Neuropsychologic theory and findings in attention-deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade.

The past decade has witnessed the establishment of several now well-replicated findings in the neuropsychology of attention-deficit/hyperactivity disorder (ADHD), which have been confirmed by meta-analyses. Progress has been notable from the importing of cognitive science and neuroscience paradigms. Yet these findings point to many neural networks being involved in the syndrome and to modest effect sizes suggesting that any one neuropsychologic deficit will not be able to explain the disorder. In this article, leading theories and key findings are briefly reviewed in four key domains: attention, executive functions, state regulation and motivation, and temporal information processing. Key issues facing the field of neuropsychologic research and theory in ADHD include 1) the need for more integrative developmental accounts that address both multiple neural systems and the socialization processes that assure their development; 2) consideration of multiple models/measures in the same study so as to examine relative contributions, within-group heterogeneity, and differential deficit; and 3) better integration of cognitive process models with affective and temperament theories so that early precursors to ADHD can be better understood. Overall, the field has witnessed notable progress as it converges on an understanding of ADHD in relation to disruption of a multicomponent self-regulatory system. The next era must articulate multipathway, multilevel developmental accounts of ADHD that incorporate neuropsychologic effects.