France A. Goulard1, Emma A. Climie1, Donald H. Saklofske2, & Vicki L.

Schwean3
Studies in Psychology, University of Calgary 2Department of Psychology, 3Faculty of Education, University of Western Ontario
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD) is defined as a chronic neurobiological disorder affecting approximately 5% of children and is the most commonly diagnosed childhood disorder (APA, 2000). One of the primary underlying factors in ADHD is a deficit in executive functioning (EF), including deficits in inhibition, working memory, and cognitive flexibility. However, previous research (e.g., Bialystok & DePape, 2009) has also demonstrated that bilingual children often have stronger overall EF abilities than comparable monolingual children. As part of the Strengths in ADHD research project at the University of Calgary, the current project investigates the EF abilities of bilingual and monolingual children with ADHD. Specifically, a comparison between working memory (WM), inhibition, and cognitive flexibility levels between these groups is examined.
1Educational

Background Research

ADHD
Executive Functions Bilingualism
Research Questions

ADHD affects the ability to stay focused, maintain attention, control behavior, and hyperactivity (APA, 2000). Children in general exhibit these behaviors, but it is the increased frequency and severity of these behaviours that differentiates children with ADHD from the rest (Barkley, 2006). Executive functions (EF) are cognitive processes necessary for complex goal-directed behavior and is understood to be the core deficit in children with ADHD (e.g., Barkley, 2006). Cognitive skills that help to plan, organize, maintain effort, and monitor activities (Johnson & Reid, 2011) Researchers have identified a bilingual advantage on EF tasks, where by bilingual children outperform their monolingual counterparts; these advanced skills are usually attributed to bilinguals extensive practice in exercising selective attention and cognitive flexibility during language use (Poulin-Dubois et al. 2010). There are no studies to date examining the EF abilities of bilingual ADHD children.

Preliminary Results Question 1

1. What are the overall executive functioning abilities of bilingual children with ADHD? 2. Within executive functioning, are there differences in working memory, inhibitory control, and cognitive flexibility between Bilingual ADHD (BA) children and Monolingual ADHD (MA) children?
Methods Participants
Participant Demographics N Gender ADHD Subtype Age 9.89 years 9.82 years

Question 2

Measures

Bilingual 14 9 males 8 ADHD-C 14 bilingual and 14 monolingual children aged 8-11 4 females or HI years and their families 5 ADHD-I Participants were matched by age, sex, and ADHD Monolingual 14 9 males 8 ADHD-C diagnosis (Combined, Hyperactive, or Inattentive type) 4 females or HI 5 ADHD-I Bilingual participants spoke two languages used at school and/or their home setting Recruitment was done through French and French Immersion school newsletter, local French and English newspapers, and through local media.

Overall EF ability for the Bilingual group performance at 25% percentile

Trail making (cognitive flexibility) - Average Color-word interference (working memory) - Low Tower test (inhibition) - Average range at 50%
percentile Average performance at 16% percentile

Mean scaled scores of both the bilingual and monolingual ADHD groups No significant differences in performance between groups on any measure of executive function (all p > .10)

Inclusionary Criteria: Parents completed the Conners-3 Rating Scale to confirm ADHD diagnosis and to determine subtype (when necessary) Children completed Wechsler Abbreviated Intelligence Scale (WASI; Wechsler, 1999) to ensure that their Full Scale IQ was minimally in the Average range (FSIQ 85) Executive Functions: Delis-Kaplan Executive Function System (D-KEFS): - Color-Word Interference: Measures working memory, inhibition/switching. e.g. Basic Colour Naming and Word Reading switching. - Trail Making: Measures cognitive flexibility on a visual-motor sequencing task. e.g. Number-letter switching - Tower Test: Measure of inhibition, visual attention, visual-spatial skills, spatial planning, rule learning, and the establishment and maintenance of cognitive set. Behaviour Rating Inventory of Executive Function (BRIEF) results not reported here
References
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed. Text rev.). Washington, DC: Author. Barkley, R. A. (2003). Attention-deficit/hyperactivity disorder. In E. J. Mash & R. A. Barkley (Eds.), Child psychopathology (pp. 75143) (2nd ed.). New York, NY, USA: Guilford Press. Barkley, R. A. (2006). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment (3rd ed.). New York: Guilford. Bialystok, E. & Depape, A. M. (2009). Musical expertise, bilingualism, and executive functioning. Journal of experimental psychology. Human perception and performance, 35. 565-574. Johnson, J. & Reid, R. (2011). Overcoming executive function deficits with students with ADHD. Theory into practice, 50, 61-67. doi: 10.1080/00405841.2011.534942 Poulin-Dubois, D., Blaye, A., Coutya, J. & Bialystok, E. (2010). The effects of bilingualism on toddlers executive functioning. Journal of experimental child psychology, 1-13. doi:10.1016/j.jecp.2010.10.009

Discussion

Bilingual children with ADHD in the current study demonstrate low average to average performance on EF tasks, with lower performance in WM; deficit may indicate that the WM task was more challenging for this group due to English not being their sole language. No significant differences between the two groups on measures of working memory, inhibition, and cognitive flexibility; with this sample of children, being bilingual does not seem to help the overall EF abilities in ADHD children. Small sample size limited analysis and potential findings Necessary to confirm level of bilingual proficiency Bilingual group consisted of a mixed language background, including speakers of French, Chinese, Spanish; given previous research on language learning, it may be possible that EF abilities may differ depending on the language root of the second language

Current Limitations

Future Direction

Expand and strengthen sample size: currently recruiting a larger French/English bilingual group Examination of parent-reported EF abilities through use of the BRIEF rating scale Possibility of determining level of proficiency in English/French through language measure such as the Peabody Picture Vocabulary Test-4th edition (PPVT-4) and Echelle de Vocabulaire en images Peabody (EVIP)

Special Thanks To Emma Climie who gave me the opportunity to do this project in conjunction with the Strengths in ADHD research team. To my school board, CSSA, and to all of the people that helped promoting my study. Finally, to all the children and families who participated in this research.

This research was supported by the Alberta Centre for Child, Family, & Community Research, the Social Sciences & Humanities Research Council of Canada, and generous support from the Carlson Family Fund.