THE CONTRIBUTION OF EARLY HOT AND COLD EXECUTIVE FUNCTIONS IN PREDICTING ADHD PROFILE IN SCHOOL-AGE SINGAPOREAN CHILDREN

Abstract

Accumulating evidence supports executive functioning (EF) deficits as the core manifestations of Attention-Deficit/Hyperactivity Disorder (ADHD). The present longitudinal birth cohort study aimed to construct structural equation models using cold and hot EF skills of children younger than 5 to predict ADHD profile at age 8.5 years. Early laboratory tasks and standardised rating scales measured from 6-months to 4.5 years loaded highly (all p < 0.05) onto the two latent variables of cold (i.e., working memory, cognitive control) and hot (i.e., motivation and affective regulation) EF. Our final structural model confirmed that both cold EF (β = -0.20, SE = 0.06, p = .002) and hot EF (β = -0.80, SE = 0.11, p <.001) impairments were strong indicators of later ADHD profile. This model reproduced the covariance matrix of our sample data with reasonable fit indices (χ2(68) = 224.12, p < .001; RMSEA = .04; CFI = .96; AIC = 38945.10). As EF is measurable and modifiable, dimensions of EF with predictive validity for a heterogeneous set of ADHD symptomatology may help to detect at-risk children early and give clues on potential EF interventions during preschool years.