Journal of the International Neuropsychological Society



Differences in attention, executive functioning, and memory in children with and without ADHD after severe traumatic brain injury


BETH S.  SLOMINE  a1 a2 c1 , CYNTHIA F.  SALORIO  a3 a4 , MARCO A.  GRADOS  a2 , ROMA A.  VASA  a2 a5 , JAMES R.  CHRISTENSEN  a3 a4 a6 and AND JOAN P.  GERRING  a2 a5
a1 Department of Neuropsychology, Kennedy Krieger Institute, Baltimore, Maryland
a2 Department of Psychiatry, School of Medicine, Johns Hopkins University, Baltimore, Maryland
a3 Department of Physical Medicine and Rehabilitation, Kennedy Krieger Institute, Baltimore, Maryland
a4 Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, Maryland
a5 Department of Psychiatry, Kennedy Krieger Institute, Baltimore, Maryland
a6 Department of Pediatrics, School of Medicine, Johns Hopkins University, Baltimore, Maryland

Article author query
slomine bs   [PubMed][Google Scholar] 
salorio cf   [PubMed][Google Scholar] 
grados ma   [PubMed][Google Scholar] 
vasa ra   [PubMed][Google Scholar] 
christensen jr   [PubMed][Google Scholar] 
gerring ajp   [PubMed][Google Scholar] 

Abstract

Although the development of Attention Deficit Hyperactivity Disorder (ADHD) after traumatic brain injury (TBI) has been described, it is unknown whether children with TBI and ADHD have greater neuropsychological impairments than children with TBI alone. This study examines attention, executive functioning, and memory in children with TBI-only and TBI + ADHD. Caregivers of 82 children with severe TBI completed structured psychiatric interviews at enrollment to diagnose premorbid ADHD and one-year after injury to diagnose post-injury ADHD. Children underwent neuropsychological testing one year after injury. One memory measure significantly differentiated children with TBI-only from children with newly developed ADHD [secondary ADHD (S-ADHD)] and those with premorbid ADHD that persisted after injury [persisting ADHD (P-ADHD)]. Compared with the TBI-only group, children with TBI + ADHD had worse performance on measures of attention, executive functioning, and memory. Results reveal that in children with severe TBI, the behavioral diagnosis of ADHD is associated with more difficulty in attention, executive functioning, and memory. Additionally, results suggest greater deficits in memory skills in the S-ADHD group compared with the P-ADHD group. Although findings provide preliminary support for distinguishing P-ADHD from S-ADHD, further research is needed to investigate neuropsychological differences between these subgroups of children with severe TBI. (JINS, 2005, 11, 645–653.)

(Received October 20 2004)
(Revised May 4 2004)
(Accepted May 4 2005)


Key Words: Attention deficit hyperactivity disorder; Brain injuries; Cognition; Pediatrics; Learning; Neuropsychology.

Correspondence:
c1 Reprint requests to: Beth S. Slomine, Ph.D., ABPP, Department of Neuropsychology, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205. E-mail: Slomine@Kennedykrieger.org


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