Inhibitory Control and Information Processing in ADHD: Comparing the Dual Task and Performance Adjustment Hypotheses
Open accessAbstract
Inhibition is a key neurocognitive domain in ADHD that is commonly assessed with the stop-signal task. The stop-signal involves both "go" and "stop" trials; previous research indicates that response times are reliably slower to "go" trials during tasks with vs. without intermittent "stop" trials. However, it is unclear whether this pattern reflects deliberate slowing to maximize inhibitory success (performance adjustment hypothesis) and/or disrupted bottom-up information processing due to increased cognitive demands (dual-task hypothesis). Given the centrality of "go" responding for estimating children's inhibitory speed, finding that children with ADHD slow differently -or for different reasons- has the potential to inform cognitive and self-regulatory theories of ADHD. The current study used a carefully-controlled experimental design to assess the mechanisms underlying stop signal-related slowing in ADHD. Children ages 8-13 with (n = 81) and without ADHD (n = 63) completed the stop-signal task and a control task that differed only in the presence/absence of "stop" trials. Using drift-diffusion modeling, Bayesian repeated-measures ANOVAs revealed a pattern consistent with the performance adjustment hypothesis, such that children adopted more cautious response strategies (BF 10 = 6221.78; d = 0.38) but did not show changes in processing speed (BF 01 = 3.08; d = 0.12) or encoding/motor speed (BF 01 = 5.73; d = 0.07) when inhibition demands were introduced. Importantly, the ADHD/Non-ADHD groups showed equivalent effects of intermittent "stop" trials (BF 01 = 4.30-5.56). These findings suggest intact self-regulation/performance monitoring in the context of adapting to increased inhibitory demands in ADHD, which has important implications for the continued isolation of potential mechanisms associated with ADHD symptoms and impairment.
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Poor performance on inhibitory control tests was attributable in large part to the tests' working memory demands rather than to actual inhibition deficits in children with ADHD.
“poor performance on inhibitory control tests was attributable, in large part, to the tests’ working memory demands rather reflecting actual inhibition deficits in children with ADHD.31,152,153”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [152]
The Discussion’s Conclusions (page not available) attribute slower responses on the stop-signal task to a deliberate, cautious strategy, not to disrupted cognitive control. The Limitations say the study could not separate the effects of inhibitory, working-memory, and divided-attention demands, so it does not establish working memory as the main cause of poor test performance. (LLM, conf=0.83)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe pattern of results is consistent with recent calls to reconceptualize inhibition as an outcome rather than a process/mechanism that produces outcomes, in which the goal is to inhibit and we rely on other processes including working memory to do so successfully.
“Finally, this pattern of results is consistent with recent calls to reconceptualize inhibition as an outcome rather than a process/mechanism that produces outcomes (117). In this view, inhibition is not something we use to suppress a response; instead, the goal is to inhibit and we rely on other processes to do so successfully (117), including engaging working memory (this study) to adopt more”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [63]
Split into 2 atoms — 0 confirmed, 0 partially supported, 1 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredThe three primary executive function components appear to be separable into subprocesses.
“Similar to how executive function can be fractionated into three primary components, the three primary components seem to be separable into subprocesses.”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [152]
The “Inhibitory Control and Response Speed” section describes inhibitory control as involving action restraint and action cancellation. That supports subprocesses within one executive-function component, but the paper does not establish that all three primary components are separable into subprocesses. Page numbers were not available in our copy. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe three executive function components are moderately interrelated, and experimental evidence demonstrates that working memory impacts performance on inhibitory control tests but not vice versa, which could potentially explain why children with ADHD show deficits on inhibition tests.
“the three executive function components are moderately interrelated, and there is experimental evidence demonstrating that working memory impacts performance on inhibitory control tests (but not vice versa), which could potentially explain why children with ADHD show deficits on inhibition tests.152,157–159”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [152]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredThe pattern of results is consistent with evidence that experimentally increasing inhibition demands does not disrupt computationally modeled cognitive information processing or encoding/motor processes, but rather equivalently causes children with and without ADHD to adopt more cautious response styles.
“It is consistent also with evidence that experimentally increasing inhibition demands does not disrupt computationally modeled cognitive information processing or encoding/motor processes, but rather equivalently causes children with and without ADHD to adopt more cautious response styles (63).”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [63]
The 'working' component of working memory can be fractionated into continuous updating, dual-processing, and serial-temporal reordering; the 'memory' component can be fractionated into verbal, visual, and spatial short-term storage systems.
“the ‘working’ component can be fractionated into interrelated but distinguishable subprocesses involving continuous updating, dual-processing and serial-temporal reordering, and the ‘memory’ component can be fractionated into distinct verbal, visual and spatial short-term storage systems (Figure 1).20,56,152”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [152]
The Reaction Time Slowing: Dual-task Requirement Hypothesis section discusses working-memory demands from maintaining two task goals, but does not describe dual-processing as a distinct working-memory subprocess. The Discussion’s theoretical implications likewise do not address continuous updating, serial-temporal reordering, or separate verbal, visual, and spatial storage systems. Searches for those terms found no passage supporting the proposed fractionation; page numbers were unavailable in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredWorking memory can be divided into a 'working' component (mental processes operating on held information) and a 'memory' component (short-term memory, passive storage and rehearsal).
“working memory can be divided into its ‘working’ component (the mental processes that operate on mentally held information) and ‘memory’ component (short-term memory, the passive storage and rehearsal mechanisms that temporarily hold information in mind).”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [152]
The “Reaction Time Slowing: Dual-task Requirement Hypothesis” section discusses maintaining task goals in working memory, but does not divide working memory into ‘working’ and ‘memory’ components. Searches for passive storage, rehearsal, and short-term memory found no passage in our copy that addresses the claimed distinction; page numbers were not available. (LLM, conf=0.72)
Experimental — accuracy not yet measuredAnxiety may be associated with small impairments, or potentially a small strength, across executive functions, and thus the obtained effect sizes may be modest over- or under-estimates of ADHD-related impairments more broadly.
“Although both ADHD groups differentiated themselves from the anxiety disorders comparison group, and the anxiety group performed similarly to the non-ADHD groups in our prior experiments (with non-overlapping samples; e.g., 63, 85), anxiety may be associated with small impairments, or potentially a small strength, across executive functions and thus the obtained effect sizes may be modest over- or”
From Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions (2024) · cites this paper as [63]
The Method (Group Assignment) reports that some children in the non-ADHD group had anxiety, and the Discussion (Limitations) considers whether including non-ADHD disorders could obscure group differences. Neither passage assesses anxiety-related strengths or impairments across executive functions, or whether anxiety would over- or underestimate ADHD effect sizes. Searches for those specific points found no supporting passage in our copy. (LLM, conf=0.76)
Experimental — accuracy not yet measuredD-KEFS Tower Test internal consistency is .56-.84 (average .67) in 8-12 year olds.
“Internal consistency coefficients for the Tower Test range from .56 to .84 (average of .67) in 8-12 year olds [33,35].”
From Neurocognition in children with cognitive disengagement syndrome: accurate but slow (2024) · cites this paper as [33]
D-KEFS Tower Test test-retest reliability is moderate.
“Test-retest reliability is moderate for the Tower test [33,35,36].”
From Neurocognition in children with cognitive disengagement syndrome: accurate but slow (2024) · cites this paper as [33]
CDS was uniquely linked to slower performance on tasks with graphomotor or visual-motor coordination demands (TMT-C Parts A and B, Sky Search time per target, DKEFS-Tower), poorer TEA-Ch DT, and slower mental processing on Color Naming and Word Reading, which together contributed to slower DKEFS-CWI Inhibition.
“As summarized in Table 5, CDS was uniquely associated with slower performance on tasks with a graphomotor or visual-motor coordination component (TMT-C Parts A and B, Sky Search time per target, DKEFS-Tower), poorer performance on TEA-Ch DT (greater decrement when having to perform two simultaneous tasks), and slower speed of mental processing on fundamental cognitive skills (Color Naming and Word”
From Neurocognition in children with cognitive disengagement syndrome: accurate but slow (2024) · cites this paper as [33]
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Self-citationUsing task performance to inform treatment planning for youth with ADHD: A systematic review
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- Authors
- Fosco, W. D., Kofler, M. J., Alderson, R. M., Tarle, S. J., Raiker, J. S., & Sarver, D. E.
- Affiliations
- University at Buffalo, State University of New York (US)
- Florida State University (US)
- Oklahoma State University (US)
- Florida International University (US)
- University of Mississippi Medical Center (US)
- Corresponding author
- Sarver, Dustin E.
- ORCID
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2018-12-13
- Volume
- 47
- Issue
- 6
- Pages
- 961-974
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC6698914
- OpenAlex
- W2903746336
- Cited by
- 42
- References
- 86
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 5 · 2023: 9 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 2
- FWCI
- 2.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Florida International University Digital Commons (Florida International University) (submittedVersion)
- Funders
- National Institute of Mental Health (R34 MH102499-01)
- Oklahoma Center for the Advancement of Science and Technology (HR17-051)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Keywords
- attention deficit hyperactivity disorder, inhibitory control, stop-signal task, response slowing, drift-diffusion modeling, self-regulation, performance monitoring, processing speed, children
- MeSH terms
- Adaptation, Psychological, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Inhibition, Psychological, Male, Psychomotor Performance, Executive Function
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