Développement de l’autorégulation et de l’inhibition chez des enfants présentant un trouble déficitaire de l’attention avec ou sans hyperactivité (TDAH)

Abstract

Self-regulation shares several affinities with executive functions. However, the specificity of self-regulation deficits in attention deficit/hyperactivity disorder (ADHD) remains unclear. The typical child starts around the age of four to develop a self-control mechanism along with an internal language that allows the child to modulate impulsively. Conversely, a child with ADHD seems to have greater difficulties delaying or retaining an action or response. In this study we aim to evaluate self-regulation of comprehension in ADHD. Our results show that children with ADHD fail to recognize inconsistencies in presented stories at a rate ranging between 72 (eight years) and 54% (ten years). We also found a positive correlation between a better control of self-regulation and our behavioral inhibition measurement. The attentional deficits exhibited through markedly longer reaction times to continuous performance test (CPT) could be responsible for a poor ability to self-regulate. Fast reaction times were found to be associated with increased vigilance/attention that in turn would permit better self-regulation. Furthermore, our findings show that older subjects with ADHD have shorter reaction times to CPT approaching this group to the typical children. This suggests that improvement overtime in self-regulation processes may be attributed to the associated development of vigilance/attention in children with ADHD. Improved vigilance/attention would result in optimal reaction times during tasks that require self-regulation. In addition, our findings suggest that subjects with ADHD have developmental trajectories similar to those observed in healthy subjects. In the present study, the lack of a comparison group does not allow us to conclude if such trajectory is delayed compared to typical subjects. Finally, there was no significant relation between the degree of intelligence and the rate of self-regulation, which makes it possible to distinguish the two functions. However, in ADHD self-regulation is favourably influenced by age as observed in developmental studies on typical children. Thus, maturation independent of intelligence, influences self-regulation processes.