# Does Cognitive Disengagement Syndrome Affect the Cognitive Flexibility of Children with Attention Deficit Hyperactivity Disorder?

## TL;DR

This study explores how cognitive disengagement syndrome affects cognitive flexibility in children with ADHD using neuropsychological tests.

## Contribution

The study identifies a specific impact of cognitive disengagement syndrome on cognitive flexibility in children with ADHD.

## Key findings

- Children with CDS+ADHD performed worse on the Wisconsin Card Sorting Test and Semantic Fluency Test.
- No significant differences were found in other neuropsychological tests between the groups.
- CDS co-occurrence is linked to lower cognitive flexibility in ADHD-diagnosed children.

## Abstract

Cognitive flexibility (CF) is an ability to adapt to a changing environment, which is a prominent skill in children at school age. ADHD is a common disorder of childhood and can be accompanied by cognitive disengagement syndrome (CDS, previously referred to as “sluggish cognitive tempo”). This study aimed to assess CDS’s effect on CF in children with ADHD by using neuropsychological tests.

The study sample consisted of 100 ADHD children aged between 6 and 12 years, including 2 groups: 60 ADHD-only and 40 CDS+ADHD. ADHD diagnosis and CDS symptoms in participants were assessed by Diagnostic and Statistical Manual of Mental Disorder Fifth Edition Text Revision (DSM-5-TR) based psychiatric interviews and rating scales. The Neuropsychological Battery, consisting of 4 different tests, Wisconsin Card Sorting Test (WCST), Stroop Color–Word Test, Verbal Fluency Test (VFT), and Color Trail Test, was applied to participants to compare CF of the ADHD-only group to CDS+ADHD.

It was found that the CDS+ADHD group showed lower performance than the ADHD-only group in the WCST and the Semantic Fluency Test—a subtest of the VFT. However, no significant performance differences were found between the groups in other tests.

It was revealed that CDS co-occurrence causes lower CF performance in ADHD-diagnosed children. A more comprehensive approach is required to understand the nature of this difficulty.