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Intelligenzdiagnostik bei Kindern und Jugendlichen mit ADHS

Eine Analyse der WISC-V-Leistungsprofile

Published Online:May 29, 2018https://doi.org/10.1026/0942-5403/a000256

Abstract

Zusammenfassung. Mit seiner neuartigen Indexstruktur bietet die Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V; Wechsler, 2014, 2017) eine differenzierte Messung kognitiver Fähigkeiten. Es wurden die Leistungen von Kindern und Jugendlichen mit ADHS (n = 103) in der WISC-V mit einer parallelisierten Kontrollgruppe verglichen. Zusätzlich zur Analyse der Leistungen auf signifikante Gruppenunterschiede wurden für alle fünf Indexwerte, den Gesamt-IQ sowie die entsprechenden Untertests Effektgrößen bestimmt und miteinander verglichen. Für die Kinder mit ADHS zeigten sich auf allen fünf Indizes und dem Gesamt-IQ signifikant niedrigere Leistungen, wobei die größten Effekte in den Bereichen Arbeitsgedächtnis, Fluides Schlussfolgern und Gesamt-IQ gefunden wurden. Spezifische Minderleistungen bei ADHS ließen sich auch auf Untertestebene identifizieren. Die Ergebnisse der vorliegenden Studie bestätigen, dass die WISC-V als valides und sensibles Instrument zur Erfassung kognitiver Defizite bei Kindern mit Aufmerksamkeitsstörungen angesehen werden kann. In der klinischen Praxis kann die WISC-V-Profilanalyse wichtige Informationen zu einer vorab diagnostizierten ADHS liefern.


Measuring Intellectual Performances of Children and Adolescents With ADHD: An Analysis of the WISC-V Profiles

Abstract. The Wechsler Scales have been proven effective in identifying specific cognitive deficits that are associated with different psychiatric disorders. With its new test structure, the German version of the recent Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V; Wechsler, 2017) enables a more in-depth examination of intellectual abilities. The present study focused on the nature of cognitive deficits in ADHD. The aim was to analyze the performances of 103 children and adolescents with ADHD on the WISC-V and to compare them with a matched control group. Analyses of variances were conducted and group differences were examined by means of effect sizes (Cohen’s d) in order to demonstrate possible cognitive deficits associated with ADHD. The results of the present study revealed significantly lower performances of children with ADHD when compared with healthy controls. On the index level, effect sizes ranged from d = 0.29 for Verbal Comprehension to d = 0.74 for Working Memory. In line with the literature, significant deficits of children with ADHD in Processing Speed were also supported by the present findings (d = 0.45). Despite some contrary findings from previous studies, a significantly lower mean FSIQ score could be identified for the clinical group, with a medium effect size of d = 0.67. WISC-V profiles additionally disclosed the diversity of cognitive deficits related to the disorder. Since the largest effects could be shown for Digit Span (d = 0.89), Letter–Number Sequencing (d = 0.67), and Arithmetic (d = 0.62), these WISC-V subtests can be considered to be sensitive to cognitive declines in ADHD. Despite the fact that the mean index and FSIQ scores of children with ADHD were all within one standard deviation below the population mean, about one third of these children fulfilled the criteria for borderline intellectual functioning in the present study. Given that disorder-related deficits could be demonstrated in Visual-Spatial as well as in Fluid Reasoning, the WISC-V can be considered suitable for detecting executive dysfunctions in ADHD. Since at least some cognitive deficits in ADHD were found to be more pronounced than expected, the role of the severity of symptoms and further possible contributing factors are finally discussed. Although the current results support the assumption that ADHD is associated with deficits in Working Memory, Fluid Reasoning, and Processing Speed, there are some study limitations to be addressed. Since previous studies highlighted the effects of further factors contributing to cognitive deficits in ADHD, it is recommended for future studies to take possible effects of comorbid disorders and severity of the disorder into consideration when analyzing cognitive profiles in ADHD. In clinical practice, the WISC-V profiles can provide additional information for decision-making but should not be used alone to carry out a clinical diagnosis.

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