that these individuals show altered patterns of risky decision-making, which may be partially explained as a function of dysfunctional reactivity to rewards and punishments. However, research findings on the relationships between ADHD and punishment sensitivity have been mixed. The current study used the Balloon Analog Risk Task (BART) to examine risky decision-making in adults with and without ADHD, with a particular interest in characterizing the manner in which participants react to loss.

612 individuals (Mage = 31.04, SDage = 78.77; 329 females, 283 males) were recruited through the UCLA Consortium for Neuropsychiatric Phenomics (CNP). All participants were administered the Structured Clinical Interview for DSM-IV-TR (SCID-IV), which provided diagnoses used for group comparisons between adults with ADHD (n = 35) and healthy controls (n = 577). A computerized BART paradigm was used to examine impulsivity and risky decision-making, while participants also completed the Barratt Impulsiveness Scale (BIS-11), and ADHD participants completed the Adult Self-Report Scale-V1.1 (ASRS-V1.1). The BART presented two colors of balloons with differing probabilities of exploding, and participants were incentivized to pump the balloons as many times as possible without causing them to explode. The primary endpoint was "mean adjusted pumps", determined as mean across trials of the number of pumps on trials that did not end in explosion. An index of reactivity to loss was calculated as the difference between the mean adjusted pumps following an explosion and the mean adjusted pumps following trials in which the balloon did not explode.

The ADHD and control groups did not differ on mean adjusted pumps across trials, but they did differ in their reactivity to explosion of balloons that followed the most pumps, incurring the greatest level of loss (F(1, 551) = 7.1, p < 0.01). Interestingly, ADHD participants showed a greater reactivity to loss on these balloons than controls (p < 0.05), indicating that they reduced their number of pumps following balloon explosions more than controls. For participants as a whole, there were small correlations between loss reactivity and scales of everyday impulsivity on the BIS-II (ps < 0.05). For ADHD participants, loss reactivity was unrelated to symptoms of inattention but was significantly correlated with symptoms of hyperactivity/impulsivity (p = 0.01) and total ADHD symptoms (p < 0.05) on the ASRS-V1.1.

In the context of a risky decision-making task, adults with ADHD showed greater reactivity to loss than controls, despite showing comparable patterns of overall performance during the BART. The magnitude of behavioral adjustment following loss was correlated with symptoms of hyperactivity/impulsivity in adults with ADHD, suggesting that loss sensitivity is clinically related to impulsive behavior in everyday life. These findings help to expand our understanding of motivational processing in ADHD and suggest new insight into the ways in which everyday symptoms of ADHD are related to sensitivity to losses and punishments.

Many children and adolescents do not achieve adequate sleep durations. The prevalence of sleep problems has been estimated at 7% for typically developing children (Corkum, Tannock, & Moldofsky, 1998) and as high as 45% for representative samples of children, including participants with various diagnoses in proportion to what would be expected in the population (Sher-Fen Gau, 2006). For children with ADHD, the prevalence of sleep problems has been estimated at between 25-50% (Corkum, Tannock, & Moldofsky, 1998). Given the important role that sleep plays in children with ADHD, a brief and effective screener is needed to aid clinicians in assessing for sleep problems, especially when the referral for a neuropsychological evaluation concerns ADHD or any other neurodevelopmental disorder for which presenting concerns involve symptoms that overlap with ADHD. While the developers of the BEARS have demonstrated its utility as a screening tool, there is currently no independent published research replicating this finding. The current study aimed to replicate the findings of the BEARS developers by demonstrating its utility as a sensitive screening tool for sleep problems. It was predicted that the BEARS would demonstrate high sensitivity in identifying children with sleep problems.

Data from 54 school aged children (aged 6-147-13, Mage = 9.83) was analysed. Children were administered the BEARS, and caregivers completed the BEARS and Children's Sleep Habits Questionnaire (CSHQ), as part of a larger study.

Binomial logistic regression model was statistically significant, x2(2) = 20.508, p < .0005. The model explained 46.8% (Nagelkerke R2) of the variance and correctly classified 70.8% of cases. Sensitivity was 78.6%, specificity was 60.0%, positive predictive value was 73.3%, and negative predictive value was 66.7%. Both predictor variables, parent reported BEARS (p = .001) and child-reported BEARS (p = .049), were significant. Children with higher BEARS parent report scores had 3.27 times higher odds, and those with higher self-report scores had 2.88 times higher odds, of exceeding the CSHQ cut-off than those with lower scores. ROC curve analysis revealed that the BEARS parent and self-report scores had excellent diagnostic utility (Hosmer et al., 2013) for accurately classifying children who exceeded the cut-off on the CSHQ from those who did not (area under the curve [AUC] = 0.849, SE = 0.054, 95% CI = .742 to .956, p < .001).

The results of the current study indicate that the BEARS has excellent diagnostic utility for accurately classifying sleep problems. Additionally, it is quick to administer making it a practical screening tool for clinicians to include as part of a comprehensive neuropsychological assessment.

Children with attention-deficit/hyperactivity disorder (ADHD) commonly exhibit impairments in their executive functions. Caregivers are primarily responsible for the daily management of their children's ADHD and executive functioning difficulties. Psychoeducation, a cornerstone of ADHD treatment, can empower caregivers by providing them the knowledge and resources they require to support their child with ADHD. This study examined the efficacy of a suite of six caregiver psychoeducation sessions delivered by a specialised ADHD service. Two of these sessions pertained to (i) Understanding ADHD and (ii) Executive Functioning in ADHD. The other four covered information around Family Self-Care and Stress Management, Social Connectedness and Communication, Sensory Processing and Self-Regulation in ADHD and, Medication.

All sessions were delivered between May 2016 and July 2022, in 2 to 3-hour sessions each. Caregivers completed pre and post-session questionnaires, rating (i) their understanding of each of the topics, (ii) whether they identified effective strategies to help their child with ADHD meet their needs, and (iii) whether they improved their knowledge of resources they can access to assist with ADHD management. Altogether, 666 caregiver responses were collected across all sessions, 35% (n=234) of which were from the Understanding ADHD sessions and 4.2% (n = 28) from the Executive Functioning sessions.

Wilcoxon signed-rank tests with Bonferroni adjusted alpha level of 0.016 were conducted to examine each session's pre- and post-session responses. Results showed that the Understanding ADHD workshops impelled significant improvements in attendee-rated levels of topic understanding (z = -8.79, p <.001, r = -.41), strategies gained (z = -8.54, p <.001, r = -.40) and perceived resource accessibility (z = -6.40, p <.001, r = -.30). Attendees reported moderate to large improvements following the Executive Functioning in ADHD sessions, including in their topic understanding (z = -4.18, p <.001, r = -.57), strategies gained (z = -3.93, p <.001, r = -.54) and perceived resource accessibility (z = -4.23, p <.001, r = -.61). Improvements across all three areas were also noted across the other four caregiver sessions, except for the medication session where no significant changes in strategies gained and perceived access to resources were noted.

This study provides evidence that caregiver sessions within a Tier-4 service are efficacious and can (i) meet caregivers' needs to better understand ADHD, executive functioning difficulties as well as of other ADHD-related issues, and (ii) may equip caregivers with the knowledge to access resources to appropriately manage their children with ADHD - a possible precursor to improved clinical and functional outcomes in children. That the session on ADHD medications only led to improved understanding of the topic but not to perceived gains in strategies or perceived access to strategies could be attributed to low pre-and post-session questionnaire response rates as well as to the nature of those sessions which were purely informative and did not discuss strategies and resources. Nonetheless, longitudinal studies, with control groups, should determine whether any post-intervention improvements are sustained over time and should establish whether these are associated with improved outcomes in children.

ADHD and anxiety symptoms are highly comorbid in childhood. While worse functional outcomes are typically expected for children with comorbid ADHD and anxiety symptoms, an emerging body of literature has suggested that anxiety symptoms may actually contribute to compensatory effects for executive functioning (EF) skills in children with ADHD symptoms. However, the results of studies investigating this claim have been quite mixed, possibly due to the use of smaller sample sizes and cross-sectional datasets. The current study extends the previous literature by examining the possible compensatory effects of anxiety symptoms in the context of ADHD symptoms on EF abilities (e.g., working memory [WM] and inhibition) both cross-sectionally and longitudinally in a large, well-validated sample.

547 children and adolescents (8-16 years) were included from a population-based sample of twins (CLDRC sample) with enrichment for reading and attention challenges. Participants were retested at a second time point approximately 5 years later. ADHD symptoms (inattention and hyperactivity-impulsivity) were measured by a DSM-based ADHD rating scale, anxiety symptoms were measured by the RCMAS, inhibition was measured by stop-signal reaction time (SSRT), and working memory was measured by Digit Span Backwards (WISC/WAIS-R/III). Covariates included age and sex assigned at birth. Multiple regression models examined cross-sectional and longitudinal associations between ADHD (inattention and H-I) symptoms, anxiety symptoms, and the interaction between ADHD and anxiety symptoms on WM and inhibition abilities.

As expected, higher anxiety, inattention, and H-I symptoms were generally associated with lower inhibition and WM abilities both cross-sectionally and longitudinally. While no significant interactions between ADHD and anxiety symptoms were identified cross-sectionally at Time 1, significant interactions between Time 1 ADHD and anxiety symptoms predicted Time 2 inhibition scores. An inattention x anxiety interaction (p=.002) and a H-I x anxiety (p=.016) interaction significantly predicted Time 2 inhibition. Simple slopes analysis confirmed a compensatory interaction pattern, where ADHD symptoms showed a stronger association with inhibition weaknesses in children without anxiety symptoms compared to those with anxiety symptoms. This suggests that anxiety symptoms may be serving as a compensatory factor for children with ADHD symptoms as compared to their peers without ADHD symptoms.

These findings help clarify a previously mixed literature. Our findings suggest that the compensatory effect of anxiety symptoms on inhibition abilities in children with ADHD symptoms may be a developmental mechanism that takes time to emerge. The fact that the compensatory effect may take time to emerge may explain conflicting results within prior cross-sectional samples. These findings also have implications for research investigating the link between ADHD symptoms and EF abilities, as anxiety symptoms may be an important moderator to consider when attempting to explain why the correlation between ADHD symptoms and EF abilities is often weaker than expected. Finally, clinical implications for this work help to provide empirical evidence to support anecdotal experiences reported by individuals with ADHD and the clinicians who assess them, who often report that anxiety symptoms help them to improve EF performance.

Metamemory is an aspect of metacognition that is one's knowledge of memory and understanding of their own memory performance (Kreutzer et al., 1975). Executive function skills are foundational skills required for the development of metamemory in early school-age children (Lockl & Schneider, 2007; Lecce et al., 2015). Previous studies have suggested children with Attention-Deficit/Hyperactivity Disorder (ADHD) may have weaker study and organizational strategies, suggesting weaker metamemory skills (O'Neill & Douglas, 1991; Voelker et al., 1989). The current study aimed to examine the metamemory knowledge of typically developing (TD) children and children with ADHD on a novel declarative metamemory questionnaire. We hypothesized that the ADHD group would have worse metamemory performance than the TD group and that executive functioning skills would be significantly associated with metamemory for all groups.

The current study recruited a total of 93 English-speaking children between the ages of 6 to 12 years old, including 70 typically developing (TD) children (M age=9.1+1.92; females 49%), and 23 children with diagnoses of ADHD (M age=9.56+1.27; females 57%). Fifty-seven percent of the ADHD group reported daily use of stimulant medication, but no participants took medication on the day of testing. The participant groups did not significantly differ regarding age or sex. Participants completed the Measure of Metamemory (MoM-10) which included 10 multiple choice questions (i.e., Accuracy) and asked participants to explain their multiple-choice answer (i.e., Explanation). This provided three scores: Accuracy (max 10 points), Explanation (max 20 points), and Total (max 30 points). Additionally, participants' parents completed the 12-item Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF-2) Screening form, evaluating the child's executive functioning, which provided a percentile based on age and sex.

Within the ADHD group, BRIEF-2 percentiles and MoM-10 scores did not differ between those who were medicated and those who were not. As previous literature has shown, the TD and ADHD groups significantly differed on the BRIEF-2 screening score percentiles (t(91)=-5.78, p<0.001; TD M=52.89+26.1; ADHD M=85.26+13.82). The TD and ADHD groups did not significantly differ on either the MoM-10 Accuracy (p=0.13; TD M=7.22+1.84; ADHD M=7.87+1.32), the Explanation (p=0.08; TD M=9.34+3.80; ADHD M=10.57+2.92), or Total (p=0.13). There was a trend towards a significant correlation between the Explanation scores and BRIEF-2 for TD participants (r=-0.23, p=0.06), but there was no significant correlation between Explanation, Accuracy, or Total scores and the BRIEF-2 for the ADHD group.

Our results tentatively suggest a possible association between metamemory and parent reported executive functioning for TD children, supporting the expected association between the development of executive functioning and the development of metamemory. However, there was no association between metamemory and executive functioning for children with ADHD, likely due to the restricted range of executive functioning scores for this group (i.e., M=85.25+13.82; Range 55-99). Additionally, metamemory did not significantly differ between diagnostic groups. Children with ADHD may have comparable metamemory knowledge to TD children as a result of executive functioning instruction and support they have received. Rather, there may be group differences in the application of metamemory judgement and strategies.

Because cognitive resources are limited, models of cognitive control predict that additional control is engaged only if it improves task performance. Increased response caution, which occurs when individuals increase the threshold of information needed before making a decision, is one example of cognitive control adaptation. While previous studies have measured increased response caution via increased reaction time, the diffusion model can be used to derive a boundary separation parameter that directly indexes response caution and eliminates capturing alternative influences on reaction time. This study aims to determine if school-aged children, either with or without ADHD, show adaptive changes in response caution during a set-shifting task. These groups have demonstrated mixed results when analyzing reaction time, so this study utilizes diffusion modeling to measure response caution more directly. The set-shifting task presents switches in a random order such that they cannot be predicted; therefore, increasing response caution is only adaptive following errors, called post-error slowing (PES), but not following switch trials. It is predicted that children will show increased response caution only when adaptive. If child with ADHD adapt their response caution fundamentally differently, then there will be individual differences in change in boundary separation.

Children ages 8-12 with (n=193) and without (n=70) ADHD completed the Navon set-shifting task. Participants saw one of four global shapes made up of local shapes and were asked to identify one or the other based upon the background color. Of the 144 trials, 70 presented a switch between global and local. Trials were presented in the same randomized order for all participants, self-paced, and followed by feedback on correctness. The diffusion model parameters boundary separation (a), drift rate (v), and nondecision time (Ter) were estimated by condition, including a) post-error versus after correct and b) post-switch versus post-same. For PES analyses, only participants with a sufficient number of errors for modeling were included (ADHD n=113, control n=19).

Participants were slower on trials immediately following errors (F(1, 130)=119.76, p<.001, n2=.48) and switches (F(1, 261)=154.93, p<.001, n2=.37). In PES, slowing was attributable to increased boundary separation, F(1, 130)=16.11, p<.001, n2=.11, as well as slower drift rate and longer nondecision time (both p<.01, n2 >.05). However, as predicted, post-switch slowing was only attributable slower drift rate and longer nondecision time (both p<.001, n2 >.10), not increased boundary separation, F(1, 261)=0.77, p=.38, n2<.01. Overall, children with ADHD had slower drift rates (F(1, 261)=4.63, p<.001, n2=.10) and narrower boundary separation (F(1, 261)=10.56, p=.001, n2=.04). However, there were no ADHD x trial-type interactions for PES or post-switch (both p>.33, n2<.01).

School-aged children demonstrated increased response caution following errors, but not following switches. This demonstrates an adaptive use of cognitive control. The diffusion model was crucial in determining this, as reaction time slowed following switches for reasons unrelated to cognitive control. Additionally, although children with ADHD demonstrated slower drift rates and narrower boundary separation overall, they showed no differences when adapting response caution.

Children with attention/deficit-hyperactivity disorder (ADHD) exhibit motivational and cognitive impairments that affect daily life functioning. These impairments may reflect a deficit in action-control; the process by which voluntary actions are selected and executed based on prior reinforcement learning. It consists of parallel opposing processes; goal-direction and habit formation. Using the outcome-devaluation paradigm, we previously showed that children with ADHD rely on reflexive habitual, at the expense of goal-directed, behavior to deploy their actions. The current study investigates action-control using a contingency degradation paradigm, which involves outcome overvaluation as opposed to outcome devaluation. We hypothesize that children with ADHD will display a habitual behavior, while healthy controls (HC) will use goal-directed behavior to control their actions.

We tested 19 ADHD and 14 HC participants (age 6-10 years) for this study. Children with ADHD were recruited from Children’s Specialized Hospital and underwent a structured clinical diagnosis. All participants were screened for ADHD and other neurologic or psychiatric conditions that could contribute to attention impairment using the SNAP-IV rating scale. Participants completed a set of the Woodcock-Johnson® IV assessments. They were tested using an outcome-overvaluation computer-based task. During learning, participants acquired stimulus-reward associations in the acquisition phase, as well as the overvaluation phase. In the latter, one of the rewards was delivered in a similar contingency to the acquisition phase (valued), while the other reward was randomly accompanied by an extra reward in 10% of the trials (overvalued). After the overvaluation phase, participants were presented with two stimuli (associated with a valued, and an overvalued outcome) and were asked to choose one stimulus in extinction. Choosing the overvalued at a higher rate was assigned as goal-directed behavior, while choosing both stimuli at the same rate was assigned as habitual behavior.

Independent-samples t-test showed that children with ADHD scored significantly higher than HC in the following measures: ADHD_inattention, ADHD_hyperactive/Impulsive, ADHD_combined, inattention/overactivity, Conner’s index, inattention domain, hyperactive/impulsive domain, and general anxiety disorder screening (P-value for all is <0.001). Results from the computer-based task showed that both groups acquired action-outcome associations during the first two phases of the task. During the extinction phase, HC, as compared to ADHD, responded at a higher rate on the stimuli that were associated with the overvalued outcome (t(31)=2.1, p=0.043); indicating higher tendency to show goal-directed behavior. Further, paired-samples t-test showed that there was no significant difference between response rate on the valued vs. overvalued stimuli in the ADHD group (t(18)=1.027, p=0.318), while there was a difference trending towards significance in response rate in the HC group (t(13)=-2.00, p=0.067). These results show that ADHD responded habitually, while HC responses were goal-directed.

Our results indicate that children with ADHD are less likely than HC to engage in goal-directed behavior as opposed to habitual responding. This is consistent with our previous research highlighting a deficit in action-control in ADHD.

Reading is an important skill, and becomes even more so beyond elementary years, when the focus shifts to comprehension as a means of learning and understanding academic material across subjects (Kamil et al., 2008; Shanahan et al., 2010; Snow, 2002). One construct receiving much recent interest in research, especially that related to academic achievement, is mind wandering (MW). MW has been defined as "a shift away from a primary task toward internal information" (Smallwood & Schooler, 2006). Though it is known to be ubiquitous among people (McVay & Kane, 2012), there are numerous theories about why MW occurs, in different contexts, and in relation to various other factors, and no one theory is currently dominant. MW and other factors such as working memory (WM) and decoding are all known to influence functional outcomes such as reading comprehension (RC), but there is little information on how all of these factors interact with one another with regard to RC. Most prior work focuses on adults and thus generalization to children is still needed. Therefore, the goals of this project were to examine the roles of WM, MW, decoding, and their interactions in relation to RC. It was hypothesized that each would demonstrate a significant relationship with the outcome of RC and that they would interact with one another beyond their individual main effects.

The sample included 214 6th and 7th grade students with a larger proportion of struggling readers. Participants were each administered the Kaufman Test of Educational Achievement -Third Edition (KTEA-3; Kaufman & Kaufman, 2014) Letter Word Recognition subtest (decoding), the Weschler Intelligence Scale for Children - Fifth Edition (WISC-5; Wechsler, 2014) Digit Span and Picture Span subtests(WM), and the Gates-MacGinitie Reading Tests - Fourth Edition (GMRT-4; MacGinitie, 1978) Comprehension subtest (RC). Four measures of MW were administered: the trait-based Mind Wandering Questionnaire (MWQ; Mrazek et al., 2013); two task-based (or state-dependent) retrospective reporting (TBRR) questionnaires (Matthews et al., 2002), and a researcher-generated single-item task-based retrospective report administered after four tasks. Correlations and regression were utilized to evaluate the relationships among predictor variables, and with regard to RC, including how predictors moderate one another.

All three key predictors demonstrated a significant relationship with RC both via zero-order correlations and main effects in the context of interactive relationships. WM and decoding demonstrated positive relationships with RC and MW demonstrated a negative relationship with RC, though only when one (MWQ) measure of MW was used, rather than the TBRR measure. There was a significant interaction of decoding and MW as measured by the TBRR questionnaires on the outcome of RC. Other interactions were not significant.

These results clarify the interactive relationships of these three key predictors on the important academic achievement outcome of RC, ultimately suggesting that intervention strategies for achievement problems in areas such as RC should consider MW in conjunction with decoding abilities in order to implement effective strategies that capitalize on individual children's strengths and build on their particular weaknesses.