ABSTRACT Objective: To demonstrate that high IQ children and adolescents diagnosed with ADHD tend to suffer from executive function (EF) impairments that: a) can be identified with a combination of standardized measures and normed self-report data; and b) occur more frequently in this group than in the general population. Method: From charts of 117 children and adolescents aged 6 to 17 years with high IQ ( ≥ 120) who fully met DSM-IV diagnostic criteria for ADHD, data on 8 normed measures of executive function (EF) were extracted: IQ index scores for working memory and processing speed, a standardized measure of auditory verbal memory, and 5 clusters of the Brown ADD Scale, a normed, age-graded rating scale for ADHD-related executive function impairments in daily life. Significant impairment was computed for each individual relative to age-appropriate norms for each measure and comparisons were made to base-line rates in the general population. Results: Sixty-two percent of participants were significantly impaired on at least 5 of these 8 markers of EF. Chi-square comparisons of scores from these high IQ participants were significantly different (p < 0.001) from standardization norms for each of the eight EF measures. Conclusions: High IQ children and adolescents with ADHD, despite their cognitive strengths, tend to suffer from significant impairments of executive functions that can be assessed with these measures; incidence of these impairments is significantly greater than in the general population. These results are fully consistent with data on high IQ adults diagnosed with ADHD.
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nullBrown, T. , Reichel, P. and Quinlan, D. (2011) Executive function impairments in high IQ children and adolescents with ADHD. Open Journal of Psychiatry, 1, 56-65. doi: 10.4236/ojpsych.2011.12009.
 Frazier, T.W., H.A. Demaree, et al. (2004). Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropschology, 18, 543-555. doi:10.1037/0894-4188.8.131.523
Katusic, M.Z., Voight, R.G., Colligan, R.C., Weaver, A.L. and Homan, K.J., et al. (2011) Attention-deficit hyperactivity disorder in children with high intelligence quotient: Results from a population-based study. Journal of Developmental and Behavioral Pediatrics, 32, 103-109.
Antshel, K.M., Faraone, S.V., et al. (2007) Is attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ? Results from the MGH longitudinal family studies of ADHD. Journal of Child Psychology and Psychiatry, 48, 687-694.
Antshel, K.M., S.V. Faraone, et al. (2008) Temporal Stability of ADHD in the High-IQ Population: Results from the MGH Longitudinal Family Studies of ADHD. Journal of American Academy Child & Adolescent Psychiatry, 47, 817-825. doi:10.1097/CHI.0b013e318172eecf
Castellanos, F.X. (1999) Psychobiology of ADHD. In: Quay, H.C. and Hogan, A.E. Eds., Handbook of Disruptive Behavior Disorders. Kluwer Academic/Plenum Publishers, New York, 179-198.
Barkley, R.A. (2006) Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. 3th Edition, Guilford Press, New York.
Barkley, R.A. (2011) Barkley deficits in executive functioning scale (BDEFS). Guilford Press, New York.
Brown, T.E. (2005) Attention deficit disorder: The unfocused mind in children and adults. Yale University Press, New Haven.
Brown, T.E. (2009) Developmental complexities of attentional disorders and comorbidities. In Brown T.E. Ed., ADHD comorbidities: Handbook for ADHD complicatons in children and adults. American Psychiatric Publishing, Inc, Washington, 3-22.
Brown, T.E. (2006) Executive functions and attention deficit hyperactivity disorder: Implications of two conflicting views. International Journal of Disability, Development and Education, 53, 35-46.
Miyake, A., Friedman, N.P., Emerson, M.J., Witzki, A.H., et al. (2000) Unity and diversity of executive functions and their contribution to complex ‘frontal lobe’ tasks: A latent variable analysis. Cognitive Psychology, 41, 49-100.
Eslinger, P.J. (1996) Conceptualizing, Describing, and measuring components of executive function. In G.R. Lyon and N.A. Krasnegor, Eds., Attention, Memory and Executive Function. Paul Brookes Publishing Co., Baltimore, 367-395.
Baumeister, R.F. and Vohs, K.D. Eds., (2004) Handbook of self-regulation: Research, theory and applications. Guilford Press, New York.
Delis, D.C., Houston, W.S., Wetter, S. Han, S.D., et al. (2007) Creativity lost: The importance of testing executive function in school-age children and adolescents. Journal of Psychoeducational Assessment, 25, 291-240.
Ardila, A., Pineda, D. and Rosselli, M. (2000) Correlation between intelligence test scores and executive function measures. Archives of Clinical Neuropsychology, 15, 31-36.
Rommelse, N.N.J., Altink, M.E., Oosterlaan, J., Buschgens, C.J.M., Buitelaar, J.K. and Sergeant, J. (2008) Support for an independent familial segregation of executive and intelligence endophenotypes in ADHD families. Psychological Medicine, 38, 1595-1606.
Schuck, S.E.B. and Crinella F.M. (2005) Why children with ADHD do not have low IQs. Journal of Learning Disabilities, 38, 262-280.
Seidman, L.J., Biederman, J., Faraone, S.V., Weber, W., Mennin, D. and Jones, J. (1997a) A pilot study of neuropsychological function in girls with ADHD. Journal of American Academy of Child and Adolescent Psychiatry, 36, 366-373. doi:10.1037/0022-006X.65.1.150
Seidman, L.J., Biederman, J., Faraone, S.V., Weber, W., and Ouellette, C. (1997b) Toward defining a neuropsychology of attention deficit-hyperactivity disorder: Performance of children and adolescents from a large clinically referred sample. Journal of Consulting and Clinical Psychology, 65, 150-160.
Seidman, L.J. (2001) Learning disabilities and executive dysfunction in boys with attention-deficit/hyper-activity disorder. Neuropsychology, 15, 544-556.
Doyle, A.E., Biederman, J., Seidman, L.J., Weber, W. and Faraone, S.V. (2000) Diagnostic efficiency of neuropsychological test scores for discriminating boys with and without attention-deficit/hyperactivity disorder. Journal of Consulting and Clinical Psychology, 68, 477-488.
Doyle, A.E., Faraone, S.V., Dupre, E.P., and Biederman, J. (2001) Separating attention deficit hyperactivity disorder and learning disabilities in girls: A familial risk analysis. American Journal of Psychiatry, 158, 1666-1672.
Martinussen, R., Hayden, J., et al. (2005) A meta-analysis of working memory impairments in children with attention-deficit hyperactivity disorder. Journal American Academy of Child Adolescent Psychiatry, 44, 377-384.
Martinussen, R. and Tannock, R. (2006) Working memory impairments in children with attention-deficit hyperactivity disorder with and without comorbid language learning disorders. Journal Clinical and Experimental Neuropsychology, 28, 1073-1094.
McInnes, A., T. Humphries, et al. (2003) Listening comprehension and working memory are impaired in attention-deficit hyperactivity disorder irrespective of language impairment. Journal Abnormal Child Psychology, 31, 427-443. doi:10.1177/108705470300600401
Quinlan, D. M. and Brown, T.E. (2003) Assessment of short-term verbal memory impairments in adolescents and adults with ADHD. Journal of Attention Disorders, 6, 143-152. doi:10.1177/108705470300600401
Shanahan, M.A., Pennington, B.F., et al. (2006) Processing speed deficits in attention deficit/hyperactivity disorder and reading disability. Journal of Abnormal Child Psychology, 34, 585-602.
Bedard, A.C., Jain, U., Hogg-Johnson, S. and Tannock, R. (2007) Effects of methylphenidate on working memory components: Influence of measurement. Journal of Child Psychology and Psychiatry, 48, 872-880.
Rapport, M., Alderson, R., Kofler, M., Sarver, D., Bolden, J. and Sims, V. (2008) Working memory deficits in boys with attention-deficit/hyperactivity disorder (ADHD): The contribution of executive and subsystem processes. Journal Abnormal Child Psychology, 36, 825-839.
Rabbitt, P. (1997) Methodologies and models in the study of executive function. In: Rabbitt P. Ed., Methodology of Frontal and Executive Function, Psychology Press Publishers, East Sussex, 1-38.
Burgess, P.W. (1997) Theory and methodology in executive function research. In: P. Rabbit Ed., Methodology of Frontal and Executive Function, Psychology Press Publishers, East Sussex, 81-116.
Biederman, J., Petty C., et al. (2008) Discordance between psychometric testing and questionnaire-based definitions of executive functions in individuals with ADHD. Journal of Attention Disorders, 12, 92-102.
Shallice, T. and Burgess, P.W. (1991) Deficits in strategy application following frontal lobe damage in man. Brain, 114, 727-741. doi:10.1093/brain/114.2.727
Alderman, N., Burgess, P.W., et al. (2003) Ecological validity of a simplified version of the multiple errands shopping test. Journal of the International Neuropsychological Society, 9, 31-44.
Willcutt, E.G., Doyle, A.E. et al. (2005) Validity of the executive function theory of attention deficit hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57, 1336-1346. doi:10.1016/j.biopsych.2005.02.006
Wechsler, D. (1991) Wechsler intelligence scale for children. 3rd Edition, The Psychological Corporation, San Antonio.
Wechsler, D. (2003) Wechsler intelligence scale for children. 4th Edition, The Psychological Corporation, San Antonio.
Wechsler, D. (1997) Wechsler adult intelligence scale. Third Edition, The Psychological Corporation, San Antonio.
Brown, T.E. (1996) Brown attention deficit disorder scales for adolescents and adults. The Psychological Corporation, San Antonio.
Brown, T.E. (2001) Brown attention deficit disorder scales for children and adolescents. The Psychological Corporation, San Antonio.
Cohen, M.J. (1997) Children’s memory scale manual. The Psychological Corporation, San Antonio.
Wechsler, D. (1997) Wechsler memory scale. 3rd Edition, The Psychological Corporation, San Antonio.
Mayes, S.D. and Calhoun, S.L. (2007) Wechsler intelligence scale for children. 3rd-4th edition, predictors of academic achievement in children with attention deficit/hyperactivity disorder. School Psychology Quarterly, 22, 234-249. doi:10.1037/1045-38184.108.40.206
Seidman, L.J., Doyle A., et al. (2004) Neuropsychological function in adults with attention-deficit/hyperactivity disorder. Psychiatric Clinics of North America, 27, 261-282.
Kaufman, A.S. and Lichtenberger, E.O. (2006) Assessing adolescent and adult intelligence. 3rd Edition, John Wiley & Sons, Hoboken.
Baddeley, A. (2007) Working memory, thought and action. Oxford University Press, New York.
Brown, T.E., Reichel, P.C. and Quinlan, D.M. (2009) Executive function impairments in high IQ adults with ADHD. Journal of Attention Disorders, 13, 161-171.
Phelps, E. (2005) The interaction of emotion and cognition: The relationship between the human amygdala and cognitive awareness. In: Hassin, R. Uleman J. and Bargh J. A. Eds., The New Unconscious, Oxford University Press, New York, 61-76.
Glaser, J. and Kihlstrom, J.F. (2005) Compensatory automaticity: Unconscious volition is not an oxymoron. In: Hassin R., Uleman J. and Bargh J. A. Eds., The New Unconscious, New York, Oxford University Press, 171-195.
Hassin, R.R. (2005) Nonconscious control and implicit working memory. In: Hassin R., Uleman J. and J.A. Bargh Eds., The New Unconscious, Oxford University Press, New York, 196-222.
Langberg, J., Epstein, J. N., et al. (2008) The transition to middle school is associated with changes in the developmental trajectory of ADHD symptomatology in young adolescents with ADHD. Journal of Clinical Child and Adolescent Psychology, 37, 651-663.
Faraone, S., Biederman, J., Spencer, T., Mick, E., Murray, K. Petty, C., et al. (2006) Diagnosing adult attention deficit hyperactivity disorder: Are late onset and subthreshold diagnoses valid? American Journal of Psychiatry, 163, 1720-1729. doi:10.1176/appi.ajp.163.10.1720