The present study examined preschool neuropsychological measures as predictors of school-age attention deficit hyperactivity disorder (ADHD). Participants included 168 children (91 males) who completed neuropsychological measures at ages 3 and 4, and who were evaluated for ADHD and oppositional defiant disorder at age 6. The Conners' Kiddie Continuous Performance Test (K-CPT), NEPSY Statue subtest, and a delay aversion task significantly distinguished at-risk children who later did and did not meet criteria for ADHD, with poor to fair overall predictive power, specificity, and sensitivity. However, only the K-CPT ADHD Confidence Index and battery added incremental predictive validity beyond early ADHD symptoms. This battery approach, which required impairment on at least 2 of the 3 significant measures, yielded fair overall predictive power, specificity, and sensitivity, and correctly classified 67% of children. In addition, there was some support for the specificity hypothesis, with evidence that cool executive function measures (K-CPT and Statue subtest) tended to predict inattentive symptoms. These findings suggest that neuropsychological deficits are evident by preschool-age in children with ADHD, but neuropsychological tests may still misclassify approximately one-third of children if used alone. Thus, neuropsychological measures may be a useful component of early ADHD assessments, but should be used with caution and in combination with other assessment methods.Keywords neuropsychological assessment; executive function; preschoolers; ADHD; oppositional defiant disorder Attention deficit hyperactivity disorder (ADHD) is one of the most commonly diagnosed childhood disorders, and is characterized by developmentally deviant levels of inattention, hyperactivity, and/or impulsivity. Children with ADHD are classified under three presentations: (i) primarily hyperactive/impulsive, (ii) primarily inattentive, or (iii) combined, depending on whether hyperactivity/impulsivity or inattentive symptoms, or both, Correspondence concerning this article should be addressed to Elizabeth A. Harvey, Tobin Hall, 135 Hicks Way, University of Massachusetts Amherst, Amherst, MA 01003. eharvey@psych.umass.edu. Tel.: (413) Fax: (413) 545-0996. Conflict of Interest: The authors declare that they have no conflict of interest.
Compliance with Ethical StandardsAll procedures performed in studies involving human participants were in accordance with the ethical standards of the University of Massachusetts Amherst institutional review board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all parents included in the study.
HHS Public AccessAuthor manuscript J Abnorm Child Psychol. Author manuscript; available in PMC 2017 November 01.
Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript are more predominant (American Psychiatric Association, 2013). ADHD symptoms can cause significant impairment in children's social, emotional, a...