The DOI matches its Crossref record; 91 of the 94 references it cites were found in a registry or an index; 3 of the 24 sources its claims cite were checked for support.
Executive Functioning Heterogeneity in Pediatric ADHD
Open accessAbstract
Neurocognitive heterogeneity is increasingly recognized as a valid phenomenon in ADHD, with most estimates suggesting that executive dysfunction is present in only about 33%-50% of these children. However, recent critiques question the veracity of these estimates because our understanding of executive functioning in ADHD is based, in large part, on data from single tasks developed to detect gross neurological impairment rather than the specific executive processes hypothesized to underlie the ADHD phenotype. The current study is the first to comprehensively assess heterogeneity in all three primary executive functions in ADHD using a criterion battery that includes multiple tests per construct (working memory, inhibitory control, set shifting). Children ages 8-13 (M = 10.37, SD = 1.39) with and without ADHD (N = 136; 64 girls; 62% Caucasian/Non-Hispanic) completed a counterbalanced series of executive function tests. Accounting for task unreliability, results indicated significantly improved sensitivity and specificity relative to prior estimates, with 89% of children with ADHD demonstrating objectively-defined impairment on at least one executive function (62% impaired working memory, 27% impaired inhibitory control, 38% impaired set shifting; 54% impaired on one executive function, 35% impaired on two or all three executive functions). Children with working memory deficits showed higher parent- and teacher-reported ADHD inattentive and hyperactive/impulsive symptoms (BF 10 = 5.23 × 10 4), and were slightly younger (BF 10 = 11.35) than children without working memory deficits. Children with vs. without set shifting or inhibitory control deficits did not differ on ADHD symptoms, age, gender, IQ, SES, or medication status. Taken together, these findings confirm that ADHD is characterized by neurocognitive heterogeneity, while suggesting that contemporary, cognitively-informed criteria may provide improved precision for identifying a smaller number of neuropsychologically-impaired subtypes than previously described.
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Claims the paper makes
13 Own result · 8 No full text of the sources · 2 Partly supported · 1 Supported so far · accuracy not yet measured
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Working memory impairments are reported in 30% to 37% (Coghill et al., 2014; Fair et al., 2012), and inhibitory control deficits are detected in 21%–46% of pediatric ADHD cases (Coghill et al., 2014; Nigg et al., 2005; Solanto et al., 2001; Sonuga-Barke et al., 2010).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Executive Functioning in ADHD
What the sources say
- Not checked — no full text of the sourcecites Coghill et al., 2014 source
- Partly supportedcites Fair et al., 2012 sourceExperimental — accuracy not yet measured
In Results (page unavailable), Fair et al. identify two ADHD subgroups with reduced working memory, comprising 17% and 20% of their ADHD sample—37% combined. The paper does not report the 30% lower bound, so it supports only part of the cited range. Fair et al. are cited for the working-memory clause, not the separate inhibitory-control range. (LLM, conf=0.86)
- Not checked — no full text of the sourcecites Nigg et al., 2005 source
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“no study of ADHD-related heterogeneity has simultaneously measured and controlled for all three primary executive functions (Miyake et al., 2000), and conclusions may be limited by the use of single tasks to assess neurocognitive construct(s) (Conway et al., 2005).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Construct Validity and Task Impurity
What the sources say
- Not checked — no full text of the sourcecites Coghill et al. (2014) source
- Not checked — no full text of the sourcecites Miyake et al., 2000 source
- Supportedcites Conway et al., 2005 source
The citing sentence attributes the ADHD-heterogeneity statement to Miyake et al., not Conway et al. Conway et al.’s Latent Variable Analysis section supports the cited methodological caution: it says multiple tasks yield a purer measure of a construct by removing task-specific factors, whereas one task does not. (LLM, conf=0.92)
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“estimates for the proportion of pediatric ADHD cases who exhibit any form of executive dysfunction range from 21% to 60% across studies employing a wide range of tasks and impairment criteria (Biederman et al., 2004; Coghill et al., 2014; Fair, Bathula, Nikolas, & Nigg, 2012; Geurts, van der Oord, & Crone, 2006; Nigg et al., 2005; Solanto et al., 2001; Sonuga-Barke, Bitsalou, & Thompson, 2010).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Executive Functioning in ADHD
What the sources say
- Not checked — no full text of the sourcecites Biederman et al., 2004 source
- Not checked — no full text of the sourcecites Coghill et al., 2014 source
- Partly supportedcites Fair, Bathula, Nikolas, & Nigg, 2012 sourceExperimental — accuracy not yet measured
The introduction says that only a subset of children with ADHD may be affected on any one neuropsychological measure, and the Results identify distinct ADHD subgroups. But the Results’ 21% refers to one subgroup with relatively high reaction-time variability; the paper does not report a 21%–60% range for any executive dysfunction across studies or impairment criteria. Page numbers were not available in our copy. (LLM, conf=0.82)
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Highly similar results were also obtained when allowing covariation among the three executive functioning estimates by specifying an oblique rather than orthogonal factor solution (84% of ADHD sample classified as impaired; sensitivity = 83.64% [71.20, 92.23], specificity = 81.48% [73.30, 89.25]).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 3: Sensitivity Analyses
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Approximately half of the children with ADHD showed impairment on a single executive function (54%), and an additional third showed impairments on two (31%) or all three (4%) executive functions.”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 1: Executive Functioning Impairments in ADHD
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“89% of children with ADHD were classified as Impaired on at least one executive function component (n = 49 of 55).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 1: Executive Functioning Impairments in ADHD
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Highly similar results were also obtained when controlling for age, gender, and SES by residualizing for these variables and then re-computing impairment estimates (82% of ADHD sample classified as impaired; sensitivity = 81.82% [69.10, 90.92], specificity = 80.25% [69.91, 88.27]).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 3: Sensitivity Analyses
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Within specific executive function domains, 62% of children with ADHD were classified as Impaired in working memory (ORlog = 2.62), 27% Impaired in inhibitory control (ORlog = 1.49), and 38% Impaired in set shifting (ORlog = 2.36).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 1: Executive Functioning Impairments in ADHD
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results indicated significantly higher ADHD symptoms for children with impaired working memory (n=37) relative to children with unimpaired working memory (n=59) (BF10 = 5.23 x 104, d=0.36).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 2: Profiles of Impaired vs. Not Impaired Children
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results indicated significant evidence against ADHD symptom differences for children with impaired inhibitory control (n=19) relative to children with unimpaired inhibitory control (n=77) (BF01 = 5.80, d=0.04).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 2: Profiles of Impaired vs. Not Impaired Children
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Children with working memory impairment (Mage = 9.91, SD = 1.41) were slightly younger than children without working memory impairment (Mage = 10.82, SD = 1.45) (BF10 = 11.35, d=0.64).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 2: Profiles of Impaired vs. Not Impaired Children
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Results indicated significant evidence against ADHD symptom differences for children with impaired set shifting (n=24) relative to children with unimpaired set shifting (n=72) (BF01 = 7.34, d=0.02).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 2: Profiles of Impaired vs. Not Impaired Children
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This overall estimate of executive functioning showed high specificity (98.77% [93.31, 99.97]) but poor sensitivity (34.55% [22.24, 48.58]), supporting ADHD-related heterogeneity across executive function domains.”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 3: Sensitivity Analyses
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only 11% (6 of 55) of children with ADHD were classified as Not Impaired on all three executive functions.”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 1: Executive Functioning Impairments in ADHD
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“defining impairment as the 10th percentile of the Non-ADHD group resulted in 91% of ADHD children being classified as Impaired on at least one executive function (n=50 of 55; sensitivity = 90.91% [80.05, 96.98], specificity = 75.31% [64.47, 84.22]).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Tier 3: Sensitivity Analyses
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The ADHD group demonstrated group-level impairments in working memory (d = 1.41; BF10 = 1.64 x 1010), inhibitory control (d= 0.60; BF10 = 33.51), and set shifting (d = 0.46; BF10 = 4.29) relative to the Non-ADHD group.”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Results > Preliminary Analyses
In the paper
“these conclusions may be premature because the evidence-base is comprised, in large part, on data from clinical tests developed to detect gross neurological impairment rather than the more subtle deficits in cognitive control hypothesized to underlie the ADHD phenotype.”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Construct Validity and Task Impurity
What the sources say
- Not checked — no full text of the sourcecites Sonuga-Barke et al. (2008) source
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“no task is process pure (Shipstead, Redick, & Engle, 2010): all tasks require multiple executive and non-executive neurocognitive abilities for successful performance, and conclusions regarding effect specificity are limited when these correlated but distinct abilities are not measured and simultaneously controlled (Miyake & Friedman, 2012).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Construct Validity and Task Impurity
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“factor analytic and theoretical work provides the most empirical support for models that include three primary executive function domains: working memory, inhibitory control, and set shifting (Miyake et al., 2000; Miyake & Friedman, 2012; St. Clair-Thompson & Gathercole, 2006; Van der Molen et al., 2006; Van der Sluis et al., 2007).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Executive Functioning
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Executive functions refer to a set of interrelated, higher-order cognitive processes that enable goal directed behavior and novel problem solving (Baddeley, 2007; Miyake et al., 2000).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Executive Functioning
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“meta-analytic effect sizes of d=0.46 to 0.55 (Willcutt et al., 2005) predict that 30%–36% of children with ADHD may demonstrate set shifting impairments based on converting effect size differences into expected population overlap proportions (Zakzanis et al., 2001).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Executive Functioning in ADHD
In the paper
“Using meta-regression, they found that their estimate of working memory deficits in ADHD increased from medium to very large (d=2.0–2.2) when based on working memory tasks with a prominent executive component congruent with contemporary cognitive definitions.”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Construct Validity and Task Impurity
What the sources say
- Not checked — no full text of the sourcecites Kasper et al., 2012 source
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“Working memory and inhibitory control have been studied extensively in pediatric ADHD, with meta-analyses indicating medium to large group-level impairments on tasks intended to assess these executive functions (Alderson et al., 2007; Kasper et al., 2012; Lijffijt et al., 2005; Martinussen et al., 2005; Willcutt et al., 2005).”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Executive Functioning in ADHD
In the paper
“only a minority of ADHD cases are classified as impaired on multiple executive function tests (Biederman et al., 2004)”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Construct Validity and Task Impurity
What the sources say
- Not checked — no full text of the sourcecites Biederman et al., 2004 source
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Results indicated that children with ADHD have large working memory deficits and medium-to-null inhibitory control and set shifting deficits relative to children without ADHD.51,53,56,58,75”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [51]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“a series of studies by some of the authors of the current Review included children with ADHD and ASD, controlled for ASD when evaluating executive functions in ADHD, and used a battery of construct-valid working memory tests.”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [51]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Similarly, Kofler et al. (9) reported that only 17% of children with ADHD have impairments in both inhibition and working memory (vs. 46% who have working memory but not inhibition deficits, and only 11% who have inhibition deficits but not working memory deficits).”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [9]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Although these effect sizes are not directly comparable because they reflect performance changes vs. between group differences, this finding is consistent with evidence that only 5-11% of children with ADHD have inhibition deficits without co-occurring working memory deficits (9, 74) and calls into question the extent to which children with ADHD have deficits in inhibitory control versus perform”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [9]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Furthermore, highly similar results were reported in recent heterogeneity studies reporting that 62%−85% of children with ADHD were classified as impaired in working memory (Fosco et al., in press; Karalunas et al., 2017; Kofler, Irwin et al., 2019).”
From Working memory and short-term memory deficits in ADHD: A bifactor modeling approach (2020) · cites this paper as Kofler, Irwin et al., 2019
The cited source says what the claim attributes to it.
In the citing paper
“Taken together, the results of the present study show that there is subtype-specific cognitive profile, measured by WISC-IV, in ADHD confirming a cognitive heterogeneity in ADHD in line with recent evidence [48].”
From ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference (2020) · cites this paper as [48]
The cited source says what the claim attributes to it.
In the citing paper
“A recent study that comprehensively examined executive functioning heterogeneity in pediatric ADHD using neuropsychological battery also found a positive association between impaired working memory and exhibiting higher ADHD symptoms [48].”
From ADHD subtype-specific cognitive correlates and association with self-esteem: a quantitative difference (2020) · cites this paper as [48]
The cited source says what the claim attributes to it.
In the citing paper
“Together, these findings suggest that only a small minority of children with ADHD have impairments in both working memory and inhibitory control, and thus appear to support models conceptualizing them as relatively independent impairments in ADHD.”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [9]
In the citing paper
“and are consistently linked with daily life executive functioning deficits (Becker et al., 2011), neuropsychological indicators of executive functioning difficulties (Kofler et al., 2019), and academic impairment (Dvorsky & Langberg, 2019).”
From Disentangling the effects of attentional difficulties on fears of social evaluation and social anxiety symptoms: Unique interactions with sluggish cognitive tempo (2020) · cites this paper as Kofler et al., 2019
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
“Sample ethnicity was mixed with 81 Caucasian Non-Hispanic (62%), 16 African American (12%), 14 Hispanic (11%), 13 multiracial children (10%), and 7 Asian (5%) children.”
§ Executive Functioning Heterogeneity in Pediatric ADHD > Method > Participants
Reported 136 · recomputed 131
Citations
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Research works printed but not linked: 2
- Kofler, M. J., Sarver, D. E., Harmon, S. L., Moltisanti, A., Aduen, P. A., Soto, E. F., & Ferretti, N. (2017). Working memory and organizational skills problems in ADHD. Journal of Child Psychology and Psychiatry.
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Cited by
Sorted by citations
Annual Research Review: The transdiagnostic revolution in neurodevelopmental disorders
Astle, D. E., Holmes, J., Kievit, R., & Gathercole, S. E. (2022) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.13481 · Cited by 384
Kaiser, A., Aggensteiner, P.-M., Baumeister, S., Holz, N. E., Banaschewski, T., & Brandeis, D. (2020) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2020.01.019 · Cited by 171
Christiansen, L., Beck, M. M., Bilenberg, N., Wienecke, J., Astrup, A. V., & Lundbye‐Jensen, J. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8060841 · Cited by 168
Executive functioning rating scales: Ecologically valid or construct invalid?
Soto, E. F., Kofler, M. J., Singh, L. J., Wells, E. L., Irwin, L. N., Groves, N. B., & Miller, C. E. (2020) · Neuropsychology · doi:10.1037/neu0000681 · Cited by 115
“Reliability and validity evidence includes high internal consistency (α = .81–.97) and 1–3-week test-retest reliability (.76–.90; Kofler et al., 2019; Sarver et al., 2015), and expected relations with criterion working memory complex span (r = .69) and updating tasks (r = .61) (Wells et al., 2018).”
BackgroundMethodInfluentialSelf-citationExecutive Functioning and Emotion Regulation in Children with and without ADHD
Groves, N. B., Wells, E. L., Soto, E. F., Marsh, C. L., Jaisle, E. M., Harvey, T. K., & Kofler, M. J. (2022) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-021-00883-0 · Cited by 110
Self-citation
Metadata
- Authors
- Kofler, M. J., Irwin, L. N., Soto, E. F., Groves, N. B., Harmon, S. L., & Sarver, D. E.
- Affiliations
- Florida State University (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Kofler, Michael J.
- ORCID
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2018-04-28
- Volume
- 47
- Issue
- 2
- Pages
- 273-286
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC6204311
- OpenAlex
- W2799310259
- Cited by
- 288
- References
- 94
- Citations by year
- 2026: 48 · 2025: 45 · 2024: 45 · 2023: 39 · 2022: 38 · 2021: 31 · 2020: 29 · 2019: 10 · 2018: 3
- FWCI
- 14.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34 MH102499)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- attention deficit hyperactivity disorder, executive function, working memory, inhibitory control, set-shifting, executive dysfunction, diagnostic criteria, inattentive symptoms, hyperactive-impulsive symptoms, children
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Inhibition, Psychological, Male, Memory, Short-Term, Neuropsychological Tests, Executive Function
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