The attention network test: a characteristic pattern of deficits in children with ADHD

Adolfsdottir, Steinunn; Sorensen, Lin; Lundervold, Astri J · 2008 · Crossref

DOI: 10.1186/1744-9081-4-9

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Summary

This study investigates whether children with Attention Deficit Hyperactivity Disorder (ADHD) exhibit a characteristic pattern of deficits on the Attention Network Test (ANT). While previous research often focused solely on reaction time (RT) measures of the alerting, orienting, and executive networks, this study aimed to determine if including accuracy and variability measures would better characterize ADHD-related attentional deficits. The authors hypothesized that children with ADHD would show lower accuracy and higher response variability compared to their non-ADHD peers, even if network-specific RT measures did not differ significantly. The research utilized data from the Bergen Child Study, involving 157 children with a mean age of 10 years. Participants were divided into three groups: those with a definite ADHD diagnosis (N = 45), those with other psychiatric diagnoses (N = 55), and those without any diagnosis (N = 57). Diagnoses were established using the Kiddie-SADS-PL semi-structured interview. All participants completed the child version of the ANT, which assesses attention through cue and flanker conditions, as well as the Wechsler Intelligence Scale for Children (WISC-III) to determine Full Scale IQ (FSIQ). Statistical analyses included one-way ANOVAs to compare groups on RT, error, and variability metrics, with post-hoc tests to identify specific differences. Correlation analyses examined the relationship between FSIQ, age, and ANT performance. The results indicated no statistically significant differences between the three groups on the RT or error measures of the alerting, orienting, and conflict networks. However, the ADHD group demonstrated significantly lower accuracy, characterized by a higher number of overall errors and wrong responses, compared to the non-ADHD groups. Additionally, the ADHD group exhibited significantly higher variability in reaction times (measured by the standard error of RT) than the group without any diagnosis. A critical finding was the strong negative correlation between FSIQ and both error and variability measures exclusively within the ADHD group. When FSIQ was included as a covariate, the significant group differences in accuracy and variability disappeared, suggesting that these attentional deficits were closely linked to lower intellectual functioning in this cohort. Medication status did not significantly influence the results. The study concludes that accuracy and variability measures, rather than the standard network efficiency measures, convey the characteristic pattern of attentional deficits in children with ADHD. The findings highlight the importance of extending ANT analysis to include these metrics to improve sensitivity. Furthermore, the strong association between IQ and performance in the ADHD group underscores the necessity of reporting results both with and without IQ as a covariate, as controlling for IQ may obscure core disorder-related deficits. The authors suggest that the ANT’s game-like nature may reduce vigilance deficits typically seen in ADHD, and they recommend revising the child version of the test to better capture conflict network impairments.

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• cognitive capacity variation