The Role of Working Memory and Organizational Skills in Academic Functioning for Children With Attention-Deficit/Hyperactivity Disorder

Objective: Children with attention-deficit/hyperactivity disorder (ADHD) exhibit difficulties with organizational skills such as task planning, managing materials, and organizing activities that have downstream consequences on academic functioning. At the same time, deficits in working memory have been linked with both the organizational skills difficulties and academic underachievement and underperformance observed in children with ADHD and have been hypothesized to account for the link between organizational and academic functioning. However, the extent to which working memory and organizational skills independently versus jointly contribute to ADHD-related academic difficulties remains unclear. Method: The present study is the first to examine the unique and shared roles of working memory and organizational skills for explaining ADHD-related underachievement and underperformance in a clinically evaluated sample of 309 children with and without ADHD (M-age = 10.34, SD = 1.42; 123 girls; 69.6% White Not Hispanic or Latino). Results: Bias-corrected, bootstrapped latent path analyses revealed that working memory and organizational skills together accounted for 100% of the academic achievement (d = -1.09) and 80.6% of the academic performance (d = -0.58) difficulties exhibited by children with ADHD. Working memory (d = -0.95 to -0.26), organizational skills (d = -0.30 to -0.11), and shared variance across working memory and organizational skills (d = -0.13 to -0.06) each independently predicted ADHD-related difficulties in both academic achievement and performance outcomes. Conclusions: These findings are consistent with models suggesting that working memory has downstream consequences for functional impairments in ADHD, as well as evidence that organizational skills and working memory are each important predictors of ADHD-related academic functioning. Key Points Question: Working memory and organizational skills are both associated with academic difficulties in attention-deficit/hyperactivity disorder (ADHD), but to what extent do these factors uniquely versus jointly contribute to ADHD-related academic functioning? Findings: Both working memory and organizational skills account for ADHD-related academic underachievement and underperformance, as well as a shared contribution of working memory and organizational skills. Importance: ADHD-related academic difficulties appear to be associated with working memory deficits independently, organizational skills deficits independently, and overlapping deficits in these domains, thus informing potential targets for cognitive and behavioral interventions. Next Steps: Experimental and/or longitudinal work is needed to clarify the directionality and interplay between working memory, organizational skills, and academic functioning over time.