Attentional impairment in relation to number and type of psychiatric diagnoses in children

The purpose of this study was to investigate the use of an attentional impairment (AI) index with children for measuring the overall severity of impairment in relation to types of diagnoses as well as to number of diagnoses. Four neuropsychological measures were used to examine different aspects of attention (shift, sustain, select, focus) in order to obtain an overall index of impairment. Comparisons were made with 127 children between the ages of 7 and 16 years of age who either had no diagnosis or were diagnosed with a type of ADHD, depressive disorder, or anxiety disorder prior to the study. Four groups were compared on the AI index based on diagnosis: No Diagnosis (ND), ADHD, Other Psychiatric (OP) disorder, and ADHD plus OP. In addition, children were compared on the basis of zero, one, two, or three-plus diagnoses. Age differences were also examined in relation to the AI index. Overall, the ND group was found to receive significantly lower (better) AI scores than the ADHD and ADHD+OP groups. Groups with a diagnosis did not significantly vary from one another. When grouped by number of diagnoses, the ND group received significantly lower scores than the multiple diagnoses (3+) group, with a linear trend of AI scores increasing, or becoming worse, as the number of diagnoses increased. In addition, a negative correlation was found between age and Al; children received scores that suggested less impairment of attention as they became older. The AI index appears to be a promising tool to help determine the magnitude of impairment in attention, although further research is needed to examine patterns among diagnostic groups.