Performance of inattentive-overactive children on selected measures of prefrontal-type function.

Several theorists have suggested that childhood inattention-overactivity ("attention deficit disorder," "hyperactivity") may arise from a deficit in the inhibitory mechanisms of the prefrontal cortex. Accordingly, it was hypothesized that inattentive-overactive children would exhibit prefrontal-type deficits on several relevant neuropsychological measures. Subjects were 21 elementary school pupils who had been referred for disruptive behavior problems and who had been rated as high in inattention-overactivity. Controls were 26 age-matched normal children from the same school. It was found that the Inattentive-Overactive group, relative to the Control group, performed in the direction of prefrontal-type deficit on three measures that have an empirical history of discriminating patients with prefrontal lesions from controls: Perseverative errors on the Wisconsin Card Sorting Test, errors on the sequential Matching Memory Task, and Necker Cube reversals. On three theoretical indices of prefrontal-type deficit--Trailmaking, the Stroop Color-Word Test, and a sequential memory task for children--the Inattentive-Overactive group also exhibited predicted deficits. There were no differences between groups on the WISC-R Vocabulary subtest. The results of the study are generally compatible with a prefrontal-deficit theory of inattention-overactivity. However, the presence of other deficits cannot be ruled out nor can an organic cause be inferred from these findings alone.