Which components of processing speed are affected in ADHD subtypes?

The term "processing speed" (PS) encompasses many components including perceptual, cognitive and output speed. Despite evidence for reduced PS in Attention-Deficit/Hyperactivity Disorder (ADHD), little is known about which component(s) is most impacted in ADHD, or how it may vary by subtypes. Participants included 151 children, ages 8-12 years, with ADHD Predominantly Inattentive Type, ADHD Combined Type and typically developing controls using DSM-IV criteria. All children completed four measures of processing speed: Symbol Search, Coding, Decision Speed, and simple reaction time. We found children with ADHD-PI and ADHD-C had slower perceptual and psychomotor/incidental learning speed than controls and that ADHD-PI had slower decision speed than controls. The subtypes did not differ on any of these measures. Mean reaction time was intact in ADHD. Hence, at a very basic output level, children with ADHD do not have impaired speed overall, but as task demands increase their processing speed becomes less efficient than controls'. Further, perceptual and psychomotor speed were related to inattention, and psychomotor speed/incidental learning was related to hyperactivity/impulsivity. Thus, inattention may contribute to less efficient performance and worse attention to detail on tasks with a higher perceptual and/or psychomotor load; whereas hyperactivity/impulsivity may affect psychomotor speed/incidental learning, possibly via greater inaccuracy and/or reduced learning efficiency. Decision speed was not related to either dimension. Results suggest that PS deficits are primarily linked to the inattention dimension of ADHD but not exclusively. Findings also suggest PS is not a singular process but rather a multifaceted system that is differentially impacted in ADHD.