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      Honing in on the Social Difficulties associated with Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement

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          Abstract

          Objective

          Sluggish cognitive tempo (SCT) symptoms are associated with social difficulties in children, though findings are mixed and many studies have used global measures of social impairment. The present study tested the hypothesis that SCT would be uniquely associated with aspects of social functioning characterized by withdrawal and isolation, whereas attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms would be uniquely associated with aspects of social functioning characterized by inappropriate responding in social situations and active peer exclusion.

          Method

          Participants were 158 children (70% boys) between ages 7–12 years being evaluated for possible ADHD. Both parents and teachers completed measures of SCT, ADHD, ODD, and internalizing (anxiety/depression) symptoms. Parents also completed ratings of social engagement and self-control. Teachers also completed measures assessing asociality and exclusion, as well as peer ignoring and dislike.

          Results

          In regression analyses controlling for demographic characteristics and other psychopathology symptoms, parent-reported SCT symptoms were significantly associated with lower social engagement (e.g., starting conversations, joining activities). Teacher-reported SCT symptoms were significantly associated with greater asociality/withdrawal and ratings of more frequent ignoring by peers, as well as greater exclusion. ODD symptoms and ADHD hyperactive-impulsive symptoms were more consistently associated with other aspects of social behavior, including peer exclusion, being disliked by peers, and poorer self-control during social situations.

          Conclusions

          Findings provide the clearest evidence to date that the social difficulties associated with SCT are primarily due to withdrawal, isolation, and low initiative in social situations. Social skills training interventions may be effective for children displaying elevated SCT symptomatology.

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          Most cited references44

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          Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population.

          s To determine the psychometric properties of the Vanderbilt Attention Deficit/Hyperactivity Disorder Parent Rating Scale (VADPRS), which utilizes information based on the Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. (DSM-IV). The VADPRS was created to collect uniform patient data and minimize the time burden of lengthy interviews. Participant data (N = 243) was used from the first 2 years of a longitudinal study on communication among physicians, teachers, and parents in diagnosing, treating, and managing children with attention deficit/hyperactivity disorder (ADHD). The reliability, factor structure, and concurrent validity of the VADPRS were evaluated and compared with ratings of children in clinical and nonclinical samples on the Vanderbilt ADHD Teacher Rating Scale and the Computerized Diagnostic Interview Schedule for Children-IV, Parent version. The internal consistency and factor structure of the VADPRS are acceptable and consistent with DSM-IV and other accepted measures of ADHD. The VADPRS is a reliable, cost-effective assessment for ADHD in clinical and research settings.
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            The Child Behavior Scale: A teacher-report measure of young children's aggressive, withdrawn, and prosocial behaviors.

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              Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity.

              Controversy continues as to whether sluggish cognitive tempo (SCT) is a subtype of attention-deficit/hyperactivity disorder (ADHD) or a distinct disorder. This study examined differences between these disorders in demographics, executive functioning (EF), impairment, and prior professional diagnoses to address the issue. There were 1,800 children 6 to 17 years of age of both sexes from various U.S. ethnic backgrounds who were divided into four groups: (a) high SCT but not ADHD (N = 41), (b) high ADHD but not SCT (N = 95), (c) high in both SCT and ADHD (N = 61), and (d) the control group (N = 1,603). Besides providing demographics, parents completed scales assessing ADHD and SCT symptoms, EF deficits, and psychosocial impairment and reported their child's history of professional diagnoses. SCT symptoms formed two distinct but interrelated factors separate from those for ADHD. SCT differed from ADHD in demographics (age, sex ratio, parental education, income). ADHD was associated with more severe and pervasive EF deficits than SCT, whereas SCT was chiefly associated with mild deficits in Self-Organization. ADHD contributed far more variance to EF deficits than did SCT. Both disorders were impairing, but ADHD was more severely and pervasively so than SCT, especially in Home-School domains; SCT was most impairing in Community-Leisure domains. Different patterns of comorbidity were evident between SCT and ADHD. SCT showed less comorbidity and was particularly associated with depression. SCT may comprise a distinct disorder from ADHD but both may coexist in 39% to 59% of cases each.
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                Author and article information

                Journal
                101133858
                29668
                J Clin Child Adolesc Psychol
                J Clin Child Adolesc Psychol
                Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53
                1537-4416
                1537-4424
                11 July 2018
                13 March 2017
                Mar-Apr 2019
                01 March 2020
                : 48
                : 2
                : 228-237
                Affiliations
                [1 ]Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
                [2 ]Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
                [3 ]Department of Psychology, Saint Louis University, St. Louis, Missouri, USA
                [4 ]TIRR Memorial Hermann, Houston, Texas, USA
                Author notes
                [5 ]Address correspondence to Stephen Becker, 3333 Burnet Ave., MLC 10006, Center for ADHD, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio 45229. Phone: +1 513 803 2066. Fax: +1 513 803 0084. stephen.becker@ 123456cchmc.org
                Article
                PMC6047915 PMC6047915 6047915 nihpa980399
                10.1080/15374416.2017.1286595
                6047915
                28287826
                6a90c16d-9399-43b4-89f3-fdf042f233f6
                History
                Categories
                Article

                social skills,sluggish cognitive tempo,peers,isolation,ADHD
                social skills, sluggish cognitive tempo, peers, isolation, ADHD

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