Assessment & Research

Associations of symptoms and subtypes of attention-deficit hyperactivity disorder with visuospatial planning ability in youth.

Chiang et al. (2013) · Research in developmental disabilities 2013
★ The Verdict

Inattention, not hyperactivity, drives visuospatial planning problems in youth with ADHD.

✓ Read this if BCBAs who assess or write BSPs for school-age clients with ADHD.
✗ Skip if Clinicians working only with autism or DCD populations.

01Research in Context

01

What this study did

Chiang et al. (2013) tested 740 youths with and without ADHD.

They looked at how inattention and hyperactivity each link to visuospatial planning.

Kids copied puzzles while researchers scored speed and accuracy.

02

What they found

Only inattention predicted poor planning scores.

Hyperactive or impulsive symptoms added no extra risk.

The link held for both boys and girls across all ages.

03

How this fits with other research

Gau et al. (2013) saw the same pattern with short-term memory: inattention hurt, hyperactivity did not.

Fenollar-Cortés et al. (2017) later found the same for fine-motor errors.

Loh et al. (2011) seems to disagree; they saw visuospatial problems only when ADHD was paired with movement disorder.

The key difference is sample: Ru studied kids who had both ADHD and DCD, while Huey-Ling looked at general ADHD youth.

04

Why it matters

When you test a child with ADHD, expect planning trouble to rise with inattention, not with how much they move.

Use brief puzzle tasks like Tower tests to spot the deficit.

Target attention training first; motor or hyperactivity drills may not fix planning skills.

Free CEUs

Want CEUs on This Topic?

The ABA Clubhouse has 60+ free CEUs — live every Wednesday. Ethics, supervision & clinical topics.

Join Free →
→ Action — try this Monday

Add a quick Tower or block-design task to your intake; score it against inattention rating, not hyperactivity.

02At a glance

Intervention
not applicable
Design
other
Sample size
740
Population
adhd, neurotypical
Finding
negative
Magnitude
small

03Original abstract

Little is known about which ADHD core symptom or subtype is most associated with visuospatial planning deficit. This issue was investigated in a sample of 408 youths with current DSM-IV diagnosis of ADHD, and 332 youths without lifetime ADHD, aged 8-17 years (mean age 12.02±2.24). All the participants and their mothers were interviewed using the Chinese Kiddie Epidemiologic version of the Schedule for Affective Disorders and Schizophrenia to obtain information about ADHD symptoms and diagnosis and other psychiatric disorders. In addition to clinical assessments, the participants were assessed with the WISC-III and the Stocking of Cambridge task of the Cambridge Neuropsychological Test Automated Battery. Multi-level regression models were used for data analysis. The results showed that univariate analyses revealed that inattention, hyperactivity, and impulsivity were significantly associated with visuospatial planning, and the magnitude of such association was amplified with increased task difficulties. Only inattention independently predicted visuospatial planning in a model that included all three ADHD symptoms. After further controlling for comorbidity, age of assessment, treatment with methylphenidate, and Full-scale IQ, inattention was still independently associated with visuospatial planning indexed by mean moves needed to solve problems. In subtype comparison, participants with combined subtype and those with prominently inattentive subtype, rather than prominently hyperactivity/impulsivity subtype, had poorer visuospatial planning performance. Our findings indicate that inattention is independently associated with impaired visuospatial planning, and dimensional approach retains the important distinction among ADHD symptoms than subtype approach in understanding the neuropsychological functioning of ADHD.

Research in developmental disabilities, 2013 · doi:10.1016/j.ridd.2013.06.020