Cross-Cultural Variations in Executive Function Impairments among Children with Attention Deficit/Hyperactivity Disorder

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Bibliographic Details
Title: Cross-Cultural Variations in Executive Function Impairments among Children with Attention Deficit/Hyperactivity Disorder
Language: English
Authors: Da-Wei Zhang (ORCID 0000-0002-6862-5627), Ameera Shahira Amran, Yishu Qin, Han Jiang, Li Sun (ORCID 0000-0002-2330-6622), Mark A. Bellgrove, Stuart J. Johnstone
Source: JCPP Advances. 2026 6(1).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 12
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Executive Function, Neurological Impairments, Attention Deficit Hyperactivity Disorder, Children, Cultural Influences, Cross Cultural Studies, Foreign Countries, Psychological Evaluation, Short Term Memory, Inhibition, Cultural Context, Intervention
Geographic Terms: China, Australia
DOI: 10.1002/jcv2.70032
ISSN: 2692-9384
Abstract: Background: Executive function (EF) impairments are heterogeneous in children with attention deficit/hyperactivity disorder (ADHD). Culture has a significant impact on EF development in typically developing (TD) children, yet its influence on EF impairments in those with ADHD remains understudied. This study aims to investigate the impact of cultural factors on EF impairments in children with ADHD through a cross-cultural comparison. Methods: To ensure a robust sample size, the study initially recruited a large participant pool of 690 children from China and Australia. We applied similar diagnostic criteria and used propensity score matching to align clinical representation. This approach resulted in a final sample of 198 children aged 7-12, including 102 children diagnosed with ADHD and 96 TD peers. The same neuropsychological testing battery was used to assess EF in terms of working memory (WM), inhibitory control (IC), and set shifting. Results: Significant cultural effects were observed: Chinese children with ADHD showed lower performance in IC and WM compared to their TD peers, a pattern not seen in Australian children. A latent profile analysis revealed distinct EF profiles, highlighting a subgroup of Chinese children with severe EF impairments. Conclusions: This study advances cross-cultural ADHD research on EF by using a robust methodology, including consistent diagnostic and testing procedures, propensity score matching, and person-centered analysis. Our findings suggest that high-EF-expectation environments may have a negative effect on EF in children with ADHD, which provides insight into the underlying contributors to heterogeneous EF and underscores the need for culturally tailored ADHD interventions.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1499408
Database: ERIC
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Abstract:Background: Executive function (EF) impairments are heterogeneous in children with attention deficit/hyperactivity disorder (ADHD). Culture has a significant impact on EF development in typically developing (TD) children, yet its influence on EF impairments in those with ADHD remains understudied. This study aims to investigate the impact of cultural factors on EF impairments in children with ADHD through a cross-cultural comparison. Methods: To ensure a robust sample size, the study initially recruited a large participant pool of 690 children from China and Australia. We applied similar diagnostic criteria and used propensity score matching to align clinical representation. This approach resulted in a final sample of 198 children aged 7-12, including 102 children diagnosed with ADHD and 96 TD peers. The same neuropsychological testing battery was used to assess EF in terms of working memory (WM), inhibitory control (IC), and set shifting. Results: Significant cultural effects were observed: Chinese children with ADHD showed lower performance in IC and WM compared to their TD peers, a pattern not seen in Australian children. A latent profile analysis revealed distinct EF profiles, highlighting a subgroup of Chinese children with severe EF impairments. Conclusions: This study advances cross-cultural ADHD research on EF by using a robust methodology, including consistent diagnostic and testing procedures, propensity score matching, and person-centered analysis. Our findings suggest that high-EF-expectation environments may have a negative effect on EF in children with ADHD, which provides insight into the underlying contributors to heterogeneous EF and underscores the need for culturally tailored ADHD interventions.
ISSN:2692-9384
DOI:10.1002/jcv2.70032