A multiple deficit model of reading disability and attention-deficit/hyperactivity disorder: searching for shared cognitive deficits.
BACKGROUND
This study tests a multiple cognitive deficit model of reading disability (RD), attention-deficit/hyperactivity disorder (ADHD), and their comorbidity.


METHODS
A structural equation model (SEM) of multiple cognitive risk factors and symptom outcome variables was constructed. The model included phonological awareness as a unique predictor of RD and response inhibition as a unique predictor of ADHD. Processing speed, naming speed, and verbal working memory were modeled as potential shared cognitive deficits.


RESULTS
Model fit indices from the SEM indicated satisfactory fit. Closer inspection of the path weights revealed that processing speed was the only cognitive variable with significant unique relationships to RD and ADHD dimensions, particularly inattention. Moreover, the significant correlation between reading and inattention was reduced to non-significance when processing speed was included in the model, suggesting that processing speed primarily accounted for the phenotypic correlation (or comorbidity) between reading and inattention.


CONCLUSIONS
This study illustrates the power of a multiple deficit approach to complex developmental disorders and psychopathologies, particularly for exploring comorbidities. The theoretical role of processing speed in the developmental pathways of RD and ADHD and directions for future research are discussed.
Massachusetts General Hospital/Harvard Medical School, USA University of Denver, USA. mcgrath@pngu.mgh.harvard.edu
Lauren M
LM
McGrath
Bruce F
BF
Pennington
Michelle A
MA
Shanahan
Laura E
LE
Santerre-Lemmon
Holly D
HD
Barnard
Erik G
EG
Willcutt
John C
JC
Defries
Richard K
RK
Olson
D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology / Q000523:psychology*; D002648:Child; D003071:Cognition; D015897:Comorbidity; D005260:Female; D006801:Humans; D007859:Learning Disabilities / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008570:Memory, Short-Term; D008960:Models, Psychological; D009483:Neuropsychological Tests; D011932:Reading; D012307:Risk Factors; D014706:Verbal Learning