Division of Mental Health, Norwegian Institute of Public Health, Oslo, Norway.
Behav Brain Funct. 2014 May 1;10:16. doi: 10.1186/1744-9081-10-16.
Working memory, inhibition, and expressive language are often impaired in ADHD and many children with ADHD have lower IQ-scores than typically developing children. The aim of this study was to test whether IQ-score influences associations between ADHD symptoms and verbal and nonverbal working memory, inhibition, and expressive language, respectively, in a nonclinical sample of preschool children.
In all, 1181 children recruited from the Norwegian Mother and Child Cohort Study were clinically assessed at the age of 36 to 46 months. IQ-score and working memory were assessed with subtasks from the Stanford Binet test battery, expressive language was reported by preschool teachers (Child Development Inventory), response inhibition was assessed with a subtask from the NEPSY test, and ADHD symptoms were assessed by parent interview (Preschool Age Psychiatric Assessment).
The results showed an interaction between ADHD symptoms and IQ-score on teacher-reported expressive language. In children with below median IQ-score, a larger number of ADHD symptoms were more likely to be accompanied by reports of lower expressive language skills, while the level of ADHD symptoms exerted a smaller effect on reported language skills in children with above median IQ-score. The associations between ADHD symptoms and working memory and response inhibition, respectively, were not influenced by IQ-score.
Level of IQ-score affected the relation between ADHD symptoms and teacher-reported expressive language, whereas associations between ADHD symptoms and working memory and response inhibition, respectively, were significant and of similar sizes regardless of IQ-score. Thus, in preschoolers, working memory and response inhibition should be considered during an ADHD assessment regardless of IQ-score, while language skills of young children are especially important to consider when IQ-scores are average or low.
在 ADHD 患者中，工作记忆、抑制和表达性语言通常受到损害，许多 ADHD 患儿的智商分数低于正常发育儿童。本研究旨在测试在非临床学龄前儿童样本中，智商分数是否分别影响 ADHD 症状与言语和非言语工作记忆、抑制和表达性语言之间的关联。
本研究共纳入了 1181 名来自挪威母婴队列研究的儿童，在 36 至 46 个月龄时进行了临床评估。智商分数和工作记忆采用斯坦福-比奈测试的子任务进行评估，表达性语言由学前教师（儿童发展量表）报告，反应抑制采用神经心理评估系统的子任务进行评估，ADHD 症状由家长访谈（学前年龄精神评估）进行评估。
结果显示，ADHD 症状和智商分数在教师报告的表达性语言上存在交互作用。在智商分数处于中位数以下的儿童中，ADHD 症状数量越多，表达性语言技能较差的可能性越大，而在智商分数处于中位数以上的儿童中，ADHD 症状的水平对报告的语言技能的影响较小。ADHD 症状与工作记忆和反应抑制的关联分别不受智商分数的影响。
智商分数的水平影响 ADHD 症状与教师报告的表达性语言之间的关系，而 ADHD 症状与工作记忆和反应抑制之间的关联则不受智商分数的影响，且具有相似的强度。因此，在学龄前儿童中，无论智商分数如何，在进行 ADHD 评估时都应考虑工作记忆和反应抑制，而对于智商分数中等或较低的幼儿，语言技能尤其需要考虑。
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