20
Hemispheric Functioning in Children With
Subtypes of Attention-Deficit/Hyperactivity Disorder
Mei Hsin Suzanne Rolfe
University of Auckland, New Zealand
Markus Hausmann
Ruhr-University Bochum, Germany
Karen E. Waldie
University of Auckland, New Zealand
Objective: The authors investigated line bisection performance in children with Attention-Deficit/Hyperactivity Disorder
(AD/HD) subtypes. Previous research with neurotypical children found a rightward bias with right-hand use and a leftward
bias with left-hand use; however, research with AD/HD participants has failed to similarly measure the effects of hand use,
which was the focus of this study. Method: Line bisection was used to measure differences in right hemisphere function-
ing in children (7 to 12 years) with AD/HD-I and AD/HD-C. Results: Initial AD/HD group findings (without subtype dif-
ferentiation) replicated previous research. However, further subtype analyses showed that the ADHD-I and ADHD-C groups
perform significantly differently. Specifically, the ADHD-I group showed a leftward bias, irrespective of hand use, and the
ADHD-C group showed a rightward bias, irrespective of hand use. Conclusion: These findings suggest that the subtypes
represent two distinct disorders and that, unlike ADHD-C, ADHD-I may not be the result of right hemisphere dysfunction.
(J. of Att. Dis. 2006;10(1)20-27)
Keywords: line bisection; ADHD-I; ADHD-C; hand use; frontostriatal
Introduction
Attention-Deficit/Hyperactivity Disorder (AD/HD) is
a neurodevelopmental disorder characterized by three
main features—inattention, hyperactivity, and impulsiv-
ity (American Psychiatric Association, 2000)—and is
often accompanied by behavioral, emotional, or learning
problems (R.T. Brown et al., 2001). AD/HD affects
between 4% and 12% of the general population of 6- to
12-year-olds (R.T. Brown et al., 2001), and between 30%
and 60% of children who develop AD/HD will continue
to display symptoms in adulthood (Mannuzza, Klein, &
Moulton, 2003).
The Diagnostic and Statistical Manual of Mental
Disorders (4th ed., text revised; DSM-IV-TR) includes
descriptions of three subtypes of AD/HD; ADHD-
Combined Type (ADHD-C), ADHD-Predominantly
Inattentive Type (ADHD-I), and ADHD-Hyperactive-
Impulsive Type (American Psychiatric Association, 2000).
However, recent imaging and behavioral studies indicate
that the disorder may more accurately include two sub-
types: ADHD-C (incorporating both the ADHD-C and
ADHD-Hyperactive-Impulsive subgroups) and ADHD-I.
For example, using magnetic resonance imaging (MRI),
Farmer (2002) reported that children with ADHD-I had
smaller right parietal and bilateral dorsolateral region vol-
umes and a larger brainstem area and children with
ADHD-C had a smaller left parietal and right dorsolateral
region when compared with healthy control children.
Functionally, ADHD-C participants performed more
poorly on the Wisconsin Card Sorting Test (WCST) than
ADHD-I participants. The WCST is believed to be a mea-
sure of the ability to shift response set, monitor perfor-
mance, and respond to feedback (Grodzinsky & Diamond,
Journal of Attention Disorders
Volume 10 Number 1
August 2006 20-27
© 2006 Sage Publications
10.1177/1087054705286053
http://jad.sagepub.com
hosted at
http://online.sagepub.com
Authors’ Note: Address correspondence to Mei Hsin Suzanne Rolfe,
Department of Psychology, University of Auckland, Private Bag
92019, Auckland, New Zealand; s.rolfe@auckland.ac.nz.
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