title: Clinical correlates of working memory deficits in youth with and without ADHD: A controlled study.
abstract: OBJECTIVE
  Both working memory (WM; a brain system that provides temporary storage and manipulation of the information) and attention-deficit/hyperactivity disorder (ADHD) have been associated with educational deficits. Since WM deficits are prevalent in children with ADHD, the main aim of the present study was to examine whether educational deficits are driven by working memory deficits or driven by the effect of ADHD itself.
  
  
  METHODS
  Participants were referred youth with (N = 276) and without (N = 241) ADHD ascertained from pediatric and psychiatric sources. Assessment included measures of psychiatric, psychosocial, educational, and cognitive functioning. Education deficits were defined as grade retention or placement in special classes and were assessed using interviews and written rating scales. Working memory was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R) Freedom from Distractibility (FFD) factor based on Digit Span, Arithmetic, and Coding.
  
  
  RESULTS
  Significantly more youth with ADHD had WM deficits than controls (31.9% vs. 13.7%, p < .05). In ADHD children, WM deficits were significantly (p < .01) associated with an increased risk for grade retention and placement in special classes as well as lower scores on reading and math achievement tests than for ADHD children without WM deficits. In contrast, no other differences were noted in other areas of functioning. Although WM deficits also had some adverse impact on educational and cognitive correlates in non-ADHD controls, these differences failed to attain statistical significance.
  
  
  CONCLUSIONS
  WM deficits significantly and selectively increase the risk for academic deficits and cognitive dysfunction in children with ADHD beyond those conferred by ADHD. Screening for WM deficits may help identify children with ADHD at high risk for academic and cognitive dysfunction.
authors.affiliation: a Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD , Massachusetts General Hospital , Boston , MA , USA.|b Department of Psychiatry , Harvard Medical School , Boston , MA , USA.
authors.forename: Ronna
authors.initials: R
authors.lastname: Fried
authors.affiliation: c Boston Children's Hospital , Boston , MA , USA.
authors.forename: James
authors.initials: J
authors.lastname: Chan
authors.affiliation: a Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Feinberg
authors.affiliation: a Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: Amanda
authors.initials: A
authors.lastname: Pope
authors.affiliation: a Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD , Massachusetts General Hospital , Boston , MA , USA.
authors.forename: K Yvonne
authors.initials: KY
authors.lastname: Woodworth
authors.affiliation: d Departments of Psychiatry and of Neuroscience and Physiology , SUNY Upstate Medical University , Syracuse , NY , USA.|e K. G. Jebsen Centre for Psychiatric Disorders, Department of Biomedicine , University of Bergen , Bergen , Norway.
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.affiliation: a Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD , Massachusetts General Hospital , Boston , MA , USA.|b Department of Psychiatry , Harvard Medical School , Boston , MA , USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Biederman
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications* / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D003072:Cognition Disorders / Q000209:etiology; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D006801:Humans; D008569:Memory Disorders / Q000150:complications* / Q000175:diagnosis; D008570:Memory, Short-Term / Q000502:physiology*; D019964:Mood Disorders / Q000453:epidemiology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D014888:Wechsler Scales
keywords: Attention deficit hyperactivity disorder; children; executive function; neuropsychology; working memory