The relation between executive functions and written expression in college students with attention deficit hyperactivity disorder

Abstract

Attention deficit hyperactivity disorder (ADHD) is the second most common disability affecting college students today. According to the DSM-IV, ADHD symptoms include a persistent pattern of inattention and/or hyperactivity-impulsivity markedly more frequent and severe than individuals at a comparable level of development. Moreover, ADHD symptoms involve impairment in executive function including planning, organization, inhibition, and integration of cognitive processes. ADHD has been linked to academic difficulty in children, adolescents, and more recently, college students. Written expression is especially important in college as students encounter required courses that involve a major writing component. Because written expression involves many of the neuropsychological abilities compromised for those with ADHD, specifically executive functions, it was hypothesized that college students with ADHD would experience difficulty with educational tasks involving writing. The present study examined the relation between executive function and written expression. Two groups of undergraduate students, aged 19 to 28 years, were recruited. Group one consisted of 31 students diagnosed with ADHD and group two consisted of 27 controls. Four measures of executive function and a measure of written expression were administered. The majority of those ADHD participants on medication went off their medication on the day of the study. A one-way between-groups multivariate analysis of variance (MANOVA) was conducted to investigate differences in executive function and written expression abilities between the ADHD and control groups. No differences were found. A standard multiple regression model including executive function measures, verbal aptitude, and ADHD symptoms was not significant for predicting the SATA Writing Quotient. Exploratory analyses were conducted to examine the individual components of the SATA Writing Quotient. Results showed that the model was not significant for predicting SATA Writing Composition; however, the model was significant for predicting SATA Writing Mechanics. In addition, a measure of inhibition was found to make a statistically significant contribution to the prediction of SATA Writing Mechanics in this model. Findings from the study provide important information about the link between specific executive function abilities and written expression in college students. Limitations of the study and implications for future research and practice are discussed.