40 Metamemory performance of children with ADHD in comparison to typically developing children.

Abstract

Objective:

Metamemory is an aspect of metacognition that is one's knowledge of memory and understanding of their own memory performance (Kreutzer et al., 1975). Executive function skills are foundational skills required for the development of metamemory in early school-age children (Lockl & Schneider, 2007; Lecce et al., 2015). Previous studies have suggested children with Attention-Deficit/Hyperactivity Disorder (ADHD) may have weaker study and organizational strategies, suggesting weaker metamemory skills (O'Neill & Douglas, 1991; Voelker et al., 1989). The current study aimed to examine the metamemory knowledge of typically developing (TD) children and children with ADHD on a novel declarative metamemory questionnaire. We hypothesized that the ADHD group would have worse metamemory performance than the TD group and that executive functioning skills would be significantly associated with metamemory for all groups.

Participants and Methods:

The current study recruited a total of 93 English-speaking children between the ages of 6 to 12 years old, including 70 typically developing (TD) children (M age=9.1+1.92; females 49%), and 23 children with diagnoses of ADHD (M age=9.56+1.27; females 57%). Fifty-seven percent of the ADHD group reported daily use of stimulant medication, but no participants took medication on the day of testing. The participant groups did not significantly differ regarding age or sex. Participants completed the Measure of Metamemory (MoM-10) which included 10 multiple choice questions (i.e., Accuracy) and asked participants to explain their multiple-choice answer (i.e., Explanation). This provided three scores: Accuracy (max 10 points), Explanation (max 20 points), and Total (max 30 points). Additionally, participants' parents completed the 12-item Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF-2) Screening form, evaluating the child's executive functioning, which provided a percentile based on age and sex.

Results:

Within the ADHD group, BRIEF-2 percentiles and MoM-10 scores did not differ between those who were medicated and those who were not. As previous literature has shown, the TD and ADHD groups significantly differed on the BRIEF-2 screening score percentiles (t(91)=-5.78, p<0.001; TD M=52.89+26.1; ADHD M=85.26+13.82). The TD and ADHD groups did not significantly differ on either the MoM-10 Accuracy (p=0.13; TD M=7.22+1.84; ADHD M=7.87+1.32), the Explanation (p=0.08; TD M=9.34+3.80; ADHD M=10.57+2.92), or Total (p=0.13). There was a trend towards a significant correlation between the Explanation scores and BRIEF-2 for TD participants (r=-0.23, p=0.06), but there was no significant correlation between Explanation, Accuracy, or Total scores and the BRIEF-2 for the ADHD group.

Conclusions:

Our results tentatively suggest a possible association between metamemory and parent reported executive functioning for TD children, supporting the expected association between the development of executive functioning and the development of metamemory. However, there was no association between metamemory and executive functioning for children with ADHD, likely due to the restricted range of executive functioning scores for this group (i.e., M=85.25+13.82; Range 55-99). Additionally, metamemory did not significantly differ between diagnostic groups. Children with ADHD may have comparable metamemory knowledge to TD children as a result of executive functioning instruction and support they have received. Rather, there may be group differences in the application of metamemory judgement and strategies.