Attention and Executive Functions of Children with Attention Deficit Hyperactivity Disorder


  • P.A. Fazal Ghafoor Associate Professor, Department of Neurology, MES Medical College, Perinthalmanna
  • Firoz Kazhungil Assistant Professor & Head, Dept. of Psychiatry, Government Medical College, Manjeri.
  • Liji Premlal Junior Resident, Department of Psychiatry, MES Medical College, Perinthalmanna
  • Suni Muraleedharan Clinical Psychologist, Department of Psychiatry, MES Medical College, Perinthalmanna
  • G Manoj Kumar
  • V Rajmohan
  • TM Raghuram



Attention Deficit Hyperactivity Disorder (ADHD) is a highly prevalent neurobehavioral disorder that may be associated with impairment in attention and executive functions. Very few Indian studies have focussed on neuropsychological functions in children with ADHD. We evaluated attention and executive functions such as psychomotor speed, response inhibition and set-shifting in 6-12 year old children with ADHD in comparison with age, gender and education matched healthy controls. The participants included 16 children, out
of which eight had ADHD and eight were healthy comparators. They were assessed with Vanderbilt ADHD Diagnostic Rating Scale, Trail Making Test A and B (TMT A and B), Stroop Colour Word Interference Test (SCWIT) and Wisconsin Card Sorting Test (WCST). The ADHD group was found to have sign ificant deficits in the TMT A (p=0.04) and TMT B (p=0.03); and in colour (p=0.01), word (p=0.008) and colour word (p=0.03) subscores of SCWIT. No significant differences were observed in SCWIT interference score or WCST scores. The study shows that ADHD is associated with impairments in attention, psychomotor speed, colour naming and word reading but not with impairments in response inhibition or set shifting. Studies with larger sample size are needed for a better understanding of neuropsychological deficits in ADHD.

Author Biography

Firoz Kazhungil, Assistant Professor & Head, Dept. of Psychiatry, Government Medical College, Manjeri.

Assistant Professor & Head of the Department,

Department of psychiatry


Swanson JM, Sergeant JA, Taylor E, Sonuga-Barke EJ, Jensen PS, Cantwell DP. Attention-deficit hyperactivity disorder and hyperkinetic disorder. Lancet. 1998; 351(9100):429-33.

Srinath S, Girimaji SC, Gururaj G, Seshadri S, Subbakrishna DK, Bhola P, et al. Epidemiological study of child & adolescent psychiatric disorders in urban & rural areas of Bangalore, India. Indian J Med Res 2005; 122(1):67-79.

Venkatesh C, Ravikumar T, Andal A, Virudhagirinathan BS. Attention-deficit/Hyperactivity Disorder in Children: Clinical Profile and Co-morbidity. Indian J Psychol Med 2012; 34(1):34-8.

Malhi P, Singhi P. Spectrum of attention deficit hyperactivity disorders in children among referrals to psychology services. Indian Pediatr 2000; 37(11):1256-60.

Barkley RA. Behavioral inhibition, sustained attention, and executive functions: constructing a unifying theory of ADHD. Psychol Bull 1997; 121(1):65-94.

Barkley RA. Attention-deficit/hyperactivity disorder, self-regulation, and time: toward a more comprehensive theory. J Dev Behav Pediatr 1997; 18(4):271-79.

Murphy KR, Barkley RA, Bush T. Executive functioning and olfactory identification in young adults with attention deficit-hyperactivity disorder. Neuropsychology 2001; 15(2):211-20.

Barkley RA, Grodzinsky G, DuPaul GJ. Frontal lobe functions in attention deficit disorder with and without hyperactivity: a review and research report. J Abnorm Child Psychol 1992; 20(2):163-88.

Pennington BF, Ozonoff S. Executive functions and developmental psychopathology. J Child Psychol Psychiatry 1996; 37(1):51-87.

Sergeant JA, Geurts H, Oosterlaan J. How specific is a deficit of executive functioning for attention-deficit/hyperactivity disorder? Behav Brain Res 2002; 130(1-2):3-28.

Oldfield RC. The assessment and analysis of handedness: The Edinburgh inventory. Neuropsychologia 1971; 9: 97-113.

Shaffer D, Schwab-Stone M, Fisher P, Cohen P, Piacentini J, Davies M. et al. The Diagnostic Interview Schedule for Children - Revised Version (DISC-R): I. Preparation, field testing, interrater reliability, and acceptability. J Am Acad of Child and Adolescent Psych 1996; 32(3):643-50.

Wolraich ML, Lambert W, Doffing MA, Bickman L, Simmons T, Worley K. Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. J Pediatr Psychol 2003; 28:559.

Scheres A, Oosterlaan J, Geurts H, Morein-Zamir S, Meiran N, Schut H, et al. Executive functioning in boys with ADHD: primarily an inhibition deficit? Arch Clin Neuropsychol 2004; 19(4):569-94.

Schwartz K, Verhaeghen P. ADHD and Stroop interference from age 9 to age 41 years: a meta-analysis of developmental effects. Psychol Med 2008; 38(11):1607-16.

Grodzinsky GM, Barkley RA. Predictive power of frontal lobe tests in the diagnosis of attention deficit hyperactivity disorder. Clin Neuropsychol 1999; 13(1):12-21.

Geurts HM, Verté S, Oosterlaan J, Roeyers H, Sergeant JA. ADHD subtypes: Do they differ in their executive functioning profile? Arch Clin Neuropsychol 2005; 20:457-77.

Tannock R, Martinussen R, Frijters J. Naming speed performance and stimulant effects indicate effortful, semantic processing deficits in attention-deficit/hyperactivity disorder. J Abnorm Child Psychol 2000; 28:237–52.

Velez-van-Meerbeke A, Zamora IP, Guzman G, Figueroa B, Lopez Cabra CA, Talero-Gutierrez C. Evaluating executive function in schoolchildren with symptoms of attention deficit hyperactivity disorder. Neurologia 2013; 28(6):348-55.






Research Report