Neuropsychological Abilities of Preschool-Aged Children Who Display Hyperactivity and/or Oppositional-Defiant Behavior Problems

Abstract

This study focused on gaining a better understanding of the neuropsychological abilities of preschool-aged children who show elevated levels of hyperactivity and oppositional-defiance. It examined the performance of children aged 48 to 67 months on tests of attention/executive function, language, memory, and sensorimotor abilities, as measured by the NEPSY and Conners' K-CPT. Two hundred thirty-seven children were divided into four subgroups based on mothers' report of behavior using rating scales and a diagnostic interview: hyperactive only (HYP), oppositional-defiant only (OD), hyperactive and oppositional-defiant (HYP/OD), and nonproblem. Children in the HYP/OD group scored significantly worse than nonproblem children on four of nine subtests on the NEPSY, including one test of executive function, one test of language comprehension, and both tests of short-term verbal memory. However, only the test of executive function (Statue) showed significant predictive power, and, while specificity of this subtest was good, sensitivity was poor. On the K-CPT, a continuous performance test, children in both the HYP and HYP/OD groups performed worse than children in the OD and nonproblem groups. When the NEPSY Statue subtest and the K-CPT were used together, overall predictive power was .74. Results suggest that neuropsychological deficits can be observed among preschool children with hyperactivity, particularly when comorbid oppositional-defiance is present; however, moderate predictive power suggests that these tests should be used in conjunction with other methods of assessment.

This study was supported by National Institute of Mental Health Grant R01MH60132. These data were presented at the National Association of School Psychologists in April, 2005, in Atlanta, GA.

We are grateful to the families who participated in this study and to staff from physicians' offices and community centers who assisted in recruiting families. Thanks also to the many graduate and undergraduate research assistants who assisted with data collection.

Notes

¹For the 4-year-old group, 50 children were classified in one of the three behavior problem groups. Seventeen children fell in the HYP group, 11 children fell in the OD group, and 22 children fell in the HYP/OD group. Ninety-eight children fell into the nonproblem group.

²Some additional children had invalid scores on some NEPSY subtests due to administration error or sudden distractions that occurred in the home (e.g., child had to go to the bathroom in the middle of a memory test or Statue).