Does Child Temperament Play a Role in the Association Between Parenting Practices and Child Attention Deficit/Hyperactivity Disorder?

Ineffective parenting practices may maintain or exacerbate attention deficit/hyperactivity disorder (ADHD) symptoms and shape subsequent development of disruptive behavior disorders (DBD’s) in youth with ADHD. Recent theoretical models have suggested that parenting may exert effects on ADHD via its role in child temperament. The current study aimed to evaluate the indirect effects of parenting dimensions on child ADHD symptoms via child temperament. Youth ages 6–17 years (N?=?498; 50.4 % ADHD, 55 % male) completed a multi-stage, multi-informant assessment that included parent, child, and teacher report measures of parenting practices, child temperament, and ADHD symptoms. Statistical models examined the direct and indirect effects of maternal and paternal involvement, poor supervision, and inconsistent discipline on inattention and hyperactivity-impulsivity via child temperament and personality traits. Results indicated differential patterns of effect for negative and positive parenting dimensions. First, inconsistent discipline exerted indirect effects on both ADHD symptom dimensions via child conscientiousness, such that higher levels of inconsistency predicted lower levels of conscientiousness, which in turn, predicted greater ADHD symptomatology. Similarly, poor supervision also exerted indirect effects on inattention via child conscientiousness as well as significant indirect effects on hyperactivity-impulsivity via its impact on both child reactive control and conscientiousness. In contrast, primarily direct effects of positive parenting (i.e., involvement) on ADHD emerged. Secondary checks revealed that similar pathways may also emerge for comorbid disruptive behavior disorders. Current findings extend upon past work by examining how parenting practices influence child ADHD via with-in child mechanisms and provide support for multi-pathway models accounting for heterogeneity in the disorder.     

Changes in ADHD Symptom Endorsement: Preschool to School Age

To investigate endorsement patterns among the 18 DSM-IV symptoms of ADHD in a longitudinal sample of children with and without ADHD (n?=?144), as assessed at ages 4-5, 5-6, and 6-7 years. Symptom endorsements and diagnoses were determined at all time-points via K-SADS-PL interview administered to parents and supplemented by teacher questionnaires and clinician observations. Changes in endorsement patterns over time for each of the 18 DSM-IV symptoms were ascertained. Several symptoms, particularly those of inattention, were infrequently endorsed and of apparently limited diagnostic utility at ages 4-5; hyperactive/impulsive symptoms were more frequently endorsed among young children with ADHD than were inattentive symptoms. However, by ages 6-7, inattention items were somewhat superior at discriminating ADHD from Non-ADHD children. Several DSM-IV and now DSM-V symptoms provide limited diagnostic differentiation prior to school-age, particularly those most commonly observed in the context of formal schooling. Consideration should be made in future iterations of the DSM that account for such developmental and contextual differences.     

The Genetic Association Between ADHD Symptoms and Reading Difficulties: The Role of Inattentiveness and IQ

Previous studies have documented the primarily genetic aetiology for the stronger phenotypic covariance between reading disability and ADHD inattention symptoms, compared to hyperactivity-impulsivity symptoms. In this study, we examined to what extent this covariation could be attributed to “generalist genes” shared with general cognitive ability or to “specialist” genes which may specifically underlie processes linking inattention symptoms and reading difficulties. We used multivariate structural equation modeling on IQ, parent and teacher ADHD ratings and parent ratings on reading difficulties from a general population sample of 1312 twins aged 7.9–10.9 years. The covariance between reading difficulties and ADHD inattention symptoms was largely driven by genetic (45%) and child-specific environment (21%) factors not shared with IQ and hyperactivity-impulsivity; only 11% of the covariance was due to genetic effects common with IQ. Aetiological influences shared among all phenotypes explained 47% of the variance in reading difficulties. The current study, using a general population sample, extends previous findings by showing, first, that the shared genetic variability between reading difficulties and ADHD inattention symptoms is largely independent from genes contributing to general cognitive ability and, second, that child-specific environment factors, independent from IQ, also contribute to the covariation between reading difficulties and inattention symptoms.     

Academic Achievement Over 8 Years Among Children Who Met Modified Criteria for Attention-deficit/Hyperactivity Disorder at 4–6 Years of Age

The predictive validity of symptom criteria for different subtypes of ADHD among children who were impaired in at least one setting in early childhood was examined. Academic achievement was assessed seven times over 8 years in 125 children who met symptom criteria for ADHD at 4–6 years of age and in 130 demographically-matched non-referred comparison children. When intelligence and other confounds were controlled, children who met modified criteria for the predominantly inattentive subtype of ADHD in wave 1 had lower reading, spelling, and mathematics scores over time than both comparison children and children who met modified criteria for the other subtypes of ADHD. In some analyses, children who met modified criteria for the combined type had somewhat lower mathematics scores than comparison children. The robust academic deficits relative to intelligence in the inattentive group in this age range suggest either that inattention results in academic underachievement or that some children in the inattentive group have learning disabilities that cause secondary symptoms of inattention. Unexpectedly, wave 1 internalizing (anxiety and depression) symptoms independently predicted deficits in academic achievement controlling ADHD, intelligence, and other predictors.     

Aggression Among Children with ADHD,Anxiety, or Co-occurring Symptoms: Competing Exacerbation and Attenuation Hypotheses

Competing hypotheses for explaining the role of anxiety in the relation between attention-deficit/hyperactivity disorder (ADHD) symptoms and childhood aggression were evaluated. Two studies tested whether anxiety exacerbated, attenuated, or had no effect on the relation between ADHD and aggression subtypes among psychiatrically hospitalized children. In Study 1 (N = 99), children who scored above clinical cut-off levels for anxiety only, ADHD only, and co-occurring ADHD and anxiety were compared on aggression subtypes (i.e., reactive, proactive, overt, and relational aggression). In Study 2, the moderating role of anxiety on the relation between ADHD and aggression subtypes was examined with a larger sample (N = 265) and with continuous variables. No support was found for either the attenuation or exacerbation hypothesis, and results remained consistent when separately examining hyperactivity/impulsivity and inattention symptoms of ADHD. Although ADHD symptoms were significantly associated with all aggression subtypes, this association did not remain when including symptoms of oppositional defiant disorder.     

Sluggish Cognitive Tempo in Psychiatrically Hospitalized Children: Factor Structure and Relations to Internalizing Symptoms, Social Problems, and Observed Behavioral Dysregulation

As research examining sluggish cognitive tempo (SCT) advances, it is important to examine the structure and validity of SCT in a variety of samples, including samples of children who are clinically-distressed but not referred specifically for attention-deficit/hyperactivity disorder (ADHD). The present study used a large sample of psychiatrically hospitalized children (N?=?680; 73 % male; 66 % African American) between the ages of 6 and 12 to examine the latent structure of SCT, ADHD, oppositional defiant disorder (ODD), depression, and anxiety using confirmatory factor analysis (CFA). Results of the CFA analyses demonstrated that SCT is distinct from these other dimensions of child psychopathology, including ADHD inattention, depression, and anxiety. Regression analyses indicated that SCT symptoms were positively associated with depression and, to a lesser degree, anxiety. SCT symptoms were also positively associated with children’s general social problems, whereas SCT symptoms were negatively associated with an observational measure of behavioral dysregulation (i.e., frequency of time-outs received as a part of a manualized behavior modification program). These associations were significant above and beyond relevant child demographic variables (i.e., age, sex, race), children’s other mental health symptoms (i.e., ADHD, ODD, depression, anxiety symptoms), and, for all relations except child anxiety, parents’ own anxiety and depression symptoms.     

Unique Associations between Childhood Temperament Characteristics and Subsequent Psychopathology Symptom Trajectories from Childhood to Early Adolescence

Existing research suggests that temperamental traits that emerge early in childhood may have utility for early detection and intervention for common mental disorders. The present study examined the unique relationships between the temperament characteristics of reactivity, approach-sociability, and persistence in early childhood and subsequent symptom trajectories of psychopathology (depression, anxiety, conduct disorder, and attention-deficit hyperactivity disorder; ADHD) from childhood to early adolescence. Data were from the first five waves of the older cohort from the Longitudinal Study of Australian Children (n = 4983; 51.2% male), which spanned ages 4–5 to 12–13. Multivariate ordinal and logistic regressions examined whether parent-reported child temperament characteristics at age 4–5 predicted the study child’s subsequent symptom trajectories for each domain of psychopathology (derived using latent class growth analyses), after controlling for other presenting symptoms. Temperament characteristics differentially predicted the symptom trajectories for depression, anxiety, conduct disorder, and ADHD: Higher levels of reactivity uniquely predicted higher symptom trajectories for all 4 domains; higher levels of approach-sociability predicted higher trajectories of conduct disorder and ADHD, but lower trajectories of anxiety; and higher levels of persistence were related to lower trajectories of conduct disorder and ADHD. These findings suggest that temperament is an early identifiable risk factor for the development of psychopathology, and that identification and timely interventions for children with highly reactive temperaments in particular could prevent later mental health problems.     

The Separation of ADHD Inattention and Hyperactivity-Impulsivity Symptoms: Pathways from Genetic Effects to Cognitive Impairments and Symptoms

Both shared and unique genetic risk factors underlie the two symptom domains of attention deficit hyperactivity disorder (ADHD): inattention and hyperactivity-impulsivity. The developmental course and relationship to co-occurring disorders differs across the two symptom domains, highlighting the importance of their partially distinct etiologies. Familial cognitive impairment factors have been identified in ADHD, but whether they show specificity in relation to the two ADHD symptom domains remains poorly understood. We aimed to investigate whether different cognitive impairments are genetically linked to the ADHD symptom domains of inattention versus hyperactivity-impulsivity. We conducted multivariate genetic model fitting analyses on ADHD symptom scores and cognitive data, from go/no-go and fast tasks, collected on a population twin sample of 1,312 children aged 7–10. Reaction time variability (RTV) showed substantial genetic overlap with inattention, as observed in an additive genetic correlation of 0.64, compared to an additive genetic correlation of 0.31 with hyperactivity-impulsivity. Commission errors (CE) showed low additive genetic correlations with both hyperactivity-impulsivity and inattention (genetic correlations of 0.17 and 0.11, respectively). The additive genetic correlation between RTV and CE was also low and non-significant at ?0.10, consistent with the etiological separation between the two indices of cognitive impairments. Overall, two key cognitive impairments phenotypically associated with ADHD symptoms, captured by RTV and CE, showed different genetic relationships to the two ADHD symptom domains. The findings extend a previous model of two familial cognitive impairment factors in combined subtype ADHD by separating pathways underlying inattention and hyperactivity-impulsivity symptoms.     

Parental Cognitive Errors Mediate Parental Psychopathology and Ratings of Child Inattention

We investigate the Depression‐Distortion Hypothesis in a sample of 199 school‐aged children with ADHD‐Predominantly Inattentive presentation (ADHD‐I) by examining relations and cross‐sectional mediational pathways between parental characteristics (i.e., levels of parental depressive and ADHD symptoms) and parental ratings of child problem behavior (inattention, sluggish cognitive tempo, and functional impairment) via parental cognitive errors. Results demonstrated a positive association between parental factors and parental ratings of inattention, as well as a mediational pathway between parental depressive and ADHD symptoms and parental ratings of inattention via parental cognitive errors. Specifically, higher levels of parental depressive and ADHD symptoms predicted higher levels of cognitive errors, which in turn predicted higher parental ratings of inattention. Findings provide evidence for core tenets of the Depression‐Distortion Hypothesis, which state that parents with high rates of psychopathology hold negative schemas for their child's behavior and subsequently, report their child's behavior as more severe.     

Evidence for a General ADHD Factor from a Longitudinal General School Population Study

Recent factor analytic studies in Attention-Deficit/Hyperactivity Disorder (ADHD) have shown that hierarchical models provide a better fit of ADHD symptoms than correlated models. A hierarchical model includes a general ADHD factor and specific factors for inattention, and hyperactivity/impulsivity. The aim of this 12-month longitudinal study was to test the generalizability of the hierarchical models of ADHD within an elementary school population of 6–9 year old children (250 boys, 260 girls). Examination of differences as a function of informant (parent vs. teacher ratings), sex, and time was conducted. Six potential factor structures for the 18 items of the SWAN (Strengths and Weaknesses of ADHD-symptoms and Normal-behavior) scale were tested using confirmatory and exploratory factor analyses. Hierarchical models with a general ADHD factor and two or three specific factors best accounted for parent and teacher reports of symptoms for both boys and girls and at two time points separated by a 12-month interval. Findings indicate that the 18 SWAN items measure a common latent trait as well as orthogonal factors or dimensions of inattention and hyperactivity/impulsivity.     

The Role of Maternal and Child ADHD Symptoms in Shaping Interpersonal Relationships

The current study investigated the influence of maternal ADHD symptoms on: (a) mothers’ own social functioning; (b) their child’s social functioning; and (c) parent–child interactions following a lab-based playgroup involving children and their peers. Participants were 103 biological mothers of children ages 6–10. Approximately half of the children had ADHD, and the remainder were comparison youth. After statistical control of children’s ADHD diagnostic status and mothers’ educational attainment, mothers’ own inattentive ADHD symptoms predicted poorer self-reported social skills. Children with ADHD were reported to have more social problems by parents and teachers, as well as received fewer positive sociometric nominations from playgroup peers relative to children without ADHD. After control of child ADHD status, higher maternal inattention and hyperactivity/impulsivity each predicted children having more parent-reported social problems; maternal inattention predicted children receiving more negative sociometric nominations from playgroup peers. There were interactions between maternal ADHD symptoms and children’s ADHD diagnostic status in predicting some child behaviors and parent–child relationship measures. Specifically, maternal inattention was associated with decreased prosocial behavior for children without ADHD, but did not influence the prosocial behavior of children with ADHD. Maternal inattention was associated with mothers’ decreased corrective feedback and, at a trend level, decreased irritability toward their children with ADHD, but there was no relationship between maternal inattention and maternal behaviors for children without ADHD. A similar pattern was observed for maternal hyperactivity/impulsivity and mothers’ observed irritability towards their children. Treatment implications of findings are discussed.     

Personality Dimensions as Common and Broadband-Specific Features for Internalizing and Externalizing Disorders

Several researchers have suggested that the nature of the covariation between internalizing and externalizing disorders may be understood better by examining the associations between temperament or personality and these disorders. The present study examined neuroticism as a potential common feature underlying both internalizing and externalizing disorders and novelty seeking as a potential broad-band specific feature influencing externalizing disorders alone. Participants were 12- to 18-year-old twin pairs (635 monozygotic twin pairs and 691 dizygotic twin pairs; 48 % male and 52 % female) recruited from the Colorado Center for Antisocial Drug Dependence. Genetic and nonshared environmental influences shared in common with neuroticism influenced the covariation among distinct internalizing disorders, the covariation among distinct externalizing disorders, and the covariation between internalizing and externalizing disorders. Genetic influences shared in common with novelty seeking influenced the covariation among externalizing disorders and the covariation between major depressive disorder and externalizing disorders, but not the covariation among internalizing disorders or between anxiety disorders and externalizing disorders. Also, after accounting for genetic and environmental influences shared in common with neuroticism and novelty seeking, there were no significant common genetic or environmental influences among the disorders examined, suggesting that the covariance among the disorders is sufficiently explained by neuroticism and novelty seeking. We conclude that neuroticism is a heritable common feature of both internalizing disorders and externalizing disorders, and that novelty seeking is a heritable broad-band specific factor that distinguishes anxiety disorders from externalizing disorders.     

Sluggish Cognitive Tempo Symptoms Contribute to Heterogeneity in Adult Attention-Deficit Hyperactivity Disorder

Attention-deficit hyperactivity disorder (ADHD) persists into adulthood in over 50% of cases, although its associated symptom profiles, comorbid problems, and neuropsychological deficits change substantially across development. Sluggish cognitive tempo (SCT) symptoms may contribute to associations between ADHD and comorbid problems and may partially explain the substantial heterogeneity observed in its correlates. 349 adults aged 18–38 years (M = 23.2, SD = 4.5, 54.7% male, 61.03% with ADHD) completed a multi-informant diagnostic procedure and a comprehensive neuropsychological battery. Adults with ADHD (n = 213) were retained for analyses. Latent class analyses (LCA) revealed three profiles of SCT symptoms among those with ADHD, which we classified as minimal, moderate, or severe SCT. Multiple analysis of covariance (MANCOVA) revealed significant differences among these profiles, which remained when controlling for persistence of ADHD symptoms and sex. In general, adults with ADHD combined with SCT symptoms (moderate and severe) had significantly more symptoms of anxiety, depression, and persistent inattention, and had more severe professional and relational impairment compared to ADHD adults without SCT. Compared to those with moderate or minimal SCT symptoms, the severe SCT group had the most symptoms of depression and internalizing disorders, and the most impairment in the domain of daily responsibility. No significant differences based on externalizing symptoms emerged when controlling for sex and persistence of inattention symptoms, suggesting the moderate and severe SCT groups do not simply reflect more symptoms. Moreover, follow-up mediation analyses revealed that SCT might at least partially explain the heterogeneity in ADHD. Findings have implications for refinement of etiological conceptualization, assessment methods, and intervention strategies.     

The Role of Temperament and Personality in Problem Behaviors of Children with ADHD

This study describes temperament, personality, and problem behaviors in children with Attention-Deficit Hyperactivity Disorder (ADHD) aged 6 to 14 years. It targets differences between an ADHD sample (N = 54; 43 boys) and a large community sample (N = 465; 393 boys) in means and variances, psychometric properties, and covariation between traits and internalizing and externalizing problems. Parents rated their children on Buss and Plomin’s and Rothbart’s temperament models, a child-oriented five-factor personality model and also on problem behavior. Relative to the comparison group, children with ADHD presented with a distinct trait profile exhibiting lower means on Effortful Control, Conscientiousness, Benevolence and Emotional Stability, higher means on Emotionality, Activity, and Negative Affect, but similar levels of Surgency, Shyness, and Extraversion. Striking similarities in variances, reliabilities and, in particular, of the covariation between trait and maladjustment variables corroborate the spectrum hypothesis and suggest that comparable processes regulate problem behavior in children with and without ADHD.     

Attention control in middle childhood: relations to psychopathological symptoms and threat perception distortions

The present study examined the construct of attention control, which is an important aspect of effortful control, in a sample of non-clinical children aged between 9 and 13 years. Results demonstrated that attention control was associated with a broad range of psychopathological complaints, including symptoms of anxiety, aggression, depression, and ADHD. As predicted, lower levels of attention control were accompanied by higher levels of these symptoms. Further, attention control was also negatively related to threat perception distortions, which indicates that children who display low levels of this regulative temperament factor are more prone to such cognitive biases. Third, when controlling for neuroticism, attention control remained significantly (negatively) associated with symptoms of anxiety, depression (child report only), and ADHD. The correlations between attention control and threat perception distortions largely disappeared when the influence of neuroticism was partialled out. Only the link between attention control and anxious interpretations of ambiguous vignettes survived this correction. Finally, no evidence was found for the hypothesised mediating role of cognitive distortions on the relation between temperament factors and psychopathological symptoms.     

Temperament and common disruptive behavior problems in preschool

The study evaluated trait associations with common Disruptive Behavior Disorders (DBD), Oppositional Defiant Disorder (ODD) and Attention-Deficit/Hyperactivity Disorder (ADHD), during an understudied developmental period: preschool. Participants were 109 children ages 3–6 and their families. DBD symptoms were available via parent and teacher/caregiver report on the Disruptive Behavior Rating Scale. Traits were measured using observational coding paradigms, and parent and examiner report on the Child Behavior Questionnaire and the California Q-Sort. The DBD groups exhibited significantly higher negative affect, higher surgency, and lower effortful control. Negative affect was associated with most DBD symptom domains; surgency and reactive control were associated with hyperactivity-impulsivity; and effortful control was associated with ADHD and inattention. Interactive effects between effortful control and negative affect and curvilinear associations of reactive control with DBD symptoms were evident. Temperament trait associations with DBD during preschool are similar to those seen during middle childhood. Extreme levels of temperament traits are associated with DBD as early as preschool.     

Anxiety as a Predictor and Outcome Variable in the Multimodal Treatment Study of Children with ADHD (MTA)

Initial moderator analyses in the Multimodal Treatment Study of Children with ADHD (MTA) suggested that child anxiety ascertained by parent report on the Diagnostic Interview Schedule for Children 2.3 (DISC Anxiety) differentially moderated the outcome of treatment. Left unanswered were questions regarding the nature of DISC Anxiety, the impact of comorbid conduct problems on the moderating effect of DISC Anxiety, and the clinical significance of DISC Anxiety as a moderator of treatment outcome. Thirty-three percent of MTA subjects met DSM-III-R criteria for an anxiety disorder excluding simple phobias. Of these, two-thirds also met DSM-III-R criteria for comorbid oppositional-defiant or conduct disorder whereas one-third did not, yielding an odds ratio of approximately two for DISC Anxiety, given conduct problems. In this context, exploratory analyses of baseline data suggest that DISC Anxiety may reflect parental attributions regarding child negative affectivity and associated behavior problems (unlike fearfulness), particularly in the area of social interactions, another core component of anxiety that is more typically associated with phobic symptoms. Analyses using hierarchical linear modeling (HLM) indicate that the moderating effect of DISC Anxiety continues to favor the inclusion of psychosocial treatment for anxious ADHD children irrespective of the presence or absence of comorbid conduct problems. This effect, which is clinically meaningful, is confined primarily to parent-reported outcomes involving disruptive behavior, internalizing symptoms, and inattention; and is generally stronger for combined than unimodal treatment. Contravening earlier studies, no adverse effect of anxiety on medication response for core ADHD or other outcomes in anxious or nonanxious ADHD children was demonstrated. When treating ADHD, it is important to search for comorbid anxiety and negative affectivity and to adjust treatment strategies accordingly.     

Which components of processing speed are affected in ADHD subtypes?

The term “processing speed” (PS) encompasses many components including perceptual, cognitive and output speed. Despite evidence for reduced PS in Attention-Deficit/Hyperactivity Disorder (ADHD), little is known about which component(s) is most impacted in ADHD, or how it may vary by subtypes. Participants included 151 children, ages 8–12 years, with ADHD Predominantly Inattentive Type, ADHD Combined Type and typically developing controls using DSM-IV criteria. All children completed four measures of processing speed: Symbol Search, Coding, Decision Speed, and simple reaction time. We found children with ADHD-PI and ADHD-C had slower perceptual and psychomotor/incidental learning speed than controls and that ADHD-PI had slower decision speed than controls. The subtypes did not differ on any of these measures. Mean reaction time was intact in ADHD. Hence, at a very basic output level, children with ADHD do not have impaired speed overall, but as task demands increase their processing speed becomes less efficient than controls’. Further, perceptual and psychomotor speed were related to inattention, and psychomotor speed/incidental learning was related to hyperactivity/impulsivity. Thus, inattention may contribute to less efficient performance and worse attention to detail on tasks with a higher perceptual and/or psychomotor load; whereas hyperactivity/impulsivity may affect psychomotor speed/incidental learning, possibly via greater inaccuracy and/or reduced learning efficiency. Decision speed was not related to either dimension. Results suggest that PS deficits are primarily linked to the inattention dimension of ADHD but not exclusively. Findings also suggest PS is not a singular process but rather a multifaceted system that is differentially impacted in ADHD.     

Negative Halo Effects in Parent Ratings of ADHD and ODD

Parent ratings of ADHD and ODD symptoms depicted in written vignettes were examined for negative halo effects. Participants were 82 parents of children ages 6–12. Both unidirectional and bidirectional halo effects were found but to a lesser extent than in similar studies with teacher and college student raters. Specifically, parents were more likely to: (a) rate a child as inattentive in the presence of hyperactivity symptoms; (b) more likely to rate a child as oppositional in the presence of inattention and hyperactivity symptoms; and (c) more likely to rate a child as inattentive and hyperactive in the presence of oppositionality symptoms. Several specific symptoms were also found to be particularly susceptible to halo effects. Results suggest that parents may be more discerning raters of disruptive behavior disorders than teachers or college students and less prone to negative halo effects. Implications for clinical practice and future research directions are discussed.     

Developmental change in the relation between executive functions and symptoms of ADHD and co‐occurring behaviour problems

In a sample of 92 children aged 6–13 years this study investigates the normal developmental change in the relation between executive functioning (EF) and the core behavioural symptoms associated with attention deficit hyperactivity disorder (ADHD) (hyperactivity/impulsivity and inattention) as well as symptoms often co‐occurring with childhood hyperactivity (conduct‐ and internalizing problems). EF was assessed by using multiple tests grouped through prior factor analysis, resulting in cognitive measures relating to disinhibition, speed/arousal, verbal working memory, non‐verbal working memory, and fluency. The results showed that although disinhibition was positively related to hyperactivity/impulsivity and inattention mainly for the youngest age group, there were no significant age effects for these relations. Instead, age effects were found for the relations between speed/arousal and inattention as well as for the relations between verbal working memory/fluency and inattention. In the oldest age group poor performance on these cognitive measures was associated with high ratings of inattention. For the total sample a relation was obtained between disinhibition and hyperactivity/impulsivity as well as between both working memory measures and internalizing problems. In conclusion, the results from this study suggest that poor inhibition is most clearly associated with ADHD symptoms for younger children, whereas poor functioning with regard to later developing and more complex executive functions such as working memory and fluency is associated with ADHD symptoms for older children. Copyright © 2006 John Wiley & Sons, Ltd.