Do children with attention-deficit/hyperactivity disorder (ADHD) have set shifting deficits?
Open accessAbstract
OBJECTIVE: Set shifting, or cognitive flexibility, is a core executive function involving the ability to quickly and efficiently shift back and forth between mental sets. Meta-analysis suggests medium-magnitude shifting impairments in attention-deficit/hyperactivity disorder (ADHD). However, this conclusion may be premature because the evidence-base relies exclusively on tasks that have been criticized for poor construct validity and may better reflect general neuropsychological functioning rather than shifting specifically. METHOD: A well-characterized sample of 77 children ages 8-13 (M = 10.46, SD = 1.54; 32 girls; 66% Caucasian/non-Hispanic) with ADHD (n = 43) and without ADHD (n = 34) completed the criterion global-local set shifting task and 2 counterbalanced control tasks that were identical in all aspects except the key processes. RESULTS: The experimental manipulation was successful at evoking set shifting demands during the global-local versus both nonshift control tasks (p < .001; ω2 = .12-.14). Mixed-model analyses of variance (ANOVAs) revealed that the ADHD group did not demonstrate disproportional decrements in speed shift costs on the shifting versus nonshift control tasks (p = .30; ω2 = .002), suggesting no evidence of impaired set shifting abilities in ADHD. In contrast, the ADHD group made disproportionately more shifting errors than the non-ADHD group (p = .03; ω2 = 0.03) that were more parsimoniously attributable to prerequisite (nonshifting) processes necessary for successful performance on the global-local task. CONCLUSIONS: Children with ADHD's impaired performance on shifting tasks may be attributable to difficulties maintaining competing rule sets and/or inhibiting currently active rule sets prior to shifting. However, when these higher-order processes are executed successfully, there is no significant evidence to suggest a unique set shifting deficit in ADHD. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Early meta-analyses of inhibitory control deficits in ASD found small to medium effect sizes on tasks similar to those used in ADHD (response inhibition d=0.55; interference control d=0.31).
“Early meta-analyses of inhibitory control deficits among youth with ASD revealed small to medium effect sizes on tasks similar to those used in the study of youth with ADHD (response inhibition: d=0.55; interference control: d=0.31)80.”
From Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder (2024) · cites this paper as [80]
The Set Shifting in ADHD section reports meta-analytic effect sizes of d=0.46–0.65 for set shifting in pediatric ADHD, not inhibitory control in youth with ASD. Searches for ASD response inhibition, interference control, and the claimed d=0.55 and d=0.31 estimates found no passage addressing those figures. Page numbers were not available in our copy. (LLM, conf=0.75)
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- Authors
- Irwin, L. N., Kofler, M. J., Soto, E. F., & Groves, N. B.
- Affiliations
- Florida State University (US)
- Venue
- Neuropsychology
- Published
- 2019-05
- Volume
- 33
- Issue
- 4
- Pages
- 470-481
- ISSN
- 0894-4105 (ISSN-L)
- 1931-1559
- PMC
- PMC6668027
- OpenAlex
- W2935350776
- Cited by
- 54
- References
- 76
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 9 · 2023: 8 · 2022: 12 · 2021: 8 · 2020: 4 · 2019: 2
- FWCI
- 5.17
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Neuropsychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R34 MH102499-01)
- 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, set-shifting, cognitive flexibility, executive function, children, inhibitory control, construct validity
- MeSH terms
- Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Female, Humans, Male, Neuropsychological Tests, Set, Psychology, Executive Function
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