Children with ADHD Exhibit Impaired “Hot” and “Cool” Executive Functioning

Executive functioning (EF) is known to be impaired in children and adults with attention-deficit hyperactivity disorder (ADHD). The majority of research examining EF in children has focused on understanding how “cool” EF, the ability to inhibit a response and general working memory capacity, affects behavior. But more recently, there has been some limited exploration into “hot” EFs, which involve delay aversion and motivation. However, no study has addressed the levels of both hot and cool EF in children with ADHD until now. B.-R. Yang of the Neuropsychology and Applied Cognitive Neuroscience Laboratory at the Institute of Psychology of the Chinese Academy of Sciences in Beijing sought to address this gap by looking at both hot and cool EFs in children with ADHD.

For the study, Yang assessed 100 children without ADHD and 100 children with ADHD, approximately half of whom also had a family history of ADHD. Yang administered a series of task tests to the children to evaluate their impulsivity, reward response, delay aversion, and working memory. The results revealed that the children with ADHD were less able to inhibit their responses than the controls. This was even more evident in the ADHD children with a family history. The children with ADHD also had more difficulty completing the working memory tasks than the controls. When examining the hot EFs, Yang discovered that the children with ADHD demonstrated an aversion to reward delay and consistently chose smaller, more immediate rewards than the controls, who were able to wait for larger rewards. Again, this finding was even more pronounced in ADHD participants with a family history.

The study indicates that cool and hot EFs are compromised in children who have ADHD and clarifies the nature of their impulsive behaviors with those of their impaired response and delay aversion behaviors. Yang believes that these factors, coupled with the inability to retain information in their working memory, elevate the risk for adverse behaviors in children with ADHD. The study suggests that specific regions of the brain that regulate cool and hot EFs should be explored more thoroughly. Yang added, “In addition, to the extent that different areas of the prefrontal cortex are involved in cool and hot EFs, these present results suggest that ADHD children may suffer from irregularities in the dorsolateral and ventromedial prefrontal areas of the brain.”

Yang, B.-R., Chan, R.C.K., Gracia, N., Cao, X.-Y., Jing, J., Mai, J.-N., et al. Cool and Hot Executive Functions in Medication-Naive Attention Deficit Hyperactivity Disorder Children. Psychological Medicine 41.12 (2011): 2593-602. Print.

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  • Travis

    March 2nd, 2012 at 4:16 PM

    This hits pretty close to home for me becaus I was htis kid that it felt like was getting left behind with ADHD. It makes me feel good knowing that there is help and that science has not left us behind.

  • Ray

    March 2nd, 2012 at 5:08 PM

    I guess my nephew runs to the hot side cause he can’t contol his impulsivity for anything

  • Seann

    March 3rd, 2012 at 1:41 PM

    When are kids just going to be allowed to be kids again? Parents want this little cookie cutter kids, but that’s no fun. I know that ADHD can wreck havoc on some families, but for the most part isn’t it a little fun to see your kids get all hyper and excited every once in a while? What do we want, little zombies going around on their meds? Not me.

  • Heather Southwell

    March 4th, 2012 at 10:19 PM

    Highly insulting naming “healthy” people and ADHD people, I am perfectly healthy despite my different outlook to life to the scientists that put us all in one suffercating box!!!

  • Tracie R

    March 5th, 2012 at 5:24 AM

    I am a classroom teacher and am always on the lookout for new ideas about how to better reach kids with ADD and ADHD. They can be such a challenge on so many levels, but really the biggest challenge that I have found within most of these students is instilling in them the belief that they can defeat this. Many times they walk in in the morning and I can already tell what kind of day it is going to be because they are allowing the disorder to overwhelm them. I try to do as much as I can to tecah them some coping skills, not only way that they can deal with the issues but also ways that they can do better and surpass it. It wears me out sometimes but it is so worth it in the end when that little learning light comes on and they see that they are more than those letters that are used as a descriptor of them.

  • admin2

    March 5th, 2012 at 10:44 AM

    Dear Heather,
    We apologize for allowing the use of “healthy” to slip into the article. The News Therapy articles are reports of studies in the literature, and sometimes we make a mistake in filtering out the judgmental language often used in those publications. We completely agree that the use of “healthy” has no place in this discussion of ADHD. Our deepest apologies for any offense this may have caused.
    The Team

  • Barb C

    March 5th, 2012 at 11:31 AM

    ADHD/ADD is not defeated nor does it “go away.” Adults who are in tune with the child and one another can and will be of help when they work together to assist the child in acquiring coping mechanisms that can be applied and strengthened. Yes, it is important to allow “kids to be kids,” but when a child is unable to turn off the overdrive switch, it is up to the adults to be consistent with redirection and age appropriate discipline measures. Yes, I do know, understand,& have lived and learned through these; and other tried and true (and some not so true) coping mechanisms for ADD/ADHD children, teens, and young adults.

  • ANCY

    March 5th, 2012 at 11:46 PM

    Most results obtained here were previously known if Im not wrong(?)

    But we definitely need to look into this “hot” and “cool” executive functioning because it may have major implications for those with ADHD.

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