Relationship between sluggish cognitive tempo and sleep, psychological, somatic, and cognitive problems and impairment in children with autism and children with ADHD

Mayes, Susan D; Calhoun, Susan L; Waschbusch, Daniel A

doi:10.1177/1359104520978459

Cited by 46Attention Deficit Hyperactivity DisorderAutism Spectrum Disorder ResearchChild and Adolescent Psychosocial and Emotional Development

Relationship between sluggish cognitive tempo and sleep, psychological, somatic, and cognitive problems and impairment in children with autism and children with ADHD

Mayes, Susan D, Calhoun, Susan L, Waschbusch, Daniel A·2021·Clinical Child Psychology and Psychiatry

DOI 10.1177/1359104520978459

Open this paper in CoChat — free account

Abstract

SCT) is a topic of renewed interest. Much remains to be learned about its association with symptoms and diagnoses that have received little research attention, particularly sleep disturbance, somatic complaints, and autism. Our study is the first to explore the relationship between SCT and sleep, internalizing, externalizing, somatic, and cognitive problems, impairment, and demographics in large samples of children with autism, ADHD-Combined, and ADHD-Inattentive. Mothers rated 1,436 children with autism and 1,056 with ADHD without autism, 2 to 17 years, on the Pediatric Behavior Scale (PBS). Factor analysis yielded a 6-item SCT factor (sluggish/slow moving/low energy, stares/preoccupied/in own world, tires easily, in a fog/confused, drowsy/sleepy/not alert, and apathetic) plus 10 additional factors. SCT was distinct from but related to several factors and was associated with social and academic impairment. The strongest independent predictors of SCT were depression, sleeping more than normal, cognitive problems, autism, and somatic complaints. Scores on the remaining factors (sleep disturbance, attention deficit, impulsivity, hyperactivity, oppositional defiant disorder, conduct disorder, and anxiety) increased explained variance by less than 2%. Findings suggest that SCT is not simply sluggish cognitive tempo, as the name implies, and is a complex construct with behavioral, affective, emotional, cognitive, and somatic components and associations. Given that 49% of children with autism had SCT, SCT symptoms should be considered in all children being evaluated for autism, as well as for ADHD-C and ADHD-I (with SCT percentages of 31% and 40%). Assessing and treating SCT is especially important because of its association with impairment.

Integrity signals

Registry

Crossref · 10.1177/1359104520978459

Cites

37 of 37 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

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?

13-16% of children with high CDS symptoms also meet criteria for an autism diagnosis, while 30-49% of children with autism present with elevated CDS symptoms.
“Studies indicate that 13-16% of children with high CDS symptoms also meet the criteria for an autism diagnosis, while 30-49% of children with autism present with elevated CDS symptoms [62-65].”
From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [63]
Studies in early childhood generally showed weak associations between CDS and slowed processing speed, while studies of older children and adults had mixed findings.
“Other evidence to support a link between CDS and a slowed processing speed comes from studies in early childhood [30, 31, 33] that generally showed weak associations, whereas studies of older children and adults have had mixed findings [10, 13, 14, 29, 32-40].”
From Pharmacologic Management of Cognitive Disengagement Syndrome (CDS) and Implications for Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment: Emerging Treatments and Recommendations for Future Research (2023) · cites this paper as [35]

Diagnostic and Statistical Manual of Mental Disorders
American Psychiatric Association (2013) · doi:10.1176/appi.books.9780890425596 · Cited by 116,369 · see citing works
Sleep Disordered Breathing in Children in a General Population Sample: Prevalence and Risk Factors
Bixler, E. O., Vgontzas, A. N., Lin, H.-M., Liao, D., Calhoun, S. L., Vela‐Bueno, A., Fedok, F. G., Vlašić, V., & Graff, G. R. (2009) · SLEEP · doi:10.1093/sleep/32.6.731 · Cited by 685 · see citing works
Self-citation
Advances in behavioral assessment of children and families
Landolf-Fritsche, B., & Roberts, M. C. (1990) · Clinical Psychology Review · doi:10.1016/0272-7358(90)90051-b · Cited by 555 · see citing works
ADHD With Comorbid Anxiety: A Review of the Current Literature
Schatz, D. B., & Rostain, A. L. (2006) · Journal of Attention Disorders · doi:10.1177/1087054706286698 · Cited by 407 · see citing works
Distinguishing Sluggish Cognitive Tempo from ADHD in Children and Adolescents: Executive Functioning, Impairment, and Comorbidity
Barkley, R. A. (2013) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2012.734259 · Cited by 398 · see citing works
The internal, external, and diagnostic validity of sluggish cognitive tempo: a meta-analysis and critical review
Becker, S. P., Leopold, D. R., Burns, G. L., Jarrett, M. A., Langberg, J. M., Marshall, S. A., McBurnett, K., Waschbusch, D. A., & Willcutt, E. G. (2016) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2015.12.006 · Cited by 368 · see citing works
Self-citation
Autism and ADHD: Overlapping and discriminating symptoms
Mayes, S. D., Calhoun, S. L., Mayes, R. D., & Molitoris, S. (2012) · Research in Autism Spectrum Disorders · doi:10.1016/j.rasd.2011.05.009 · Cited by 324 · see citing works
Self-citation
Dimensions and types of attention deficit disorder
LAHEY, B. B., PELHAM, W. E., SCHAUGHENCY, E. A., ATKINS, M. S., MURPHY, H. A., HYND, G., RUSSO, M., HARTDAGEN, S., & LORYS-VERNON, A. (1988) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-198805000-00011 · Cited by 313 · see citing works
The Relation Between Sluggish Cognitive Tempo and DSM-IV ADHD
Hartman, C. A., Willcutt, E. G., Rhee, S. H., & Pennington, B. F. (2004) · Journal of Abnormal Child Psychology · doi:10.1023/b:jacp.0000037779.85211.29 · Cited by 222 · see citing works
Validity of the sluggish cognitive tempo symptom dimension in children: sluggish cognitive tempo and ADHD-inattention as distinct symptom dimensions
Lee, S., Burns, G. L., Snell, J., & McBurnett, K. (2014) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-013-9714-3 · Cited by 200 · see citing works
Validity of the sluggish cognitive tempo, inattention, and hyperactivity symptom dimensions: neuropsychological and psychosocial correlates
Bauermeister, J. J., Barkley, R. A., Bauermeister, J. A., Martínez, J. V., & McBurnett, K. (2012) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-011-9602-7 · Cited by 195 · see citing works
Comparison of Scores on the Checklist for Autism Spectrum Disorder, Childhood Autism Rating Scale, and Gilliam Asperger’s Disorder Scale for Children with Low Functioning Autism, High Functioning Autism, Asperger’s Disorder, ADHD, and Typical Development
Mayes, S. D., Calhoun, S. L., Murray, M. J., Morrow, J. D., Yurich, K. K. L., Mahr, F., Cothren, S., Purichia, H., Bouder, J. N., & Petersen, C. A. (2009) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-009-0812-6 · Cited by 156 · see citing works
Self-citation
Symptom Profile of ADHD in Youth With High-Functioning Autism Spectrum Disorder: A Comparative Study in Psychiatrically Referred Populations
Joshi, G., Faraone, S. V., Wozniak, J., Tarko, L., Fried, R., Galdo, M., Furtak, S. L., & Biederman, J. (2017) · Journal of Attention Disorders · doi:10.1177/1087054714543368 · Cited by 155 · see citing works
Attention-deficit/hyperactivity disorder and sluggish cognitive tempo throughout childhood: Temporal invariance and stability from preschool through ninth grade
Leopold, D. R., Christopher, M. E., Burns, G. L., Becker, S. P., Olson, R. K., & Willcutt, E. G. (2016) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12505 · Cited by 130 · see citing works
Biological and Environmental Predictors of Behavioral Sequelae in Children Born Preterm
Conrad, A. L., Richman, L. C., Lindgren, S. D., & Nopoulos, P. (2009) · PEDIATRICS · doi:10.1542/peds.2009-0634 · Cited by 126 · see citing works
Sluggish Cognitive Tempo and ADHD Symptoms in a Nationally Representative Sample of U.S. Children: Differentiation Using Categorical and Dimensional Approaches
Burns, G. L., & Becker, S. P. (2021) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2019.1678165 · Cited by 116 · see citing works
Clinical differentiation of sluggish cognitive tempo and attention-deficit/hyperactivity disorder in children
Servera, M., Sáez, B., Burns, G. L., & Becker, S. P. (2018) · Journal of Abnormal Psychology · doi:10.1037/abn0000375 · Cited by 113 · see citing works
How Valid Is the Checklist for Autism Spectrum Disorder When a Child Has Apraxia of Speech?
Tierney, C. D., Mayes, S. D., Lohs, S. R., Black, A., Gisin, E., & Veglia, M. (2015) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000189 · Cited by 111 · see citing works
Self-citation
Brief Report: Excellent Agreement Between Two Brief Autism Scales (Checklist for Autism Spectrum Disorder and Social Responsiveness Scale) Completed Independently by Parents and the Autism Diagnostic Interview-Revised
Murray, M. J., Mayes, S. D., & Smith, L. A. (2011) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-011-1178-0 · Cited by 104 · see citing works
Self-citation
Explosive, oppositional, and aggressive behavior in children with autism compared to other clinical disorders and typical children
Mayes, S. D., Calhoun, S. L., Aggarwal, R., Baker, C. N., Mathapati, S., Anderson, R., & Petersen, C. A. (2011) · Research in Autism · doi:10.1016/j.rasd.2011.08.001 · Cited by 100 · see citing works
Self-citation
Optimal items for assessing sluggish cognitive tempo in children across mother, father, and teacher ratings
Sáez, B., Servera, M., Becker, S. P., & Burns, G. L. (2019) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2017.1416619 · Cited by 89 · see citing works
Differential impact of trait sluggish cognitive tempo and <scp>ADHD</scp> inattention in early childhood on adolescent functioning
Becker, S. P., Burns, G. L., Leopold, D. R., Olson, R. K., & Willcutt, E. G. (2018) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.12946 · Cited by 81 · see citing works
Checklist for Autism Spectrum Disorder
Mayes, S. D. (2012) · PsycTESTS Dataset · doi:10.1037/t03996-000 · Cited by 68 · see citing works
Self-citation
Sleep, internalizing problems, and social withdrawal: unique associations in clinic-referred youth with elevated sluggish cognitive tempo symptoms
Rondon, A. T., Hilton, D. C., Jarrett, M. A., & Ollendick, T. H. (2020) · Journal of Attention Disorders · doi:10.1177/1087054718756197 · Cited by 66 · see citing works
The association between Disruptive Mood Dysregulation Disorder symptoms and sleep problems in children with and without ADHD
Waxmonsky, J. G., Mayes, S. D., Calhoun, S. L., Fernández‐Mendoza, J., Waschbusch, D. A., Bendixsen, B. H., & Bixler, E. O. (2017) · Sleep Medicine · doi:10.1016/j.sleep.2017.02.006 · Cited by 64 · see citing works
Self-citation
Sluggish Cognitive Tempo in Children Referred to a Pediatric Sleep Disorders Center: Examining Possible Overlap with Sleep Problems and Associations with Impairment
Becker, S. P., Garner, A. A., & Byars, K. C. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.03.005 · Cited by 63 · see citing works
Autism and reactive attachment/disinhibited social engagement disorders: Co-occurrence and differentiation
Mayes, S. D., Calhoun, S. L., Waschbusch, D. A., & Baweja, R. (2017) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104516678039 · Cited by 58 · see citing works
Self-citation
Sleep Problems in Children with Autism, ADHD, Anxiety, Depression, Acquired Brain Injury, and Typical Development
Mayes, S. D., Calhoun, S. L., Bixler, E. O., & Vgontzas, A. N. (2009) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2008.12.004 · Cited by 52 · see citing works
Self-citation
The neurocognitive nature of children with ADHD comorbid sluggish cognitive tempo: Might SCT be a disorder of vigilance?
Baytunca, M. B., Inci, S. B., Ipci, M., Kardas, B., Bolat, G. U., & Ercan, E. S. (2018) · Psychiatry Research · doi:10.1016/j.psychres.2018.03.038 · Cited by 51 · see citing works
Long-Term Temporal Stability of Measured Inattention and Impulsivity in Typical and Referred Children
Mayes, S. D., Gordon, M., Calhoun, S. L., & Bixler, E. O. (2012) · Journal of Attention Disorders · doi:10.1177/1087054712448961 · Cited by 49 · see citing works
Self-citation
Testing the Longitudinal Structure and Change in Sluggish Cognitive Tempo and Inattentive Behaviors From Early Through Middle Childhood
Dvorsky, M. R., Becker, S. P., Tamm, L., & Willoughby, M. T. (2021) · Assessment · doi:10.1177/1073191119872247 · Cited by 43 · see citing works
Clinical correlates of sluggish cognitive tempo in adolescents with autism spectrum disorder
Duncan, A., Tamm, L., Birnschein, A. M., & Becker, S. P. (2019) · Autism · doi:10.1177/1362361318811329 · Cited by 42 · see citing works
Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: Social impairments and internalizing symptoms
Reinvall, O., Kujala, T., Voutilainen, A., Moisio, A., Lahti‐Nuuttila, P., & Laasonen, M. (2017) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12379 · Cited by 36 · see citing works
Sluggish Cognitive Tempo in Autism Spectrum Disorder, ADHD, and Their Comorbidity: Implications for Impairment
McFayden, T. C., Jarrett, M. A., White, S. W., Scarpa, A., Dahiya, A. V., & Ollendick, T. H. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2020.1716365 · Cited by 32 · see citing works
Sleep Difficulties are Associated with Parent Report of Sluggish Cognitive Tempo
Koriakin, T. A., Mahone, E. M., & Jacobson, L. A. (2015) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0000000000000224 · Cited by 27 · see citing works
Sluggish cognitive tempo in autism, ADHD, and neurotypical child samples
Mayes, S. D., Calhoun, S. L., & Waschbusch, D. A. (2020) · Research in Autism · doi:10.1016/j.rasd.2020.101678 · Cited by 20 · see citing works
Self-citation
Correlates of sluggish cognitive tempo among clinic-referred youth: expanding awareness of somatic symptoms and stress in the clinical picture
Callan, P. D., Shepler, D. K., Justice, M. D., & Oliver, C. E. (2020) · Journal of Pediatric Neuropsychology · doi:10.1007/s40817-020-00083-6 · Cited by 13 · see citing works

Flagged first, then by citations

Sorted by citations

Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome
Becker, S. P., Willcutt, E. G., Leopold, D. R., Fredrick, J. W., Smith, Z. R., Jacobson, L. A., Burns, G. L., Mayes, S. D., Waschbusch, D. A., Froehlich, T. E., et al. (2023) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1016/j.jaac.2022.07.821 · Cited by 175 · see citing works
Self-citation
Associations between sleep problems and domains relevant to daytime functioning and clinical symptomatology in autism: A meta‐analysis
Han, G. T., Trevisan, D. A., Abel, E. A., Cummings, E. M., Carlos, C., Bagdasarov, A., Kala, S., Parker, T., Canapari, C. A., & McPartland, J. C. (2022) · Autism Research · doi:10.1002/aur.2758 · Cited by 43 · see citing works
Executive function deficits in attention-deficit/hyperactivity disorder and autism spectrum disorder
Kofler, M. J., Soto, E. F., Singh, L. J., Harmon, S. L., Jaisle, E. M., Smith, J. N., Feeney, K. E., & Musser, E. D. (2024) · Nature Reviews Psychology · doi:10.1038/s44159-024-00350-9 · Cited by 51 · see citing works
“…of outcomes implicated in both ASD and ADHD (in many cases even after controlling for ADHD and ASD symptoms) including social difficulties, informant-reported cognitive problems, academic challenges, internalizing impairments and reduced global functioning apart from ADHD and ASD 187,188,193,194 .”
Relationship between sluggish cognitive tempo and sleep, psychological, somatic, and cognitive problems in elementary school children
Mayes, S. D., Waschbusch, D. A., Fernandez-Mendoza, J., & Calhoun, S. L. (2021) · Journal of Pediatric Neuropsychology · doi:10.1007/s40817-021-00109-7 · Cited by 27 · see citing works
“Findings were similar in a sample of 2,492 children with autism and/or ADHD (Mayes et al., 2021).”
BackgroundMethodResultInfluentialSelf-citation
Academic functioning in children with and without sluggish cognitive tempo
Becker, S. P., Epstein, J. N., Burns, G. L., Mossing, K. W., Schmitt, A. P., Fershtman, C. E. M., Vaughn, A. J., Zoromski, A. K., Peugh, J., Simon, J. O., et al. (2022) · Journal of School Psychology · doi:10.1016/j.jsp.2022.10.001 · Cited by 27 · see citing works
What is the Cognitive Deficit in Sluggish Cognitive Tempo (SCT)? A Review of Neuropsychological Research
Barkley, R. A., Willcutt, E., & Jacobson, L. A. (2022) · The ADHD Report · doi:10.1521/adhd.2022.30.2.1 · Cited by 27 · see citing works
Clinical distinction between cognitive disengagement syndrome and ADHD presentations in a nationally representative sample of Spanish children and adolescents
Burns, G. L., Becker, S. P., Moreno, J. J. M., & Servera, M. (2024) · Journal of Child Psychology and Psychiatry · doi:10.1111/jcpp.14005 · Cited by 20 · see citing works
Comparison of the Cognitive Disengagement and Hypoactivity Components of Sluggish Cognitive Tempo in Autism, ADHD, and Population-Based Samples of Children
Mayes, S. D., Becker, S. P., Calhoun, S. L., & Waschbusch, D. A. (2022) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-022-00969-3 · Cited by 18 · see citing works
Self-citation
Relationship between sluggish cognitive tempo, IQ and academic achievement test scores, and academic impairment in autism, ADHD, and elementary school samples
Mayes, S. D., Kallus, R., Bangert, L. R., Fosco, W. D., Calhoun, S. L., & Waschbusch, D. A. (2021) · Child Neuropsychology · doi:10.1080/09297049.2021.1970735 · Cited by 18 · see citing works
Self-citation
Pharmacologic Management of Cognitive Disengagement Syndrome (CDS) and Implications for Attention-Deficit/Hyperactivity Disorder (ADHD) Treatment: Emerging Treatments and Recommendations for Future Research
Wiggs, K. K., Froehlich, T. E., & Becker, S. P. (2023) · CNS Drugs · doi:10.1007/s40263-023-00999-5 · Cited by 16 · see citing works
Cognitive Disengagement Syndrome (CDS) (Formerly Sluggish Cognitive Tempo), Autism, and Insomnia Symptoms in Childhood Predict CDS in Adolescence: A Longitudinal Population-Based Study
Mayes, S. D., Waschbusch, D. A., Fernández‐Mendoza, J., & Calhoun, S. L. (2023) · Child Psychiatry & Human Development · doi:10.1007/s10578-023-01565-2 · Cited by 16 · see citing works
“Research shows that autism is a significant correlate of CDS that is independent of its association with ADHD [6, 7].”
InfluentialSelf-citation
Relationship Between Sluggish Cognitive Tempo and Age and IQ in Preschool and School-Age Children and Adolescents with Autism and with ADHD
Mayes, S. D., Seebeck, J., & Waschbusch, D. A. (2022) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-021-05222-2 · Cited by 15 · see citing works
Self-citation
Physical Aggression Toward Others and Self: Correlates in Autism, Attention-Deficit/Hyperactivity Disorder, and Population-Based Child Samples
Baweja, R. K., Waschbusch, D. A., & Mayes, S. D. (2023) · JAACAP Open · doi:10.1016/j.jaacop.2023.07.004 · Cited by 15 · see citing works
Self-citation
Sluggish cognitive tempo (Cognitive Disengagement Syndrome) symptoms are more associated with a higher risk of internet addiction and internet gaming disorder than ADHD symptoms: A study with medical students and resident doctors
Gül, A., & Gül, H. (2023) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2023.104557 · Cited by 14 · see citing works
Stability of Sluggish Cognitive Tempo Compared to Externalizing and Internalizing Parent Symptom Ratings from Age 9 to 8-Years Follow-up in a Population-Based Sample
Mayes, S. D., Waschbusch, D. A., Mattison, R. E., Kallus, R., Baweja, R. K., Fernández‐Mendoza, J., & Calhoun, S. L. (2022) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-022-09977-5 · Cited by 13 · see citing works
Self-citation
Is Histamine and Not Acetylcholine the Missing Link between ADHD and Allergies? Speer Allergic Tension Fatigue Syndrome Re-Visited
Blasco-Fontecilla, H. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12165350 · Cited by 12 · see citing works
“There is still controversy as if SCT is a subtype of ADHD or a separate disorder.”
Background
The Associations Between Sluggish Cognitive Tempo, Internalizing Symptoms, and Academic Performance in Children With Reading Disorder: A Longitudinal Cohort Study
Hossain, B., Bent, S., Parenteau, C. I., Widjaja, F., Davis, M., & Hendren, R. L. (2022) · Journal of Attention Disorders · doi:10.1177/10870547221085493 · Cited by 11 · see citing works
“Interestingly, we did not find any associations between SCT and depression in our sample, which contradicts the findings of many other studies that have shown a relationship between higher levels of SCT symptoms and increased depression (Becker et al., 2021; Bernad et al., 2014, 2016; Burns et al., 2017; Mayes et al.,…”
BackgroundResult
Sluggish cognitive tempo: Association with neuropsychological test scores, motor incoordination, and dysgraphia in elementary school children
Mayes, S. D., Bangert, L. R., Kallus, R., Fosco, W. D., Calhoun, S. L., & Waschbusch, D. A. (2022) · Clinical Child Psychology and Psychiatry · doi:10.1177/13591045221110730 · Cited by 9 · see citing works
“…validity and internal consistency, and is statistically correlated with but distinct from other symptom constellations, such as ADHD-Inattentive symptoms (Becker et al., 2016a; Dvorsky et al., 2019; Hartman et al., 2004; Mayes et al., 2012a, 2020, 2021b; Penny et al., 2009; Saez et al., 2019).”
BackgroundResultInfluentialSelf-citation
A Twin Study of the Relationships between Cognitive Disengagement Syndrome and Anxiety Phenotypes in Childhood and Adolescence
Scaini, S., Medda, E., Battaglia, M., De Giuli, G., Stazi, M. A., D’Ippolito, C., & Fagnani, C. (2023) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-023-01029-0 · Cited by 7 · see citing works
Cognitive Disengagement Syndrome and Child Sleep Problems in ADHD, Anxiety and Depression
Cano-Crespo, A., García, I. M., Servera, M., & Ortíz, M. M. (2023) · Healthcare · doi:10.3390/healthcare11142022 · Cited by 8 · see citing works
“[12] demonstrated the association between CDS and sleep problems, as in the research carried out by O’Hare et al.”
Result
Cognitive Disengagement Syndrome (Formerly Sluggish Cognitive Tempo) and Comorbid Symptoms in Child Autism, ADHD, and Elementary School Samples
Mayes, S. D., Calhoun, S. L., Kallus, R., Baweja, R., & Waschbusch, D. A. (2024) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-024-10145-0 · Cited by 6 · see citing works
“This is not explained by the fact that most children with autism have ADHD, because even children who have autism without ADHD have a CDS prevalence comparable to that reported in ADHD (Mayes et al., 2020; McFayden et al., 2022).”
InfluentialSelf-citation
Clinical and neurophysiological manifestations of sluggish cognitive tempo in children
Chutko, L. S., Yakovenko, E. A., Surushkina, S. Y., Анисимова, Т. И., Cherednichenko, D. V., Didur, М. D., & Александровна, Ч. С. (2024) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro2024124051120 · Cited by 6 · see citing works
Oppositional Defiant Disorder in Autism and ADHD
Mayes, S. D., Pardej, S. K., & Waschbusch, D. A. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06437-9 · Cited by 9 · see citing works
“…in females in the general population (Card et al., 2008; Demmer et al., 2017; Hawes et al., 2023; Lindgren & Koeppl, 1987; Maughan et al., 2004; Mayes et al., 2020; Waschbusch & King, 2006; Waschbusch & Willoughby, 2008) and in referred samples (Carlson et al., 1997; Jensen et al., 1997),…”
Self-citation
Sleep Disturbance and Its Association With Sluggish Cognitive Tempo and Attention in Pediatric Brain Tumor Survivors
Olsthoorn, I. M., Holland, A. A., Hawkins, R. C., Cornelius, A. E., Baig, M. U., Yang, G. C. H., Holland, D., Zaky, W. T., & Stavinoha, P. L. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.918800 · Cited by 6 · see citing works
Prevalence and Correlates of Poor Safety Awareness and Accidental Injury in ASD, ADHD, ASD + ADHD, and Neurotypical Youth Samples
Pardej, S. K., & Mayes, S. D. (2024) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-024-06417-z · Cited by 5 · see citing works
“Items on these PBS factors have good divergent and convergent validity and internal consistency in clinical and population-based samples (Mayes et al., 2021b, c).”
Self-citation
Cognitive Disengagement Syndrome and Autism Traits are Empirically Distinct from each Other and from Other Psychopathology Dimensions
Mayes, S. D., Becker, S. P., & Waschbusch, D. A. (2025) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-024-01281-y · Cited by 5 · see citing works
“…in the literature are similar for autistic youth and youth with ADHD, ranging from 30%−62% for autism (Brewe et al., 2020; Duncan et al., 2019; Mayes et al., 2020; McFayden et al., 2022; Reinvall et al., 2017) and 27%−63% for ADHD (Barkley, 2013; Burns & Becker, 2021; Ekinci et al., 2021;…”
InfluentialSelf-citation
Relationship between cognitive disengagement syndrome (CDS) (formerly sluggish cognitive tempo) and social functioning in child autism, ADHD, and elementary school samples
Mayes, S. D., Calhoun, S. L., & Waschbusch, D. A. (2023) · Research in Autism · doi:10.1016/j.rasd.2023.102250 · Cited by 6 · see citing works
Self-citation
Psychopathology of cognitive disengagement syndrome (CDS): a network analysis based on CBCL scales in 72,106 Chinese school students
Jiang, Z., Xu, H., Wang, X., Zhang, W., Zhang, A., Yu, L., Hu, S., Yang, K., Yang, Q., Cui, Y., et al. (2024) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-024-02540-5 · Cited by 5 · see citing works
“This aligned with our findings in the psychological pathology framework and was consistent with previous research on factors influencing CDS [55, 56, 58].”
Health anxiety and somatic symptoms in adults on the autism spectrum
Huang, W., LEVENTHAL, B. L., Lin, C.-C., & Chien, Y. (2025) · Psychiatry Research · doi:10.1016/j.psychres.2025.116550 · Cited by 3 · see citing works
Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies
De Giuli, G., Amico, C., De Francesco, S., Giani, L., Tüzün, G., Galli, F., Caputi, M., Forresi, B., & Scaini, S. (2025) · Applied Sciences · doi:10.3390/app15116067 · Cited by 2 · see citing works
Exploring the link between sleep and cognitive disengagement syndrome (CDS) in young adults: Integrating the role of ADHD.
Gul, H., Gul, A., & Murat, N. (2025) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2025.105000 · Cited by 2 · see citing works
Transidentification in Adolescents and Young Adults: Understanding Parental Concerns to Improve Psychological Support for Families
Cognet-Kayem, A., Ledrait, A., Lamoureux, C., Mégalakaki, O., & Masson, C. (2025) · Archives of Sexual Behavior · doi:10.1007/s10508-025-03139-w · Cited by 2 · see citing works
The Role of Cognitive Disengagement Syndrome Symptoms in the Association Between ADHD Symptoms and Sleep Problems: Findings from An Epidemiological Survey
Tahıllıoğlu, A., Kardaş, B., Kardaş, Ö., Duman, N. S., Gökten, E., Uytun, M. Ç., Kahraman, Ö., Özdemir, E., Taşdemir, A. I., Şan, Z., et al. (2025) · Muğla Sıtkı Koçman Üniversitesi tıp dergisi · doi:10.47572/muskutd.1602215 · Cited by 1 · see citing works
Mapping the association between cognitive disengagement syndrome and internalizing disorders: A systematic scoping review with meta-analysis and meta-regression
Boccaccio, F. M., Rizzo, R., Pirrone, C., & Buitelaar, J. K. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2026.122159 · Cited by 1 · see citing works
An affective assessment: incarnate biases in picture captions for autistic children
Ke, Y., & Zhou, X. (2023) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2023.2269325 · Cited by 1 · see citing works
Attention Deficit/Hyperactivity Disorder and Cognitive Disengagement Syndrome: The Mediating Role of Executive Functions in Iranian College Students
Jourjade, S. R. N., Mashhadi, A., Bigdeli, I., & Tabataba’i, S. K. R. (2024) · مجله دانشگاه علوم پزشکی جیرفت. · doi:10.61186/jjums.11.2.1601 · Cited by 1 · see citing works
Concurrent and Longitudinal Predictors and Stability of Parent-Reported Sleep Problems in a Population-Based Sample at Mean Ages 8 and 15
Mayes, S. D., Fernández‐Mendoza, J., Waschbusch, D. A., & Calhoun, S. L. (2023) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-023-10111-2
Self-citation
A Comparison of Cognitive Disengagement Syndrome in Children with Major Depression Versus Attention Deficit and Hyperactivity Disorder
Sevinçok, D., Özbek, T. C., & Özbek, M. M. (2024) · European Journal of Therapeutics · doi:10.58600/eurjther2249
Does sleep impact Sluggish Cognitive Tempo (Cognitive Disengagement Syndrome)? Or do SCT symptoms affect Sleep?: A study of young adults taking into account ADHD.Preprint
Gül, H., Gül, A., & Murat, N. (2024) · doi:10.22541/au.172907286.64739938/v1
Somatic Symptoms in a Population-Based Sample from Childhood to Adolescence: Stability and Concurrent and Longitudinal Predictors
Pardej, S. K., Waschbusch, D. A., Calhoun, S. L., & Mayes, S. D. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01794-z
“Factor analysis demonstrated good convergent and divergent validity for the PBS psychopathology factors and sleep problems and somatic complaints items in population-based and clinical samples [35–37].”
Self-citation
Can Depressive Symptoms Mediate the Relationship Between Sleep Quality and Cognitive Disengagement Syndrome? A Cross-Sectional Study in an Adult Clinical Sample
Yıldırım, S., Akbaş, İ. H., Yildirim, B., Peker, O., & Ugural, N. E. (2025) · Bratislavské lekárske listy/Bratislava medical journal · doi:10.1007/s44411-025-00424-x
“Although CDS appears to be more closely associated with depression in the literature, studies have also demonstrated its relationship with anxiety [6, 8, 14, 34].”
Standardization study of the Italian cognitive disengagement syndrome scale (ICDSS) in an Italian sample of school-aged children
Scaini, S., Giani, L., Francesco, S. D., Amico, C., Giuli, G. D., Denevi, A., & Caputi, M. (2026) · Current Psychology · doi:10.1007/s12144-025-09001-5
“…of the inattentive subtype of ADHD, from which this condition however differs due to the presence of peculiar symptoms (Becker et al., 2016; Dvorsky et al., 2021 ; Lee et al., 2014 ; Mayes et al., 2021a; Mayes et al., 2020, 2023 ; Mayes, Waschbusch, Mayes et al., 2021a, b ; Willcutt et al., 2014 ).”
Multi-informant Examination of Cognitive Disengagement Syndrome in Relation to Sleep and Circadian Preference in Early Adolescents
Miller, M. C., Peugh, J., Epstein, J. N., Tamm, L., & Becker, S. P. (2026) · Child Psychiatry & Human Development · doi:10.1007/s10578-026-01990-z
Cognitive Disengagement Syndrome: Changes in Severity, Comorbid Conditions, and Impairment from Childhood to Adolescence
Mayes, S. D., Andino, M. V., & Waschbusch, D. A. (2026) · Research on Child and Adolescent Psychopathology · doi:10.1007/s10802-026-01509-z
Self-citation
Differential Associations of Parent-Reported Sleep Difficulties With Teacher-Rated Cognitive Disengagement Syndrome and ADHD Symptom Dimensions in School-Aged ChildrenPreprint
Hwang-Gu, S.-L., Chou, S.-W., Jan, Y.-W., Wang, L., & Ni, H. (2026) · Research Square · doi:10.21203/rs.3.rs-10935592/v1

Sluggish Cognitive Tempo in Autism Spectrum Disorder, ADHD, and Their Comorbidity: Implications for Impairment
McFayden, T. C., Jarrett, M. A., White, S. W., Scarpa, A., Dahiya, A. V., & Ollendick, T. H. (2020) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2020.1716365 · Cited by 32 · see citing works
Sluggish cognitive tempo in autism, ADHD, and neurotypical child samples
Mayes, S. D., Calhoun, S. L., & Waschbusch, D. A. (2020) · Research in Autism · doi:10.1016/j.rasd.2020.101678 · Cited by 20 · see citing works
Self-citation
Symptoms of Attention Deficit/Hyperactivity Disorder, Sleep Problems, and Executive Dysfunction, as Predictors of Sluggish Cognitive Tempo, in Children With High-Functioning Autism Spectrum Disorder
Razavi, K., Poshtmashhadi, M., Pourmohamadreza-Tajrishi, M., & Yarandi, R. B. (2026) · Iranian Journal of Psychiatry and Clinical Psychology · doi:10.32598/ijpcp.31.5115.1
Sluggish Cognitive Tempo in Children Referred to a Pediatric Sleep Disorders Center: Examining Possible Overlap with Sleep Problems and Associations with Impairment
Becker, S. P., Garner, A. A., & Byars, K. C. (2016) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2016.03.005 · Cited by 63 · see citing works
Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: Social impairments and internalizing symptoms
Reinvall, O., Kujala, T., Voutilainen, A., Moisio, A., Lahti‐Nuuttila, P., & Laasonen, M. (2017) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12379 · Cited by 36 · see citing works

Authors: Mayes, S. D., Calhoun, S. L., & Waschbusch, D. A.
Affiliations: Pennsylvania State University (US)
Corresponding author: Mayes, Susan D
ORCID: Mayes, Susan D
Calhoun, Susan L
Waschbusch, Daniel A
Venue: Clinical Child Psychology and Psychiatry
Publisher: SAGE Publications
Published: 2020-12-18
Volume: 26
Issue: 2
Pages: 518-530
ISSN: 1359-1045 (ISSN-L)
1461-7021
DOI: 10.1177/1359104520978459
OpenAlex: W3114515590
Cited by: 46
References: 37
Citations by year: 2026: 6 · 2025: 7 · 2024: 11 · 2023: 10 · 2022: 9 · 2021: 3
FWCI: 4.01
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Clinical Child Psychology and Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: sluggish cognitive tempo, autism spectrum disorder, attention deficit hyperactivity disorder, sleep disorders, somatic symptoms, internalizing problems, externalizing problems, cognitive impairment, social dysfunction, academic impairment, depression, attention deficits
MeSH terms: Attention Deficit Disorder with Hyperactivity, Autistic Disorder, Child, Cognition, Cognition Disorders, Female, Humans, Sleep

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Relationship between sluggish cognitive tempo and sleep, psychological, somatic, and cognitive problems and impairment in children with autism and children with ADHD

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks