Social and Academic Problems in ADHD: The Role of Implicit and Explicit Learning

Abstract:

The goal of this study is to better understand the cognitive and learning processes that contribute to two of the most common, co-occurring, and chronic impairments seen in children with ADHD: social maladjustment and academic underachievement. Both are significant risk factors for a host of negative outcomes including delinquency, substance abuse, as well as lower occupational and socioeconomic status. Despite the availability of a number of empirically supported psychosocial treatments for ADHD, none have demonstrated long term benefits in the normalization of peer status or academic achievement. The void in our basic understanding of skill acquisition processes in ADHD, combined with a need to improve our existing psychosocial and academic remediation programs, argues for a comprehensive study of learning in ADHD, and of the cognitive processes that contribute to the acquisition of skill.

The first aim of the present study therefore asks whether slow speed of processing accounts for ADHD-related deficits in executive functions (EF) as well as the poor acquisition of explicit cognitive skills, which in turn would predict chronic academic underachievement. If this proves to be the case, then psychotherapeutic and pharmacologic interventions should target processing speed (as opposed to the more molar EF process), which would have positive downstream implications for a number of higher order EFs.

The second and third aims examine whether the implicit learning system, a learning system largely independent of EF, but dependent upon neuroanatomical structures implicated in ADHD (i.e. basal ganglia and striatum) and responsible for learning complex nonverbal rules used in directing social behavior, is (a) intact in children with ADHD, and (b) can predict social performance deficits in ADHD.

To meet these goals, we have adopted an SEM approach to systematically examine the potential conjoint contributions of EFs, speeded performance, and explicit/implicit learning processes on social and academic performance in children aged 8-12 with and without DSM-IV ADHD.