Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders
Open accessAbstract
IQ scores are volatile indices of global functional outcome, the final common path of an individual’s genes, biology, cognition, education, and experiences. In studying neurocognitive outcomes in children with neurodevelopmental disorders, it is commonly assumed that IQ can and should be partialed out of statistical relations or used as a covariate for specific measures of cognitive outcome. We propose that it is misguided and generally unjustified to attempt to control for IQ differences by matching procedures or, more commonly, by using IQ scores as covariates. We offer logical, statistical, and methodological arguments, with examples from three neurodevelopmental disorders (spina bifida meningomyelocele, learning disabilities, and attention deficit hyperactivity disorder) that: (1) a historical reification of general intelligence, g , as a causal construct that measures aptitude and potential rather than achievement and performance has fostered the idea that IQ has special status and that in studying neurocognitive function in neurodevelopmental disorders; (2) IQ does not meet the requirements for a covariate; and (3) using IQ as a matching variable or covariate has produced overcorrected, anomalous, and counterintuitive findings about neurocognitive function. ( JINS , 2009, 15 , 331–343.)
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There is substantial evidence of a significant relationship between general intelligence and performance-based EF measures.
“There is substantial evidence of a significant relationship between general intelligence and performance-based EF measures (Brydges, Reid, Fox, & Anderson, 2012;Dennis et al., 2009;Duggan & Garcia-Barrera, 2015;Engelhardt et al., 2016).”
From Assessment of executive function in ADHD adolescents: contribution of performance tests and rating scales (2018) · cites this paper as Dennis et al., 2009
In “IQ and ADHD” (page unavailable), the paper says correlations between IQ and executive function were not significant in the ADHD-family evidence it discusses. That is contrary to citing it as evidence of a significant relationship, although the paper’s statement is specific to that setting rather than all performance-based EF measures. (LLM, conf=0.84)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredIQ was not included as a covariate because of statistical, methodological, and conceptual arguments against covarying IQ when studying cognitive processes in ADHD.
“IQ was not included as a covariate based on compelling statistical, methodological, and conceptual rationale against covarying IQ when investigating cognitive processes in ADHD (Dennis et al., 2009; Kofler et al., 2016).”
From Working memory and short-term memory deficits in ADHD: A bifactor modeling approach (2020) · cites this paper as Dennis et al., 2009
ADHD has been significantly associated with both EF and IQ deficits.
“ADHD has been significantly associated with both EF and IQ deficits (Dennis et al., 2009;Duggan & Garcia-Barrera, 2015).”
From Assessment of executive function in ADHD adolescents: contribution of performance tests and rating scales (2018) · cites this paper as Dennis et al., 2009
Replicated evidence supports the view that conditions such as ASD and ADHD are extreme ends along natural continuums of characteristics that are normally distributed across the general population.
“replicated evidence supports the view that conditions such as ASD168,169 and ADHD170 are extreme ends along natural continuums of characteristics that are normally distributed across the general population.”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [170]
Citation 170 is attached to ADHD. The paper’s “IQ and ADHD” section discusses IQ differences and executive-function deficits, but does not say that ADHD lies at the extreme of normally distributed traits in the general population. Searches for a continuum, an extreme end, and normal distribution did not find that claim in our copy. (LLM, conf=0.75)
Experimental — accuracy not yet measuredOnly age was used as a covariate in cognitive analyses because IQ and sex are inherently confounded with ASD and ADHD and could not be separated from disorder effects.
“If differences were detected, only age was implemented as a covariate in further analyses on cognitive data, as both IQ and sex are inherently confounded with ASD and ADHD, and therefore could not be separated from the effects of the disorders.37”
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“4 IQ was not included as a covariate based on compelling statistical, methodological, and conceptual rationale against covarying IQ when investigating cognitive processes in ADHD (Dennis et al., 2009; Kofler et al., 2016).”
BackgroundHeterogeneity in ADHD: Neurocognitive predictors of peer, family, and academic functioning
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BackgroundMethodInfluentialWells, E. L., Kofler, M. J., Soto, E. F., Schaefer, H. S., & Sarver, D. E. (2018) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2017.10.024 · Cited by 84 · see citing works
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“This residual IQ score represents intellectual functions that are important for IQ test performance but unrelated to executive functioning, and was computed to improve construct specificity because IQ performance depends heavily on more specific executive functions such as working memory, even for IQ subtests not labe…”
MethodChantiluke, K., Barrett, N., Giampietro, V., Brammer, M., Simmons, A., Murphy, D. G., & Rubia, K. (2015) · Cerebral Cortex · doi:10.1093/cercor/bht365 · Cited by 59 · see citing works
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“, 2015] and thus correction for IQ might introduce a possible bias to the findings [Dennis et al., 2009].”
ResultPatros, C. H. G., Alderson, R. M., Lea, S. E., Tarle, S. J., Kasper, L. J., & Hudec, K. L. (2015) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2014.12.016 · Cited by 43 · see citing works
Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder
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“170 for compelling statistical, methodological and conceptual rationale).”
Learning and Memory in Adolescents with Critical Biventricular Congenital Heart Disease
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“, 2004) and adding it as a covariate may produce overcorrected and inconsistent findings (Dennis et al., 2009).”
BackgroundResultIrwin, L. N., Soto, E. F., Chan, E. S. M., Miller, C. E., Carrington-Forde, S., Groves, N. B., & Kofler, M. J. (2021) · Child Neuropsychology · doi:10.1080/09297049.2020.1866521 · Cited by 39 · see citing works
“In the current sample, IQ was not included as a covariate based on compelling statistical, methodological, and conceptual rationale against covarying IQ when investigating cognitive processes in ADHD (Dennis et al., 2009).”
BackgroundInfluentialConcordance of teacher-rated and performance-based measures of executive functioning in preschoolers
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The effects of ADHD on cognitive performance
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“Similarly, no models adjusted for IQ, as IQ is causal in cognitive functioning such that adjusting for IQ would remove warranted variation in EF outcomes (Dennis et al. 2009).”
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- Authors
- DENNIS, M., FRANCIS, D. J., CIRINO, P. T., SCHACHAR, R., BARNES, M. A., & FLETCHER, J. M.
- Affiliations
- Hospital for Sick Children (CA)
- University of Houston (US)
- University of Toronto (CA)
- Corresponding author
- DENNIS, MAUREEN
- Venue
- Journal of the International Neuropsychological Society
- Publisher
- Cambridge University Press (CUP)
- Published
- 2009-05
- Volume
- 15
- Issue
- 3
- Pages
- 331-343
- ISSN
- 1355-6177 (ISSN-L)
- 1469-7661
- PMC
- PMC3075072
- OpenAlex
- W2008850124
- Cited by
- 875
- References
- 108
- Citations by year
- 2026: 17 · 2025: 30 · 2024: 38 · 2023: 45 · 2022: 55 · 2021: 54 · 2020: 55 · 2019: 54 · 2018: 70 · 2017: 61 · 2016: 65 · 2015: 69 · 2014: 70 · 2013: 65 · 2012: 54
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of the International Neuropsychological Society (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Child Health and Human Development
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (P01HD035946, P01 HD 35946, P50HD052117, P01 HD35946-06)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Down syndrome and intellectual disability research
- Keywords
- neurodevelopmental disorders, general intelligence, matching procedure, neurocognitive function, learning disabilities, attention deficit hyperactivity disorder, overcorrection, cognitive outcomes
- MeSH terms
- Analysis of Variance, Attention Deficit Disorder with Hyperactivity, Child, Cognition, Cognition Disorders, Humans, Intelligence, Learning Disabilities, Spina Bifida Cystica
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