Hostname: page-component-78c5997874-ndw9j Total loading time: 0 Render date: 2024-11-19T07:36:16.376Z Has data issue: false hasContentIssue false

Deconstructing Cognitive Heterogeneity in Puerto Rican Spanish-Speaking Children With ADHD

Published online by Cambridge University Press:  26 February 2020

Alicia Nuñez
Affiliation:
Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
Liza San Miguel
Affiliation:
Advanced Neuroscience Center, HIMA-San Pablo Hospital, Caguas, Puerto Rico University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
Jennifer Keene
Affiliation:
Department of Sociology, College of Liberal Arts, University of Nevada, Las Vegas, Las Vegas, NV, USA
Bradley Donohue
Affiliation:
Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
Daniel N. Allen*
Affiliation:
Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
*
*Correspondence and reprint requests to: Daniel N. Allen, Department of Psychology, University of Nevada, Las Vegas, 4505 Maryland Parkway, Las Vegas, NV89154-5030, USA. E-mail: [email protected]

Abstract

Objective:

There is limited understanding of the cognitive profiles of Spanish-speaking children with Attention-Deficit/Hyperactivity Disorder (ADHD). The current study investigated the cognitive cluster profiles of Puerto Rican Spanish-speaking children with ADHD using the Wechsler Intelligence Scales for Children-Fourth Edition Spanish (WISC-IV Spanish) Index scores and examined the association between cognitive cluster profiles with other potentially relevant factors.

Method:

Hierarchical cluster analysis was used to identify WISC-IV clusters in a sample of 165 Puerto Rican children who had a primary diagnosis of ADHD. To examine the validity of the ADHD clusters, analysis of variances and chi-square analyses were conducted to compare the clusters across sociodemographics (e.g., age and education), type of ADHD diagnosis (ADHD subtype, Learning Disorder comorbidity), and academic achievement.

Results:

Clusters were differentiated by level and pattern of performance. A five-cluster solution was identified as optimal that included (C1) multiple cognitive deficits, (C2) processing speed deficits, (C3) generally average performance, (C4) perceptual reasoning strengths, and (C5) working memory deficits. Among the five clusters, the profile with multiple cognitive deficits was characterized by poorer performance on the four WISC-IV Spanish Indexes and was associated with adverse sociodemographic characteristics.

Conclusions:

Results illustrate that there is substantial heterogeneity in cognitive abilities of Puerto Rican Spanish-speaking children with ADHD, and this heterogeneity is associated with a number of relevant outcomes.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

This manuscript was used to partially fulfill the dissertation requirements for first author, Alicia Nuñez.

References

REFERENCES

Aldenderfer, M. & Bashfield, R. (1984). Cluster Analysis. Newbury Park, CA: SAGE.CrossRefGoogle Scholar
Allen, D.N. & Goldstein, G. (2013). Cluster Analysis In Neuropsychological Research Recent Applications. New York, NY: Springer.CrossRefGoogle Scholar
Allen, D.N., Leany, B.D., Thaler, N.S., Cross, C., Sutton, G.P., & Mayfield, J. (2010). Memory and attention profiles in pediatric traumatic brain injury. Archives of Clinical Neuropsychology, 25(7), 618633. doi: 10.1093/arclin/acq051CrossRefGoogle ScholarPubMed
Allen, D.N., Thaler, N.S., Donohue, B., & Mayfield, J. (2010). WISC-IV profiles in children with traumatic brain injury: similarities to and differences from the WISC-III. Psychological Assessment, 22, 5764. doi: 10.1037/a0016056CrossRefGoogle ScholarPubMed
Alloway, T. (2011). A comparison of working memory profiles in children with ADHD and DCD. Child Neuropsychology, 17(5), 483494.CrossRefGoogle ScholarPubMed
American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Washington, DC: Author.Google Scholar
Barkley, R.A. (2013). Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. Journal of Clinical Child & Adolescent Psychology, 42, 161173. doi: 10.1080/15374416.2012.734259CrossRefGoogle ScholarPubMed
Beale, E.M.L. (1969). Cluster Analysis. London: Scientific Control Systems.Google Scholar
Buré-Reyes, A., Hidalgo-Ruzzante, N., Vilar-López, R., Gontier, J., Sánchez, L., Pérez-García, M., & Puente, A. (2013). Neuropsychological test performance of Spanish speakers: is performance different across different Spanish-speaking subgroups? Journal of Clinical and Experimental Neuropsychology, 35, 404412.CrossRefGoogle ScholarPubMed
Capdevila-Brophy, C., Artigas-Pallarés, J., Navarro-Pastor, J. B., García-Nonell, K., Rigau-Ratera, E., & Obiols, J. E. (2014). ADHD predominantly inattentive subtype with high sluggish cognitive tempo: a new clinical entity? Journal of Attention Disorders, 18, 607616. doi: 10.1177/1087054712445483CrossRefGoogle ScholarPubMed
Cockcroft, K. (2011). Working memory functioning in children with attention-deficit/hyperactivity disorder ADHD): a comparison between subtypes and normal controls. Journal of Child and Adolescent Mental Health, 23(2), 107118. doi: 10.2989/17280583.2011.634545CrossRefGoogle ScholarPubMed
Cohen, J. (1968). Weighted kappa: nominal scale agreement provision for scaled disagreement or partial credit. Psychological Bulletin, 70(4), 213220.CrossRefGoogle ScholarPubMed
Coker, T.R., Elliott, M.N., Toomey, S.L., Schwebel, D.C., Cuccaro, P., Tortolero Emery, S., Visser, S.N., Schuster, M.A., & Schuster, M. (2016). Racial and ethnic disparities in ADHD diagnosis and treatment. Pediatrics, 138, 19.CrossRefGoogle ScholarPubMed
Danielson, M., Bitsko, R., Ghandour, R., Holbrook, J., Kogan, M., & Blumberg, S. (2018). Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. Children and adolescents, 2016. Journal of Clinical Child & Adolescent Psychology, 47(2), 199212.CrossRefGoogle Scholar
De Clercq-Quaegebeur, M., Casalis, S., Lemaitre, M. P., Bourgois, B., Getto, M., & Vallée, L. (2010). Neuropsychological profile on the WISC-IV of French children with dyslexia. Journal of Learning Disabilities, 43, 563574. doi: 10.1177/0022219410375000CrossRefGoogle ScholarPubMed
Dupaul, G., Gormley, M., Laracy, S., Montague, M., & Cavendish, W. (2013). Comorbidity of LD and ADHD: implications of DSM-5 for assessment and treatment. Journal of Learning Disabilities, 46(1), 4351.CrossRefGoogle ScholarPubMed
Fenollar Cortés, J., Navarro Soria, I., Gonzalez, C., & Garcia Sevilla, J. (2015). Cognitive profile for children with ADHD by using WISC-IV: subtype differences? Revista de Psicodidáctica, 20(1), 157176. doi: 10.1387/RevPsicodidact.12531CrossRefGoogle Scholar
Fisher, R. (1936). The use of multiple measurements in taxonomic problems. Annals of Eugenics, 7(2), 179188.CrossRefGoogle Scholar
Flores, G. & Tomany-Korman, S.C. (2008). Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics, 121, e286e298.CrossRefGoogle ScholarPubMed
Frazier, T., Demaree, H., & Youngstrom, E. (2004). Meta-analysis of intellectual and neuropsychological test performance in attention-deficit/hyperactivity disorder. Neuropsychology, 18(3), 543555.CrossRefGoogle ScholarPubMed
Goldstein, G., Allen, D.N., & Seaton, B.E. (1998). A comparison of clustering solutions for cognitive heterogeneity in schizophrenia. Journal of the International Neuropsychological Society, 4, 353362.CrossRefGoogle Scholar
Gomez, R., Miranjani Gomez, R.M., Winther, J., & Vance, A. (2014). Latent profile analysis of working memory performance in a sample of children with ADHD. Journal of Abnormal Child Psychology, 42(8), 13671379. doi: 10.1007/s10802-014-9878-5CrossRefGoogle Scholar
Gonzalez-Barrera, A. & Lopez, M.H. (2013). Spanish is the most spoken non-English language in U.S. homes, even among non-Hispanics. Retrieved from http://www.pewresearch.org/fact-tank/2013/08/13/spanish-is-the-most-spoken-non-english-language-in-u-s-homes-even-among-non-hispanics/Google Scholar
Hair, J.F., Black, B., Babin, B., Anderson, R.E., & Tatham, R. (2005). Multivariate Data Analysis (6th ed.). Upper Saddle River, NJ: Prentice Hall.Google Scholar
Hair, J.F., Black, B., Babin, B., Anderson, R.E., & Tatham, R. (1992). Multivariate Data Analysis with Reading (6th ed.). Upper Saddle River, NJ: Prentice Hall.Google Scholar
Huang, F., Sun, L., Qian, Y., Liu, L., Ma, Q.G., Yang, L., Cheng, J., Cao, Q.J., Su, Y., Gao, Q., Wu, Z.M., Li, H.M., Qian, Q.J., & Wang, Y.F. (2016). Cognitive function of children and adolescents with attention deficit hyperactivity disorder and learning difficulties: a developmental perspective. Chinese Medical Journal, 129(16), 19221928. doi: 10.4103/0366-6999.187861CrossRefGoogle ScholarPubMed
Jacobson, L.A., Ryan, M., Martin, R.B., Ewen, J., Mostofsky, S.H., Denckla, M.B., & Mahone, E.M. (2011). Working memory influences processing speed and reading fluency in ADHD. Child Neuropsychology, 17(3), 209224. doi: 10.1080/09297049.2010.532204CrossRefGoogle ScholarPubMed
Johnstone, S., Roodenrys, J., Blackman, S., Johnston, R., Loveday, E., Mantz, K., & Barratt, S. (2012). Neurocognitive training for children with and without AD/HD. ADHD Attention Deficit and Hyperactivity Disorders, 4(1), 1123.CrossRefGoogle ScholarPubMed
Kim, E.J., Bahk, Y., Oh, H., Lee, W., Lee, J., & Choi, K. (2018). Current status of cognitive remediation for psychiatric disorders: a review. Frontiers in Psychiatry, 9, 461.CrossRefGoogle ScholarPubMed
Kubo, Y., Kanazawa, T., Kawabata, Y., Tanaka, K., Okayama, T., Fujta, M., Tsutsumi, A., Yokota, S., & Yoneda, H. (2018). Comparative analysis of the WISC between two ADHD subgroups. Psychiatry investigation, 15(2), 172177. doi: 10.30773/pi.2017.07.12CrossRefGoogle ScholarPubMed
Loh, P.R., Piek, J.P., & Barrett, N.C. (2011). Comorbid ADHD and DCD: examining cognitive functions using the WISC-IV. Research in Developmental Disabilities, 32, 12601269. doi: 10.1016/j.ridd.2011.02.008CrossRefGoogle ScholarPubMed
Martinussen, R., Hayden, J., Hogg-Johnson, S., & Tannock, R. (2005). A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 44(4), 377384. doi: 10.1097/01.chi.0000153228.72591.73CrossRefGoogle ScholarPubMed
Mayes, S.D. & Calhoun, S.L. (2006). Frequency of reading, math, and writing disabilities in children with clinical disorders. Learning and Individual Differences, 16, 145157. doi: 10.1016/j.lindif.2005.07.004CrossRefGoogle Scholar
Medina, N.G. (2018). Cognitive modification in students with reading problems and ADHD-CT. Revista Puertorriquena de Psicologia, 29(2), 302315.Google ScholarPubMed
Mehta, N.K., Lee, H., & Ylitalo, K.R. (2013). Child health in the United States: recent trends in racial/ethnic disparities. Social Science & Medicine, 95, 615.CrossRefGoogle ScholarPubMed
Melikyan, Z.A., Agranovich, A.V., Puente, A E. (2019). Fairness in psychological testing. In Goldstein, G., Allen, D.N., & Deluca, J. (Eds.), Handbook of Psychological Assessment (4th ed.) (pp. 551564). Cambridge, MA:Academic Press.CrossRefGoogle Scholar
Morgan, P.L., Staff, J., Hillemeier, M.M., Farkas, G., & Maczuga, S. (2013). Racial and ethnic disparities in ADHD diagnosis from kindergarten to eighth grade. Pediatrics, 132, 8593.CrossRefGoogle ScholarPubMed
Morris, R., Blashfield, R.K., & Satz, P. (1981). Neuropsychology and cluster analysis: potentials and problems. Journal of Clinical Neuropsychology, 3, 7999.CrossRefGoogle ScholarPubMed
Mulder, H., Pitchford, N.J., & Marlow, N. (2011). Processing speed mediates executive function difficulties in very preterm children in middle childhood. Journal of The International Neuropsychological Society, 17(3), 445454. doi: 10.1017/S1355617711000373CrossRefGoogle ScholarPubMed
Muñoz-Sandoval, A.F., Woodcock, R.W., McGrew, K.S., Mather, N., & Schrank, F.A. (2005). Batería III Woodcock-Muñoz: Suplemento diagnóstico para las pruebas de habilidades cognitivas. Itasca, IL: Riverside Publishing.Google Scholar
Murphy, K.R., Barkley, R.A., & Bush, T. (2001). Executive functioning and olfactory identification in young adults with attention deficit-hyperactivity disorder. Neuropsychology, 15, 211220.CrossRefGoogle ScholarPubMed
Negrón de Montilla, A. (1975). Americanization in Puerto Rico and the Public-School System, 1900–1930 (2nd ed.). Rio Piedras: Editorial Universitaria, Universidad de Puerto Rico.Google Scholar
Orban, S.A., Rapport, M.D., Friedman, L.M., & Kofler, M.J. (2014). Executive function/cognitive training for children with ADHD: Do results warrant the hype and cost? The ADHD Report, 22, 814.CrossRefGoogle Scholar
Pastor, P.N., Reuben, C.A., Duran, C.R., & Hawkins, L.D. (2015). Association between diagnosed ADHD and selected characteristics among children Aged 4–17 Years: United States, 2011–2013. NCHS Data Brief. Number 201. Centers for Disease Control and Prevention. Hyattsville, MD: National Center for Health Statistics.Google Scholar
Parke, E.M., Thaler, N.S., Etcoff, L.M., & Allen, D.N. (2015). Intellectual profiles in children with ADHD and comorbid learning and motor disorders. Journal of Attention Disorders, 110. doi: 10.1177/1087054715576343Google ScholarPubMed
Pew Hispanic Center. (2016). Statistical Portrait of Hispanics in the United States. Retrieved from http://www.pewhispanic.org/2016/04/19/statistical-portrait-of-hispanics-in-the-united-states-key-charts/Google Scholar
Pievsky, M. & McGrath, R. (2018). The neurocognitive profile of attention-deficit/hyperactivity disorder: A review of meta-analyses. Archives of Clinical Neuropsychology, 33(2), 143157.CrossRefGoogle ScholarPubMed
Puente, A.E. & Puente, N. (2009). The challenges of measuring abilities and competencies in Hispanics/Latinos. In Grigorenoko, E.L. (Ed.), Multicultural Psychoeducational Assessment, (pp. 417441). New York, NY: Springer.Google Scholar
Puente, A.E., Ojeda, C., Zink, D., & Portillo Reyes, V. (2015). Neuropsychological testing of Spanish speakers. In Geisinger, K.F. & Geisinger, K.F. (Eds.), Psychological Testing of Hispanics: Clinical, Cultural, and Intellectual Issues (2nd ed.) (pp. 135152). Washington, DC: American Psychological Association. doi: 10.1037/14668-008CrossRefGoogle Scholar
Rapport, M.D., Orban, S.A., Kofler, M.J., & Friedman, L.M. (2013). Do programs designed to train working memory, other executive functions, and attention benefit children with ADHD: A meta-analytic review of cognitive, academic, and behavioral outcomes. Clinical Psychology Review, 33, 12371252.CrossRefGoogle ScholarPubMed
Reynolds, C. & Voress, J.K. (2007). Test of Memory and Learning (2nd ed.). Austin, TX: PRO-ED.Google Scholar
San Miguel Montes, L.E., Allen, D.N., Puente, A.E., & Neblina, C. (2010). Validity of the WISC–IV Spanish for a clinically referred sample of Hispanic children. Psychological Assessment, 22(2), 465469. doi: 10.1037/a0018895CrossRefGoogle ScholarPubMed
Saez, P.A., Bender, H.A., Barr, W.B., Rivera Mindt, M., Morrison, C.E., Hassenstab, J., Rodriguez, M., & Vazquez, B. (2014). The impact of education and acculturation on nonverbal neuropsychological test performance among Latino/a patients with epilepsy. Applied Neuropsychology: Adult, 21, 108119. doi: 10.1080/09084282.2013.768996CrossRefGoogle ScholarPubMed
Seidman, L., Biederman, J., Valera, E., Monuteaux, M., Doyle, A., & Faraone, S. (2006). Neuropsychological functioning in girls with attention-deficit/hyperactivity disorder with and without learning disabilities. Neuropsychology, 20(2), 166177.CrossRefGoogle ScholarPubMed
Shanahan, M.A., Pennington, B.F., Yerys, B.E., Scott, A., Boada, R., Willcutt, E.G., Olson, R.K., & DeFries, J.C. (2006). Processing speed deficits in attention deficit/hyperactivity disorder and reading disability. Journal of Abnormal Child Psychology, 34(5), 585602. doi: 10.1007/s10802-006-9037-8CrossRefGoogle ScholarPubMed
Snow, J.B. & Sapp, G.L. (2000). WISC – III subtest patterns of ADHD and normal samples. Psychological Reports, 87, 759765. doi: 10.2466/pr0.2000.87.3.759Google ScholarPubMed
Solanto, M.V., Gilbert, S.N., Raj, A., Zhu, J., Pope-Boyd, S., Stepak, B., Vail, L., & Newcorn, J.H. (2007). Neurocognitive functioning in AD/HD, predominantly inattentive and combined subtypes. Journal of Abnormal Child Psychology, 35, 729744. doi: 10.1007/s10802-007-9123-6CrossRefGoogle ScholarPubMed
Thaler, N., Bello, D., & Etcoff, L. (2012). WISC-IV Profiles are associated with differences in symptomatology and outcome in children with ADHD. Journal of Attention Disorders, 17(4), 291301.CrossRefGoogle ScholarPubMed
Thaler, N.S., Bello, D.T., Randall, C., Goldstein, G., Mayfield, J., & Allen, D.N. (2010). IQ profiles are associated with differences in behavioral and emotional functioning following pediatric traumatic brain injury. Archives of Clinical Neuropsychology, 25, 781790. doi: 10.1093/arclin/acq073CrossRefGoogle Scholar
Thaler, N.S., Terranova, J., Turner, A., Mayfield, J., & Allen, D.N. (2015). A comparison of IQ and memory cluster solutions in moderate and severe pediatric traumatic brain injury. Applied Neuropsychology: Child, 4(1), 2030. doi: 10.1080/21622965.2013.790820CrossRefGoogle ScholarPubMed
Walg, M., Hapfelmeier, G., El-Wahsch, D., & Prior, H. (2017). The faster internal clock in ADHD is related to lower processing speed: WISC-IV profile analyses and time estimation tasks facilitate the distinction between real ADHD and pseudo-ADHD. European Child & Adolescent Psychiatry, 26(10), 11771186. doi: 10.1007/s00787-017-0971-5CrossRefGoogle ScholarPubMed
Walshaw, P.D., Alloy, L.B., & Sabb, F.W. (2010). Executive function in pediatric bipolar disorder and attention-deficit hyperactivity disorder: In search of distinct phenotypic profiles. Neuropsychology Review, 20(1), 103120. doi: 10.1007/s11065-009-9126CrossRefGoogle ScholarPubMed
Wechsler, D. (2003). Wechsler Intelligence Scale for Children-Fourth Edition. San Antonio, TX: Psychological Corporation.Google Scholar
Wechsler, D. (2005). Manual: Wechsler Intelligence Scale for Children (4th ed. Spanish). San Antonio, TX: Harcourt Assessment.Google Scholar
Weiss, L.G., Saklofske, D., Prifitera, A., & Holdnack, J.A. (2006). WISC-IV Advanced Clinical Interpretation. Burlington, MA: Elsevier.CrossRefGoogle Scholar
Willcutt, E.G., Doyle, A.E., Nigg, J.T., Faraone, S.V., & Pennington, B.F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57(11), 13361346. doi: 10.1016/j.biopsych.2005.02.006CrossRefGoogle ScholarPubMed
Woodcock, R.W., McGrew, K.S., & Mather, N. (2001). Woodcock-Johnson III. Itasca, IL: Riverside Publishing.Google Scholar