Unique Patterns of Eye Movements Characterizing Inattentive Reading in ADHD.

OBJECTIVE: We aimed to identify unique patterns of eye-movements measures reflecting inattentive reading among adults with and without ADHD. METHOD & RESULTS: We recorded eye-movements during uninterrupted text reading of typically developed (TD) and ADHD adults. First, we found significantly longer reading time for the ADHD group than the TD group. Further, we detected cases in which words were reread more than twice and found that such occasions were much more frequent in participants with ADHD than in TD participants. Moreover, we discovered that the first reading pass of these words was less sensitive to the length of the word than the first pass of words read only once, indicating a less meaningful reading. CONCLUSION: We propose that high rate of words that were reread is a correlate of inattentive reading which is more pronounced among ADHD readers. Implications of the findings in the context of reading comprehension are discussed.

Near and Far Transfer Effects of Computerized Progressive Attention Training (CPAT) Versus Mindfulness Based Stress Reduction (MBSR) Practice Among Adults With ADHD.

OBJECTIVE: The present study evaluated the near (attention) and far (reading, ADHD symptoms, learning, and quality of life) transfer effects of a Computerized Progressive Attention Training (CPAT) versus Mindfulness Based Stress Reduction (MBSR) practice among adults with ADHD compared to a passive group. METHOD: Fifty-four adults participated in a non-fully randomized controlled trial. Participants in the intervention groups completed eight 2-hr weekly training sessions. Outcomes were assessed before, immediately after, and 4 months post-intervention, using objective tools: attention tests, eye-tracker, and subjective questionnaires. RESULTS: Both interventions showed near-transfer to various attention functions. The CPAT produced far-transfer effects to reading, ADHD symptoms, and learning while the MBSR improved the self-perceived quality of life. At follow-up, all improvements except for ADHD symptoms were preserved in the CPAT group. The MBSR group showed mixed preservations. CONCLUSION: Both interventions have beneficial effects, however only the CPAT group exhibited improvements compared to the passive group.

Listen up! ADHD slows spoken-word processing in adverse listening conditions: Evidence from eye movements.

BACKGROUND: Cognitive skills such as sustained attention, inhibition and working memory are essential for speech processing, yet are often impaired in people with ADHD. Offline measures have indicated difficulties in speech recognition on multi-talker babble (MTB) background for young adults with ADHD (yaADHD). However, to-date no study has directly tested online speech processing in adverse conditions for yaADHD. AIMS: Gauging the effects of ADHD on segregating the spoken target-word from its sound-sharing competitor, in MTB and working-memory (WM) load. METHODS AND PROCEDURES: Twenty-four yaADHD and 22 matched controls that differ in sustained attention (SA) but not in WM were asked to follow spoken instructions presented on MTB to touch a named object, while retaining one (low-load) or four (high-load) digit/s for later recall. Their eye fixations were tracked. OUTCOMES AND RESULTS: In the high-load condition, speech processing was less accurate and slowed by 140ms for yaADHD. In the low-load condition, the processing advantage shifted from early perceptual to later cognitive stages. Fixation transitions (hesitations) were inflated for yaADHD. CONCLUSIONS AND IMPLICATIONS: ADHD slows speech processing in adverse listening conditions and increases hesitation, as speech unfolds in time. These effects, detected only by online eyetracking, relate to attentional difficulties. We suggest online speech processing as a novel purview on ADHD. WHAT THIS PAPER ADDS?: We suggest speech processing in adverse listening conditions as a novel vantage point on ADHD. Successful speech recognition in noise is essential for performance across daily settings: academic, employment and social interactions. It involves several executive functions, such as inhibition and sustained attention. Impaired performance in these functions is characteristic of ADHD. However, to date there is only scant research on speech processing in ADHD. The current study is the first to investigate online speech processing as the word unfolds in time using eyetracking for young adults with ADHD (yaADHD). This method uncovered slower speech processing in multi-talker babble noise for yaADHD compared to matched controls. The performance of yaADHD indicated increased hesitation between the spoken word and sound-sharing alternatives (e.g., CANdle-CANdy). These delays and hesitations, on the single word level, could accumulate in continuous speech to significantly impair communication in ADHD, with severe implications on their quality of life and academic success. Interestingly, whereas yaADHD and controls were matched on WM standardized tests, WM load appears to affect speech processing for yaADHD more than for controls. This suggests that ADHD may lead to inefficient deployment of WM resources that may not be detected when WM is tested alone. Note that these intricate differences could not be detected using traditional offline accuracy measures, further supporting the use of eyetracking in speech tasks. Finally, communication is vital for active living and wellbeing. We suggest paying attention to speech processing in ADHD in treatment and when considering accessibility and inclusion.

Are attention and cognitive control altered by fMRI scanner environment? Evidence from Go/No-go tasks in ADHD.

It is widely assumed that cognitive processes studied in fMRI are equivalent to cognitive processes engaged in the same experimental paradigms in typical behavioral lab settings. Yet very few studies examined this common assumption, and the results have been equivocal. In the current study we directly tested the effects of fMRI environment on sustained attention and response inhibition, using a Go/No-go task, among participants with (n = 42) and without (n = 21) attention deficit/hyperactivity disorder (ADHD). Participants with ADHD are characterized by deficits in these cognitive functions and may be particularly susceptible to environmental effects on attention. We found a substantial slowing of reaction time in the scanner for all participants, and a trend for enhanced sustained attention, particularly in ADHD participants with poor performance. We also report limited stability of individual differences in scores obtained in the lab and in the scanner. These findings call for cautious interpretation of neuroimaging task-related results, especially those obtained in clinical populations.

Association between attention, nonverbal intelligence and school performance of school-age children with Autism Spectrum Disorder from a public health context in Brazil.

BACKGROUND: Autism Spectrum Disorder (ASD) is characterized by impairments in social interaction, restricted and repetitive behaviour, interests or activities. Difficulties in a broad spectrum of cognitive skills is often present, including attentional processes and nonverbal intelligence, which might be related to academic difficulties. AIMS: In this study, the association between attentional skills and nonverbal intelligence to school performance of children with ASD was assessed. METHODS AND PROCEDURES: 32 children/adolescents between 8-14 years old, who attended a treatment unit linked to the public health system of São Paulo-Brazil participated in the study. The following instruments were utilized: Cancellation Attention Test; Raven's Coloured Progressive Matrices; and School Performance Test. OUTCOMES AND RESULTS: After correlation analysis, statistically significant associations were found between attention and nonverbal intelligence with school performance. Regression analysis showed that attention drives school performance irrespective of nonverbal intelligence. CONCLUSIONS AND IMPLICATIONS: Results evidence the link between attention and school performance in ASD, suggesting that attentional mechanisms may be a promising route to follow in the design of interventions for school improvement of children and adolescents with ASD.

Attention training in children with autism spectrum disorder improves academic performance: A double-blind pilot application of the computerized progressive attentional training program.

Atypical attention has been reported in individuals with autism spectrum disorder (ASD) with studies pointing to an increase in attention deficit and hyperactivity disorder-like symptomatology. Individuals with ASD may also present academic difficulties and it is possible that they face a double-barrier for academic attainment from both core ASD symptomatology and from attention atypicalities, which are directly linked to academic performance. This raises the possibility that academic difficulties in ASD may benefit from cognitive training targeting attention. To test this possibility, we used the computerized progressive attentional training (CPAT) intervention in a double-blind, active control with follow-up intervention study in Brazil. The CPAT is a computerized attention training program that was recently piloted with schoolchildren with ASD in the UK. Twenty-six participants (8-14 years) with ASD in the São Paulo's ASD Reference Unit were assigned to either the CPAT (n = 14) or active control group (n = 12), which were matched at baseline. Two 45-min intervention sessions per week were conducted over a 2-month period. School performance, attention, fluid intelligence, and behavior were assessed before, immediately after and 3 months following the intervention. Significant group by time interactions show improvements in math, reading, writing and attention that were maintained at follow-up for the CPAT (but not the active control) group, while parents of children from both groups tended to report behavioral improvements. We conclude that attention training has the potential to reduce obstacles for academic attainment in ASD. Combined with the previous pilot study, the current results point to the generality of the approach, which leads to similar outcomes in different cultural and social contexts. LAY ABSTRACT: Attention difficulties tend to occur in ASD and are linked to academic performance. In this study, we demonstrate that school performance in math, reading and writing in children with ASD can improve following an intervention that trains basic attention skills (the CPAT intervention). The improvements we report are stable and were maintained 3-months following the intervention. This study, which was conducted in a public-health setting in Brazil, extends previous research in schools in the UK pointing to the cross-cultural and cross-settings efficacy of the intervention.

Hierarchical Processing in ASD is Driven by Exaggerated Salience Effects, not Local Bias.

The role of relative salience in processing of hierarchical stimuli in individuals with autism spectrum disorder (ASD) was examined in this study. Participants with ASD and typically developing controls performed a Navon letters task under conditions of global salience, local salience or equal salience of both levels. Results revealed no group differences in level of processing (global or local) and no local bias for ASD. Rather, both groups showed better performance when targets were more salient compared to when distractors were more salient. Importantly, participants with ASD exhibited increased sensitivity to salience at the distractor level. We conclude that inconsistent findings in the context of global/local processing in ASD may stem from such exaggerated salience effects.

Coping strategies among adults with ADHD: The mediational role of attachment relationship patterns.

BACKGROUND: For adults with attention/hyperactivity disorder (ADHD), research is scarce on their coping with stress (despite studies demonstrating other self-regulation deficits) and their attachment patterns (despite rare research in younger persons with ADHD showing high vulnerability to insecure attachments). Attachment was linked with coping and self-regulation in general populations but not yet in ADHD. This study explored the possible mediational role of attachment patterns in explaining associations between adults' ADHD symptoms and dysregulated coping. METHODS: Participants comprised 62 adults (32 females, 30 males) ages 21-40 years (M = 27.60, SD = 4.80) in two groups: 31 adults with formally diagnosed ADHD and 31 demographically matched adults without ADHD. Instruments included computerized neuropsychological tests (sustained/executive attention) and self-reports (ADHD, coping, attachment). RESULTS: Disorder status was verified via ADHD-symptom self-reports and computerized testing. Preliminary analyses revealed significant intergroup differences on coping strategies and attachment. PROCESS analyses (Hayes, 2013) pinpointed attachment measures' mediating role (especially attachment anxiety) regarding ADHD's association with coping. CONCLUSIONS: Significantly more maladaptive attachment and coping outcomes emerged for adults with ADHD than controls. Attachment insecurity's role in mediating ADHD's association with coping was partially supported. Possible unique adaptive value of attachment relationships was discussed for coping with stressors in adulthood with ADHD.

Fronto-parietal engagement in response inhibition is inversely scaled with attention-deficit/hyperactivity disorder symptom severity.

BACKGROUND: Impaired response inhibition is one of the most consistent findings in attention deficit hyperactivity disorder (ADHD). However, the underlying brain mechanisms are not clear. This study aimed to underpin atypical inhibition-related brain activation and connectivity patterns in ADHD using a novel Go/No-go task design, and to determine its association with clinical symptoms of the disorder. METHODS: Forty-eight adults with ADHD performed a Go/No-go task in which target frequency was manipulated during functional MRI. Specific inhibition-related brain activation was correlated with ADHD symptom severity, to assess the relationship of individual differences in engagement of inhibition-related brain circuits with the magnitude of every-day functioning impairments. Finally, generalized psychophysical interaction analyses were carried out to examine whether not only engagement but also functional connectivity between regions implicated in response inhibition is related to symptom severity. RESULTS: We found no evidence for the expected parietal modulation by increased demand for inhibition at the group-level results. However, this lack of modulation was mediated by individual differences in ADHD symptom severity - increased engagement of the intraparietal sulcus (IPS) in inhibition-demanding events was evident in individuals with less severe symptoms but dissipated with increase in symptomatology. Similarly, functional connectivity between the IPS and the right inferior frontal gyrus (rIFG) was elevated under high inhibitory demand conditions, but this effect diminished with increased symptom severity. CONCLUSIONS: The results highlight the importance of IPS engagement in response inhibition and suggest that IPS modulation may be driven by top-down control from the IFG. Moreover, the current findings force the point of treating ADHD as a continuum whereby brain correlates are scaled with severity of the disorder, and point to the potential use of individual differences in the modulation of IPS activation and connectivity as a neuromarker of ADHD.

The complexity of the interaction between binge-eating and attention.

OBJECTIVE: To investigate whether binge-eating in patients with eating disorders (EDs) is associated with attentional deficits. METHODS: We studied ED patients with binge-eating (n = 51), no binge-eating (n = 59) and controls (n = 58). ED patients were assessed following the stabilization of weight and ED pathology. Attention assessment included evaluation of attention deficit hyperactivity disorder (ADHD) diagnosis, the Adult ADHD Self-Report (ASRS) and ADHD Rating Scale-IV-Home Version (ADHD-RS) questionnaires, and attention functioning assessed with neuropsychological tools. The severity of eating-related pathology, depression, anxiety and obsessionality was also monitored. RESULTS: Patients with binge-eating showed more ADHD symptomatology on the ADHD-RS compared with non-binge-eating patients. No differences were found between binge-eating and non-binge-eating patients in ADHD diagnosis and neuropsychological functioning. Among the specific ED subtypes, patients with anorexia nervosa binge/purge type (AN-B/P) showed the highest rates of ADHD symptomatology on the ADHD-RS, and were characterized with sustained attention deficits. CONCLUSION: Binge-eating is not associated with attention deficits as measured by objective neuropsychological tools. Nonetheless, it is associated with attentional difficulties as measured with the self-reported ADHD-RS. AN-B/P patients are the only ED category showing objective sustained attention deficits.

Sustained attention in sensory modulation disorder and attention deficit/hyperactivity disorder.

BACKGROUND: There are high comorbidity rates between sensory modulation disorder (SMD) and attention deficit hyperactivity disorder (ADHD). Knowledge regarding the objective neuropsychological differentiation between them is scarce. AIM: This study examines the effects of SMD and ADHD on a sustained attention task with and without aversive auditory conditions. METHOD: Sixty six young adult females were tested on the Conjunctive - Continuous Performance Task-Visual (CCPT-V) measuring sustained attention, under two conditions: 1) aversive condition (with the three most aversive sounds chosen by the participant), and 2) non-aversive condition (without sounds). RESULTS: Both the SMD and ADHD factors exhibited performance deficits in the sustained attention task. All study participants performed worse on both sustained attention and speed of processing when aversive sounds were present. CONCLUSION: We conclude that impaired sustained attention cannot differentiate between SMD and ADHD. Hence, these results should be taken under consideration in the assessment process of ADHD vs. SMD.

High pretreatment cognitive impulsivity predicts response of oppositional symptoms to methylphenidate in patients with attention-deficit hyperactivity disorder/oppositional defiant disorder.

The aim of this study was to compare impulsivity levels, as assessed by a continuous performance test (CPT), and the correlations between baseline CPT performance and response to methylphenidate (MPH), as assessed by the conjunctive CPT (CCPT), in children with only Diagnostic and Statistical Manual of Mental Disorders, 5th ed. attention-deficit hyperactivity disorder with no oppositional defiant disorder (ADHD/noODD) or with comorbid ODD (ADHD/ODD). Fifty-three children and adolescents were included in the study (ADHD/noODD group, n = 25, 12 women/13 men and ADHD/ODD group, n = 28, eight females/20 males). Attention was assessed at baseline using CCPT. ADHD and ODD severities were assessed at baseline and following a 12-week MPH treatment using the ADHD-rating scale (ADHD-RS) completed by the parent and by a teacher and the Kiddie-Schedule for Affective Disorders and Schizophrenia for School-Age Children-ODD (K-SADS-ODD) completed by the treating psychiatrist. Higher baseline commission-errors rates (P = 0.0031) in ADHD-RS/parent-child, ADHD-RS/teacher, and K-SADS-ODD scores were detected in ADHD/ODD compared with the ADHD/noODD. Significant improvements in ADHD-RS/parent-child, ADHD-RS/teacher, and K-SADS-ODD scores were achieved following MPH treatment in both groups. Significant correlations were found between baseline CCPT commission-error rates and improvement in ADHD-RS-teacher in ADHD/noODD, but not in ADHD/ODD. Among the ADHD/ODD, but not the ADHD/noODD, a significant correlation was found between baseline CCPT commission-error rates and improvement in K-SADS-ODD. Baseline cognitive impulsivity (as measured by the CCPT) can predict response of ODD to MPH treatment in ADHD/ODD patients.

Reduced distractor interference in neurotypical adults with high expression of autistic traits irrespective of stimulus type.

Attention atypicality is evident in autism spectrum disorder (ASD) and its broader phenotype with previous studies suggesting that in some cases participants can be more efficient at ignoring distracting irrelevant information. However, it is not clear to what extent this improved filtering capacity is driven by perceptual atypicality, such as local bias or atypical face processing, which is also sometimes reported in these populations. For instance, better ability to ignore the global aspect of a display could stem from a local perceptual bias rather than from improved distractor inhibition. To test whether distractor suppression per se, is associated with high expression of autistic traits, in the present study a large cohort of neurotypical participants (n = 218), in whom expression of autistic traits was assessed, performed two nonspatial attention selection tasks with different categories of stimuli (global/local and face/scene). Importantly, both tasks involved a conflict with one aspect of the stimuli designated as the target and the other designated as the distractor. Across the two experiments adults with high autistic traits were overall, better able to ignore distractors than adults with low autistic traits, irrespective of the type of perceptual processing involved. These results support the notion that autistic tendencies are associated with increased attention filtering (at least when target and distractor remain constant) which is not dependent on perceptual biases. Thus, future work in the broader autism phenotype should explicitly consider the effect played by attention mechanisms in this population. Autism Res 2018, 11: 1345-1355. © 2018 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In the present study, we show that neurotypical adults with high autistic traits are better able to avoid distraction from conspicuous (but completely irrelevant) distractors when told in advance to do so. This ability is not affected by the type of visual input (for instance, whether the distractor is a face or whether small rather than large letters should be reported). This finding could be important in better understanding the way attention is utilized in Autism.

Attention Training in Autism as a Potential Approach to Improving Academic Performance: A School-Based Pilot Study.

This study assessed the effectiveness of an attention intervention program (Computerized Progressive Attentional Training; CPAT) in improving academic performance of children with ASD. Fifteen 6-10 year olds with ASD attending a mainstream and a special school were assigned to an experimental (CPAT; n = 8) and active control (computer games; n = 7) group. Children were assessed pre- and post-intervention on measures of behavioural symptoms, cognitive skills and academic performance. The intervention was conducted in school twice a week for 8 weeks. Children in the CPAT group showed cognitive and academic improvements over and above the active control group, while children in both groups showed improvements in behaviour. Results suggest that attention training is a feasible approach to improving academic performance in this population.

Perception of Aversive Auditory Stimuli Is Different in Sensory Modulation Disorder and Attention Deficit Hyperactivity Disorder.

This study examined whether sensory modulation disorder-sensory overresponsivity (SMD-SOR) and attention deficit hyperactivity disorder (ADHD) have a significant effect on the perception of aversive auditory stimuli. Participants were 66 young adult women. The diagnosis of SOR was made using the Sensory Responsiveness Questionnaire, and ADHD was diagnosed by a qualified psychiatrist or neurologist using criteria from the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.). Participants were presented with the Battery of Aversiveness to Sounds, short presentations of daily life sounds, and rated each sound stimulus verbally according to its perceived unpleasantness. Participants with SOR rated low-intensity aversive sounds as significantly more aversive than participants without SOR. High-intensity sounds obtained a marginal significant difference exclusively in participants with ADHD. The perception of aversive auditory stimuli in adults with SOR appears to be unique and different than the profile of adults with ADHD.

Prestimulus Inhibition of Saccades in Adults With and Without Attention-Deficit/Hyperactivity Disorder as an Index of Temporal Expectations.

Knowing when to expect important events to occur is critical for preparing context-appropriate behavior. However, anticipation is inherently complicated to assess because conventional measurements of behavior, such as accuracy and reaction time, are available only after the predicted event has occurred. Anticipatory processes, which occur prior to target onset, are typically measured only retrospectively by these methods. In this study, we utilized a novel approach for assessing temporal expectations through the dynamics of prestimulus saccades. Results showed that saccades of neurotypical participants were inhibited prior to the onset of stimuli that appeared at predictable compared with less predictable times. No such inhibition was found in most participants with attention-deficit/hyperactivity disorder (ADHD), and particularly not in those who experienced difficulties in sustaining attention over time. These findings suggest that individuals with ADHD, especially those with sustained-attention deficits, have diminished ability to benefit from temporal predictability, and this could account for some of their context-inappropriate behaviors.

Attenuated hemispheric asymmetry in metaphor processing among adults with ADHD.

OBJECTIVE: To characterize the hemispheric processing of metaphors in adults with ADHD compared to controls. METHOD: We investigated the hemispheric processing of metaphors in 24 adult participants diagnosed with ADHD and 24 control participants. The hemispheric processing was examined using a divided visual field paradigm, in which different kinds of metaphors as well as literal word pairs and unrelated word pairs were presented either to the right visual field/left hemisphere (RVF/LH) or to the left visual field/right hemisphere (LVF/RH). RESULTS: Control participants processed metaphors more efficiently when presented in the LVF/RH than when presented in the RVF/LH, whereas participants with ADHD demonstrated attenuated asymmetry of hemispheric processing. Furthermore, asymmetry of hemispheric processing, together with sustained attention, contributed significantly to the prediction of self-report of ADHD symptoms. CONCLUSION: Our results suggest that the hemispheric processing of adults with ADHD is less lateralized than the hemispheric processing of control participants. Moreover, the diminished lateralization of metaphor processing along with deficient sustained attention may reflect distinct cognitive mechanisms underlying ADHD and as such our results support multiple pathway models of ADHD. (PsycINFO Database Record

Isolating response inhibition in the brain: Parietal versus frontal contribution.

Response inhibition is a main function of cognitive control and its neural substrates have been studied extensively. However, it is still a question whether previous brain imaging investigations were successful in isolating specific response inhibition activation. In the current study we attempted to pinpoint response inhibition in the brain using a Go/No-go task and fMRI, by contrasting rare-No-go trials with prevalent-No-go trials. Although inhibition is required in all No-go trials, task variants with rare-No-go cases (25%) create a prepotent response which elicits a strong demand for inhibition, while task variants with prevalent-No-go cases (75%) require very little inhibition effort. Since the neural activation in this design is extracted solely from No-go trials, differing only in the extent of inhibitory demand, the analysis avoids contamination of the data with motor effects or visual factors. Using this experimental design we highlight the contribution of the parietal cortex (bilaterally) to inhibitory processes, while casting doubts about the specificity of frontal activation in such processes. Future studies are required to verify that bilateral intraparietal sulcus and left temporo-parietal junction activations could be markers of inhibitory control.

Attention Functioning Among Adolescents With Multiple Learning, Attentional, Behavioral, and Emotional Difficulties.

Attention-deficit/hyperactivity disorder (ADHD) is characterized by high levels of inattention, hyperactivity, and impulsivity; however, these symptoms can result from a variety of reasons. To obtain a comprehensive understanding of the various difficulties of individuals with ADHD, especially when co-occurrence difficulties are present, it is essential to combine neuropsychological and subjective assessment tools. In the present field study the authors investigated a group of adolescents with multiple deficits (MD) using neuropsychological and subjective measures. Teachers' ratings verified extremely high levels of symptoms of oppositional behavior, inattention, hyperactivity-impulsivity, social problems, and emotional problems in this group. As expected, MD group participants showed decreased abilities to maintain attention on task for a long period of time, focus attention and effectively inhibit adjacent distractors, and resist conflicting irrelevant information. Importantly, although significant differences in the attention measures were observed at the group level, not all MD participants displayed deviant performance. Thus, we conclude that the heterogeneous group of adolescents with MD comprises individuals with primary attention deficits as well as those with other nonattentional deficits that show equivalent behavioral symptoms. Using neuropsychological tools can be useful in differentiating between different core deficits and in guiding appropriate interventions.

Semantic conflicts are resolved differently by adults with and without ADHD.

Attention Deficit/Hyperactivity Disorder (ADHD) is a common neurobehavioral disorder characterized by various behavioral and cognitive difficulties. Previous studies indicated that children with ADHD have language difficulties, including difficulties in metaphor understanding but the relation between metaphor processing and specific cognitive functions needs further investigation. In the current study we examined how adults with and without ADHD resolve semantic conflicts between a metaphorical prime and a metaphorical or literal target sentence. Twenty-six adults with ADHD and 24 age-matched control participants underwent a thorough evaluation of neuropsychological skills, as well as assessment of various aspects of attention. Results suggested that people with ADHD were less efficient than controls in resolving conflicts between metaphorical and literal meanings of sentence pairs. In addition they showed deficient sustained attention and executive attention. Moreover, the ability to resolve semantic conflicts was related to semantic fluency in the ADHD group, but to executive attention in the control group. These findings emphasize the various specific difficulties of adults with ADHD and shed light on the different role of attention in the resolution of semantic conflicts among ADHD individuals as compared to controls.