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Longitudinal Trajectories of Sustained Attention Development in Children and Adolescents with ADHD

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Abstract

The present study characterizes changes in sustained attention ability over ages 9–14, and whether longitudinal trajectories of attention development differ between persistent ADHD, remitted ADHD and control groups. The Sustained Attention to Response Task (SART) was administered to 120 children with ADHD and 123 controls on three occasions between ages 9 and 14. Trajectories of sustained attention development, indicated by changes in SART performance (standard deviation of response time [SDRT], omission errors, and ex-Gaussian parameters sigma and tau), were examined using generalized additive mixed models. For all measures there was a significant main effect of age; response time variability and number of omission errors improved linearly as children aged. However, children with ADHD had significantly greater SDRT, tau and omission errors than controls across waves. There were no significant group differences in sigma, indicating that the greater overall response time variability (SDRT) observed in ADHD was likely driven by more intermittent long responses (larger tau). Trajectories of sustained attention performance did not differ between children with persistent ADHD or ADHD in remission. Longitudinal trajectories of sustained attention development are comparable between ADHD and controls, however children with ADHD (regardless of remission status) display a performance deficit equivalent to typical controls 1–3 years younger. Findings highlight the need for continued clinical support for children in remission from ADHD and provide support for tau as an endophenotype of ADHD.

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Data Availability

The data that support the findings of this study are available from the corresponding authors, PT and TS, upon reasonable request.

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Acknowledgements

We would like to thank all of the many families and schools for their participation in the Neuroimaging of the Children’s Attention Project.

Funding

The study was funded by the National Medical Health and Research Council of Australia (NHMRC; project grant #1065895). The Children’s Attention Project was as funded by an NHMRC project grant #1008522 and a grant from the Collier Foundation. This research was conducted at the Murdoch Children’s Research Institute and Deakin University. It was supported by the Murdoch Children’s Research Institute, The Royal Children’s Hospital, The Royal Children’s Hospital Foundation, Department of Paediatrics at The University of Melbourne and the Victorian Government’s Operational Infrastructure Support Program. ES is supported by an NHMRC Career Development Fellowship (#1110688) and a veski Inspiring Women’s Fellowship. DE is supported by a Clinical Scientist Fellowship from the Murdoch Children’s Research Institute.

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Authors and Affiliations

  1. Department of Paediatrics, The University of Melbourne, Melbourne, Australia

    Phoebe Thomson, Emma Sciberras, Daryl Efron & Timothy J. Silk

  2. Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Australia

    Phoebe Thomson & Timothy J. Silk

  3. School of Psychology, Deakin University, Melbourne, Australia

    Nandita Vijayakumar, Emma Sciberras & Timothy J. Silk

  4. Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia

    Katherine A. Johnson & Charles B. Malpas

  5. Department of Medicine, Royal Melbourne Hospital, Melbourne Medical School, The University of Melbourne, Melbourne, Australia

    Charles B. Malpas

  6. Health Services, Murdoch Children’s Research Institute, Melbourne, Australia

    Emma Sciberras & Daryl Efron

  7. The Royal Children’s Hospital, Melbourne, Australia

    Daryl Efron

  8. Discipline of Psychiatry, The University of Sydney, Sydney, Australia

    Philip Hazell

Authors
  1. Phoebe Thomson
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  2. Nandita Vijayakumar
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  3. Katherine A. Johnson
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  4. Charles B. Malpas
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  5. Emma Sciberras
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  6. Daryl Efron
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  7. Philip Hazell
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  8. Timothy J. Silk
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Corresponding authors

Correspondence to Phoebe Thomson or Timothy J. Silk.

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Conflict of Interest

Philip Hazell or his employer has received payment from Eli Lilly and Janssen for consultancies; Eli Lilly, Janssen, Novartis and Shire for participation in advisory boards; Eli Lilly, Janssen, Pfizer and Shire for speaker’s bureau; Eli Lilly and Celltech for the conduct of clinical trials. All other authors declare that they have no conflict of interest.

Ethics Approval

This study was approved by the Royal Children’s Hospital Melbourne Human Research Ethics Committee and was performed in accordance with the ethical standards.

Consent to Participate

Written informed consent was obtained from the parents.

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Not applicable.

Code Availability

All code implemented in the current study were based on detailed R documentation for Generalized Additive Mixed Models from https://www.rdocumentation.org/packages/mgcv/versions/1.8-31/topics/gamm. Custom code that yielded the findings of the current article are available from the corresponding authors upon request.

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Thomson, P., Vijayakumar, N., Johnson, K.A. et al. Longitudinal Trajectories of Sustained Attention Development in Children and Adolescents with ADHD. J Abnorm Child Psychol 48, 1529–1542 (2020). https://doi.org/10.1007/s10802-020-00698-5

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