Executive Functions in Girls With and Without Childhood ADHD Followed Through Emerging Adulthood: Developmental Trajectories

Abstract

Using an all-female sample, we examined trajectories of executive functioning (EF) performance from childhood through emerging adulthood—and their prediction of key emerging-adult outcomes. One hundred forty girls carefully diagnosed with attention deficit/hyperactivity disorder (ADHD) and 88 matched comparison girls were administered EF measurements assessing global EF, response inhibition, and verbal working memory during childhood (M age = 9.5 years), adolescence (M age = 14.1 years), the earliest years of adulthood (M age = 19.6 years), and the end of emerging adulthood (M age = 25.6 years). Retention rates were excellent. Hierarchical linear modeling was used to estimate growth curves for each EF measure. The linear EF slopes were then used to explore how changes in EF interacted with each participant’s persistence/remission of ADHD over time to influence behavioral, emotional, and academic impairment in emerging adulthood. Although all women experienced absolute improvements in EF performance across time, women with histories of ADHD consistently lagged behind comparison women, even if their ADHD symptoms had remitted by early adulthood. However, EF performance over time did not significantly influence the link between ADHD status and (a) maternal reports of associated behavioral and emotional impairment or (b) objective measures of academic achievement. These findings indicate that EF deficits should be considered when developing and implementing treatments for ADHD through emerging adulthood. Future research should be aimed at understanding the mechanisms behind these observed trajectory differences.