Evaluation of Children with Attention Deficit Hyperactivity Disorder on the Wechsler Intelligence Scale for Children-IV

Abstract

Objective: The aim of this study was to evaluate the cognitive performance and clinical characteristics of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) who had attended a tertiary center. Method: Fifty-six children and adolescents aged 7-16 years with ADHD who had been admitted to the Child and Adolescent Psychiatry clinic between June 2020 and March 2021 were retrospectively included in the study. A semi-structured interview form for the Affective Disorders and Schizophrenia Interview Schedule-Present Version for School-Age Children was used to determine mental disorders. The Clinical Global Impression Scale (CGIS) was completed to assess the severity of ADHD symptoms. The Wechsler Intelligence Scale for Children-IV (WISC-IV) was used in the assessment of cognitive skills. Results: The median age of the participants was 13 and 71.4% of them were male. The Working memory index (s=83.3) and Full-Scale IQ (FSIQ) (s=84) were found to be the lowest scores. According to the comparisons between CGIS, the FSIQ score (χ2=0.736; p=0.947), verbal comprehension index (χ2=2.882; p=0.578), perceptual reasoning index (χ2=1.412; p=0.842), working memory index (χ2=1.980; p=0.739), processing speed index (χ2=1.673; p=0.796) were not found to be statistically different between the groups. Conclusion: The WISC-IV scale, which is increasingly preferred in the clinic use, could help to obtain information about cognitive performance in children with ADHD, regardless of the severity of ADHD symptoms.

Keywords

• Wechsler intelligence scale for children
• fourth edition
• attention deficit hyperactivity disorder
• symptom severity

Dikkat Eksikliği Hiperaktivite Bozukluğu Olan Çocukların Wechsler Çocuklar İçin Zeka Ölçeği-IV ile Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, üçüncü basamak bir merkezde değerlendirilerek Dikkat Eksikliği Hiperaktivite Bozukluğu (DEHB) tanısı almış çocuk ve ergenlerin bilişsel performanslarını ve klinik özelliklerini incelemektir. Yöntem: Haziran 2020-Mart 2021 tarihleri arasında Çocuk ve Ergen Psikiyatrisi kliniğine başvuran 7-16 yaş arası DEHB’li 56 çocuk ve ergen geriye dönük olarak çalışmaya dahil edildi. Ruhsal bozuklukları belirlemek için yarı yapılandırılmış bir görüşme formu olan Okul Çağı Çocukları için Duygulanım Bozuklukları ve Şizofreni Görüşme Çizelgesi-Şimdi Versiyonu uygulanmıştır. DEHB semptomlarının şiddetini değerlendirmek için Klinik Global İzlenim Ölçeği (KGİÖ) tamamlandı. Bilişsel becerilerin incelenmesinde Wechsler Çocuklar İçin Zeka Ölçeği-IV (WÇZÖ-IV) kullanılmıştır. Bulgular: Katılımcıların ortanca yaşı 13 idi ve %71,4’ü erkekti. Çalışma belleği indeksi (s=83,3) ve Tüm Ölçek IQ (TÖIQ) (s=84) en düşük puanlar olarak bulundu. TÖIQ puanı (χ2=0,736; p=0,947), sözel kavrama indeksi (χ2=2,882; p=0,578), algısal akıl yürütme indeksi (χ2=1,412; p=0,842), çalışma belleği indeksi (χ2=1,980; p=0,739), işlemleme hızı indeksi (χ2=1,673; p=0,796) açısından KGİÖ grupları arasında istatistiksel olarak farklı bulunmadı. Sonuç: Klinik kullanımda giderek daha fazla tercih edilen WÇZÖ-IV, DEHB semptom şiddetinden bağımsız olarak DEHB’li çocuklarda bilişsel performans hakkında bilgi edinmeye yardımcı olabilir.

Keywords

• Wechsler çocuklar için zeka ölçeği
• dördüncü sürüm
• dikkat eksikliği hiperaktivite bozukluğu
• belirti şiddeti

References

1. 1. Çelik C, Yiğit İ, Yiğit MG, Erden G. Klinik ve normal örneklemlerde WISC-IV’ün faktör yapısının incelenmesi: çoklu grup doğrulayıcı faktör analizi. Düşünen Adam 2020;33(3):296-309. google scholar
2. 2. Çelik C. Use of Wechsler Intelligence Scales for Children in the assessment of attention deficit hyperactivity disorder. Turk J Child Adolesc Ment Health 2014;21:65-78. google scholar
3. 3. Uluc S, Oktem F, Erden G, Gencoz T, Sezgin N. Wechsler Intelligence Scale for Children-IV: A New Era for Turkey in Evaluation of Intelligence in the Clinical Context. Turkish Psychological Articles 2011;14:49-57. google scholar
4. 4. Faraone SV, Sergeant J, Gillberg C, Biederman J. The worldwide prevalence of ADHD: is it an American condition? World psychiatry 2003;2(2):104. google scholar
5. 5. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM- 5®). American Psychiatric Pub. google scholar
6. 6. Sharma A, Couture J. A review of the pathophysiology, etiology, and treatment of attention-deficit hyperactivity disorder (ADHD). Ann Pharmacother 2014;48(2):209-25. google scholar
7. 7. Damasio AR, Tranel D, Damasio HC. Behavior: theory and preliminary testing. Frontal lobe function and dysfunction. 1991;217. google scholar
8. 8. Castellanos FX, Sonuga-Barke EJ, Milham MP, Tannock R. Characterizing cognition in ADHD: beyond executive dysfunction. Trends Cogn Sci 2006;10(3):117-23. google scholar

9. 9. Al-Yagon M, Forte D, Avrahami L. Executive functions and attachment relationships in children with ADHD: Links to externalizing/internalizing problems, social skills, and negative mood regulation. J Atten Disord 2020;24(13):1876-90. google scholar
10. 10. Çelik C, Erden G. Wechsler çocuklar için zekâ ölçekleri ile dikkat eksikliği hiperaktivite bozukluğu olan çocukların bilişsel profillerinin incelenmesi: Ankara Üniversitesi Sosyal Bilimler Enstitüsü Psikoloji (Doktora Tezi; 2013). google scholar
11. 11. Frazier TW, Demaree HA, Youngstrom EA. Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology 2004;18(3):543. google scholar
12. 12. Jensen PS. A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 1999;56(12):1073-86. google scholar
13. 13. Schwean VL, McCrimmon A. Attention-deficit/hyperactivity disorder: Using the WISC-IV to inform intervention planning. WISC-IV clinical assessment and intervention 2008;2:193-215. google scholar
14. 14. Ercan ES, Motavallı Mukaddes, N., Yazgan, Y., Pekcanlar Akay, A. & Yıldız Gündoğdu, Ö. (2016). Dikkat Eksikliği Hiperaktivite Bozukluğu. Pekcanlar Akay, A. & Ercan, E.S. (Ed), Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları (pp. 33-55). Ankara: Türkiye Çocuk ve Genç Psikiyatrisi Derneği. google scholar
15. 15. Mayes SD, Calhoun SL. WISC-IV and WISC-III profiles in children with ADHD. J Atten Disord 2006;9(3):486-93. google scholar
16. 16. Baykal S, Ceylan G, Karabekiroğlu K, Tekin A. Relationship between WISC-R subtests and psychiatric symptom groups in attention and learning disorders. Cukurova Med 2018;43(4):785-91. google scholar
17. 17. Thaler NS, Bello DT, Etcoff LM. WISC-IV profiles are associated with differences in symptomatology and outcome in children with ADHD. J Atten Disord 2013;17(4):291-301. google scholar
18. 18. Yu Z-Z, Yang B-R, Zhang S-H, Wang P. Intellectual characteristics of children with attention deficit hyperactivity disorder and developmental dyslexia. Chinese Journal of Contemporary Pediatrics2021;23(2):148-52. google scholar
19. 19. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P, et al. Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36(7):980-8. google scholar
20. 20. Gökler B, Ünal F, Pehlivantürk B, Kültür EÇ, Akdemir D, Taner Y. Reliability and Validity of Schedule for Affective Disorders and Schizophrenia for School Age Children--Present and Lifetime Version--Turkish Version (K-SADS-PL-T). Turk J Child Adolesc Ment Health 2004;11(3):109-16. google scholar
21. 21. Guy W. ECDEU Assessment Manual for Psychopharmacology (revised) National Institute of Mental Health; Rockville, MD: 1976. Clinical Global Impression. 217-21. google scholar
22. 22. Kuntsi J, Eley T, Taylor A, Hughes C, Asherson P, Caspi A, et al. Co-occurrence of ADHD and low IQ has genetic origins. Am J Med Genet B Neuropsychiatr Genet 2004;124(1):41-7. google scholar
23. 23. Antshel KM, Faraone SV, Stallone K, Nave A, Kaufmann FA, Doyle A, et al. Is attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ? Results from the MGH Longitudinal Family Studies of ADHD. J Child Psychol Psychiatry 2007;48(7):687-94. google scholar
24. 24. Erdoğan-Bakar E, Soysal A, Kiriş N, Şahin A, Karakaş S. The Place of Wechsler Intelligence Scale for Children-Revised in Assessment of Attention Deficit Hyperactivity Disorder. Klin Psikiyatr Derg 2005;8(1):5-17. google scholar
25. 25. Evinç ŞG, Gençöz T. WISC-R profiles of children with attention deficit hyperactivity disorder: A comparative study. Türk Psikiyatri Derg 2007;18(2):109-17. google scholar
26. 26. Fenollar-Cortes J, Navarro Soria I, Gonzalez Gomez C, Garda-Sevilla J. Cognitive profile for children with ADHD by using WISC-IV: subtype differences? Rev. de Psicodidactica 2015;20(1),157-76. google scholar
27. 27. Jonides J, Lacey SC, Nee DE. Processes of working memory in mind and brain. Curr Dir Psychol Sci 2005;14(1):2-5. google scholar
28. 28. Weiss L, Saklofske DH, Holdnack JA, Prifitera A. WISC-V: Advances in the assessment of intelligence. San Diego, CA. 2016:9. google scholar
29. 29. Karaman D, Türkbay T, Gökçe FS. Cognitive profiles in special learning disorder comorbid with attention deficit hyperactivity disorder. Turk J Child Adolesc Ment Health 2006;13(2):60-8. google scholar
30. 30. İçmeli C, Özçetin A, Ataoğlu B, Ankaralı H. Characteristics of Attention Deficit and Hyperactivity Disorder in Children and Adolescents Having Mental Retardation. Düzce Univ Sağlık Bilim Enst Derg 2015;5(2):12-8. google scholar
31. 31. Naglieri JA, Goldstein S, Delauder BY, Schwebach A. Relationships between the WISC-III and the Cognitive Assessment System with Conners’ rating scales and continuous performance tests. Arch Clin Neuropsychol 2005;20(3):385-401. google scholar
32. 32. Mattison RE, Mayes SD. Relationships between learning disability, executive function, and psychopathology in children with ADHD. J Atten Disord 2012;16(2):138-46. google scholar
33. 33. Jepsen JRM, Fagerlund B, Mortensen EL. Do attention deficits influence IQ assessment in children and adolescents with ADHD? J Atten Disord 2009;12(6):551-62. google scholar