A diffusion model analysis of sustained attention in children with attention deficit hyperactivity disorder

Objective: Whether children with attention deficit hyperactivity disorder (ADHD) have deficits in sustained attention remains unresolved due to the ongoing use of cognitive paradigms that are not optimized for studying vigilance and the fact that relatively few studies report performance over time. Method: In three independent samples of school-age children with (total N = 128) and without ADHD (total N = 59), we manipulated event rate, difficulty of discrimination, and use signal detection (SDT) and diffusion models (DM) to evaluate the cause of the vigilance decrement during a continuous performance task. Results: For both groups of children, a bias toward "no-go" over time (as indexed by the SDT parameter B" and the DM parameter z/a) was responsible for generating the vigilance decrement. However, among children with ADHD, the rate at which information accumulated to make a no-go decision (vNoGo) also increased with time on task, representing a possible secondary mechanism that biases children against engagement. At all time points, children with ADHD demonstrated reduced sensitivity to discriminate targets from nontargets. Conclusion: Children with ADHD are particularly sensitive to the cost of task engagement, but nonspecific slower drift rate may ultimately provide a better conceptualization of the cognitive atypicalities commonly observed in that group. Results are interpreted in the context of updated conceptualizations of sustained attention and vigilance.