A novel task for examining strategic planning: Evidence for impairment in children with ADHD

Abstract

Children with attention deficit hyperactivity disorder (ADHD) often show poor performance on tasks that require strategic planning. To assess this ability, we developed a paper and pencil task that required consistent use of a simple test-taking strategy to maximize the number of points. The visual discrimination task with minimal cognitive demands required children to maximize their gains by responding only to outlined high-point problems and to skip the low-point problems. The task was administered twice, the second time with explicit instructions on how to implement the strategy. Few of the children in the ADHD or control group, ages 8–13 years, were able to discover the strategy on their own, but after explicit instruction 90% of the children in the control group but only 57.5% of children with ADHD used the strategy to maximize points (p < .005). The ADHD group used the strategy less efficiently, despite the fact that they did not differ on the total number of problems completed. The findings suggest that children with ADHD have impaired ability to implement strategic approaches for tasks similar to school assignments. The task can potentially be developed as a diagnostic aid and as a basis for further research assessing strategic planning in ADHD.

*Supported by K08 NS 02039 (S.H.M.), K02 NS 044850 (S.H.M.), R01 NS047781 (S.H.M.), and M01 RR00052 (Johns Hopkins General Clinical Research Center). The authors do not receive any financial support from manufacturer(s) of any commercial products(s) and/or provider(s) of commercial services, and there was no commercial support of the research reported in the manuscript.