"Ecological" and highly demanding executive tasks detect real-life deficits in high-functioning adult ADHD patients

J Atten Disord. 2013 Jan;17(1):11-9. doi: 10.1177/1087054710389988. Epub 2012 Jul 23.


Objective: Many adult ADHD patients with a convincing history of real-life executive deficits perform entirely within normal limits or with minimally impaired performance in classical executive tests. The authors assessed a group of high cognitive functioning adult ADHD participants on "ecological" and "highly demanding" executive tasks.

Method: A total of 117 adult ADHD participants were classified as showing either a high-functioning (Hi-ADHD) or a low-functioning (Lo-ADHD) neuropsychological profile based on standard assessment. Their performance was compared with healthy controls (n = 21) on an ecological task of executive function (the hotel task) and computerized tasks of high cognitive demand.

Results: Lo-ADHD significantly differed from controls on multiple standard neuropsychological variables as well as on the experimental tasks. Hi-ADHD and healthy controls did not differ significantly on any of the standard neuropsychological variables, but a significant difference was found between the groups on measures of the experimental tasks.

Conclusion: Real-life executive dysfunction of patients with ADHD who perform within normal range on standard assessment can be detected with the use of more ecological and highly demanding tasks.

MeSH terms

  • Adult
  • Attention Deficit Disorder with Hyperactivity / psychology*
  • Case-Control Studies
  • Cognition
  • Executive Function*
  • Female
  • Humans
  • Male
  • Neuropsychological Tests