Further validation of a new ADHD screening questionnaire measuring parents’ explanations (time processing, cognition, and motivation) of inattention symptoms in their school-aged children

Figures & data

Table 1. Descriptions of neuropsychological tests and dependent variables.

Test and measured construct	Description	Dependent variable(s)	Psychometric properties
T- Time reproduction task: reproduce various time intervals (adapted from Hurks & Hendriksen, 2010).	A jungle was presented for 500 ms, after which a fixation point (i.e., bananas) appeared in the middle of the screen. After 1000 ms, an ape cartoon picture appeared for a variable time interval. After the ape disappeared, the fixation point reappeared for 1000 ms. Then the ape appeared for the second time and children were instructed to press the spacebar for the same period as the ape had appeared during the previous time. As soon as the spacebar was released, the ape disappeared and the procedure repeated itself. Four different time intervals (i.e., 3, 6, 9, 12s) were presented twice in randomized order.	Reproduction accuracy coefficient across time intervals was calculated by (a) dividing the reproduced duration by the presented duration and (b) subtracting this ratio score from 1 to calculate the absolute difference from the optimal ratio.	Validity is supported by relevant group differences: children with ADHD were less accurate than controls, and in control samples accuracy increased between childhood and adolescence (Block et al., 1999; Hurks & Hendriksen, 2010). Internal consistency and test – retest reliability were fair in typically developing children and children with ADHD (Marx et al., 2021).
T- Time discrimination task: discriminate between 2 time intervals (adapted from Rubia et al., 2007).	Cartoon pictures of a lion and a pig were presented in succession. The lion was always presented first for a fixed duration of 500 ms. After this, the pig was presented for 500 ± 200 ms (i.e., the comparison). Then children had to indicate which picture appeared the longest, by pressing either “1” (lion) or “2” (pig). The test is adaptive in a way that the duration difference between the 2 pictures presented decreased with 5 ms when children answered 2 consecutive trials correctly and increased with 5 ms when children answered 1 trial incorrectly. Children completed 48 trials.	Minimal time discrimination difference between the 2 pictures in ms.	Validity is supported by relevant group differences: children with ADHD have less sensitive duration discrimination thresholds than controls (Noreika et al., 2013). Test – retest reliability was poor in typically developing children and children with ADHD (Marx et al., 2021).
C- Attention Switching Task (AST): switch attention between different task instructions (Cepeda et al., 2000; Keulers & Jonkman, 2019).	AST consisted of 2 non-switch (each 48 trials) and 1 switch (96 trials) blocks. In each trial 1 of 4 stimuli appeared on the screen with equal probability, i.e., 1, 3, 111 or 333. In the first non-switch block, a cue “WHICH NUMBER?” indicated that children had to identify whether the presented stimulus contained the number 1 (press left) or 3 (press right), irrespective of the number of presented digits. In the second non-switch block, a cue “HOW MANY NUMBERS?” indicated that children had to identify how many digits the number was made up of, 1 digit (press left) or 3 digits (press right). During the switch block the cues alternated randomly between “WHICH NUMBER?” and “HOW MANY NUMBERS?,” requiring the children to switch between rules on approximately half of the trials. Each trial consisted of the presentation of the cue followed 200 ms later by 1 of the 4 stimuli, which remained on the screen until a response was given.	Switching costs: difference in percentage correct responses between switch trials and non-switch trials (mean across the 2 non-switch blocks).	Validity is supported by relevant group differences: switching costs decreased between childhood and adulthood and were higher in ADHD than non-ADHD children (Cepeda et al., 2000, 2001). Research on reliability is not available.
C- Number Running Span: update working memory (Keulers & Jonkman, 2019).	Series of numbers (from 1–9) were presented 1 at a time on the screen for 1s, followed by an inter-stimulus-interval of 500 ms. Children were instructed to remember the sequence. After presentation of each sequence, children were presented with a screen showing the beginning N numbers of the sequence followed by question marks at the places where the missing numbers had to be filled in, for example 3 7 2? ? ?. Always the last 3 numbers of a sequence had to be recalled. Four trials of 5, 6 and 7 number sequence lengths (12 in total) were presented randomly.	Mean percentage errors across all trials.	Validity is supported by relevant group differences (on a pictorial variant of this task): mean percentage of error decreased between ages 6–15 in typically developing children (Lee et al., 2013). Research on reliability is not available.
M- Delay aversion task: choose between small immediate and larger delayed rewards (adapted from Kuntsi, Stevenson, et al., 2001).	Children are captain of a spaceship and have to destroy the spacecrafts of the enemy in this task. They can choose between (a) destroying 1 hostile spacecraft after a 2s delay and receiving 1 point (e.g., small immediate reward) and (b) destroying 2 hostile spacecrafts after 30s delay and receiving 2 points (larger delayed reward). The goal of the task is to obtain as many points as possible. Children get to choose 20 times in total.	Percentage immediate reward choices.	Validity is supported by relevant group differences: percentage immediate reward choices was higher in hyperactive compared to control children (Kuntsi, Oosterlaan, et al., 2001). Test-retest reliability is satisfactory in typically developing children aged 7–11 (Kuntsi, Stevenson, et al., 2001).

T = Time; C = Cognition; M = Motivation.

Table 2. Raw scores on and correlations^{^} between PASSC inattention sumscores and performance tests measuring the same/another construct (i.e., convergent/discriminant validity).

	Mean	SD (range)	PASSC inattention symptoms	PASSC inattention symptoms explained by Time	PASSC inattention symptoms explained by Cognition	PASSC inattention symptoms explained by Motivation
PASSC sumscores Inattention symptoms	n = 71 12.15	7.96 (0–35)
Inattention symptoms explained by Time	5.62	5.20 (0–20)
Inattention symptoms explained by Cognition	11.18	9.10 (0–36)
Inattention symptoms explained by Motivation	9.10	7.05 (0–30)
Core explanation^# 1 core explanation Time Cognition Motivation None 2 core explanations 3 core explanations	87.3% 1.4% 45.1% 32.4% 8.5% 2.8% 5.6%
T- Reproduction Reproduction accuracy coefficient	n=70 0.169	0.109 (0.027–0.460)	−.029	−.118	−.101	−.093
T- Discrimination Minimal time discrimination difference	n=72 168.68	20.60 (120–195)	.073	.244**	.087	.002
C- AST Switching cost accuracy	n = 72 16.32	11.04 (−2.92–43.70)	.166	.267**	.197*	−.123
C- Running Span Percentage errors	n = 72 0.456	0.304 (0–1)	.177	.337***	.225*	−.012
M- Delay Aversion Percentage immediate reward choices	n = 72 64.26	26.37 (0–100)	.129	.142	.083	.015

Note. ^{^}Correlation coefficients are based on age-regressed neuropsychological test scores and raw PASSC sumscores; PASSC= Parental ADHD Screening Questionnaire: Signaling the Core explanation underlying the behavioral symptoms; ^#in the case of one core explanation parents chose the same neuropsychological explanation (i.e., time, cognition or motivation) for the majority of inattention symptoms (e.g., minimal fvie out of nine symptoms) and otherwise parents indicated two or three core explanations equally for the attention problems of their child; T = Time; C = Cognition; AST = Attention Switching Task; M = Motivation. Grey blocks indicate convergent validity, and white blocks in the last three columns discriminant validity. Correlation coefficients up to 0.30 were considered low, from 0.31 to 0.50 were considered moderate and those exceeding 0.50 were considered strong (Cohen et al., 2013). ***p < .010; **p < .025; p < .050*.

Hurks, P. P., & Hendriksen, J. G. (2010). Retrospective and prospective time deficits in childhood ADHD: The effects of task modality, duration, and symptom dimensions. Child Neuropsychology, 17(1), 34–50. https://doi.org/10.1080/09297049.2010.514403

 PubMed Web of Science ®Google Scholar

Block, R. A., Zakay, D., & Hancock, P. A. (1999). Developmental changes in human duration judgments: A meta-analytic review. Developmental Review, 19(1), 183–211. https://doi.org/10.1006/drev.1998.0475

 Web of Science ®Google Scholar

Marx, I., Rubia, K., Reis, O., & Noreika, V. (2021). A short note on the reliability of perceptual timing tasks as commonly used in research on developmental disorders. European Child and Adolescent Psychiatry, 30(1), 169–172. https://doi.org/10.1007/s00787-020-01474-y

 PubMed Web of Science ®Google Scholar

Rubia, K., Smith, A., & Taylor, E. (2007). Performance of children with attention deficit hyperactivity disorder (ADHD) on a test battery of impulsiveness. Child Neuropsychology, 13(3), 276–304. https://doi.org/10.1080/09297040600770761

 PubMed Web of Science ®Google Scholar

Noreika, V., Falter, C. M., & Rubia, K. (2013). Timing deficits in attention-deficit/hyperactivity disorder (ADHD): Evidence from neurocognitive and neuroimaging studies. Neuropsychologia, 51(2), 235–266. https://doi.org/10.1016/j.neuropsychologia.2012.09.036

 PubMed Web of Science ®Google Scholar

Cepeda, N. J., Cepeda, M. L., & Kramer, A. F. (2000). Task switching and attention deficit hyperactivity disorder. Journal of Abnormal Child Psychology, 28(3), 213–226. https://doi.org/10.1023/A:1005143419092

 PubMed Web of Science ®Google Scholar

Keulers, E. H., & Jonkman, L. M. (2019). Mind wandering in children: Examining task-unrelated thoughts in computerized tasks and a classroom lesson, and the association with different executive functions. Journal of Experimental Child Psychology, 179, 276–290. https://doi.org/10.1016/j.jecp.2018.11.013

 PubMed Web of Science ®Google Scholar

Cepeda, N. J., Kramer, A. F., & Gonzalez de Sather, J. (2001). Changes in executive control across the life span: Examination of task-switching performance. Developmental Psychology, 37(5), 715. https://doi.org/10.1037/0012-1649.37.5.715

 PubMed Web of Science ®Google Scholar

Lee, K., Bull, R., & Ho, R. M. (2013). Developmental changes in executive functioning. Child Development, 84(6), 1933–1953. https://doi.org/10.1111/cdev.12096

 PubMed Web of Science ®Google Scholar

Kuntsi, J., Stevenson, J., Oosterlaan, J., & Sonuga‐Barke, E. J. (2001). Test‐retest reliability of a new delay aversion task and executive function measures. The British Journal of Developmental Psychology, 19(3), 339–348. https://doi.org/10.1348/026151001166137

 Google Scholar

Kuntsi, J., Oosterlaan, J., & Stevenson, J. (2001). Psychological mechanisms in hyperactivity: I response inhibition deficit, working memory impairment, delay aversion, or something else? Journal of Child Psychology and Psychiatry, 42(2), 199–210. https://doi.org/10.1111/1469-7610.00711

 PubMed Web of Science ®Google Scholar

Cohen, J., Cohen, P., West, S. G., & Aiken, L. S. (2013). Applied multiple regression/correlation analysis for the behavioral science. Routledge. https://doi.org/10.4324/9780203774441

 Google Scholar