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Comparison of the Cognitive Disengagement and Hypoactivity Components of Sluggish Cognitive Tempo in Autism, ADHD, and Population-Based Samples of Children

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Abstract

An international Sluggish Cognitive Tempo (SCT) Work Group proposed a new term for SCT, “cognitive disengagement syndrome,” that more accurately describes the syndrome than does SCT. According to the Work Group, symptoms of SCT represent a cognitive dimension (cognitive disengagement) and a motor dimension (hypoactivity). Our study determined (1) if distinct factors representing cognitive disengagement and hypoactivity emerged when SCT items were factor analyzed and (2) the degree of differences in cognitive disengagement and hypoactivity within diagnostic groups. Mothers rated 1,177 children with autism, 725 with ADHD-Combined, and 307 with ADHD-Inattentive (4–17 years) and 665 elementary school children (6–12 years) on the Pediatric Behavior Scale (PBS). SCT prevalence rates were autism 32%, ADHD-Inattentive 27%, ADHD-Combined 18%, and elementary school students 7%. Factor analysis of the SCT items yielded two factors reflecting cognitive disengagement (in a fog/confused and stares/preoccupied/in own world) and hypoactivity (sluggish/slow moving/low energy, drowsy/sleepy/not alert, and tires easily) in all diagnostic groups. Cognitive disengagement prevalence rates and scores were significantly higher than hypoactivity in the autism and ADHD-C groups and in the autism and ADHD-C subgroups of children with SCT (but not in the ADHD-I and elementary school total groups and SCT subgroups). Our findings factor analyzing five SCT items support two SCT subfactors: cognitive disengagement and hypoactivity.

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Funding

This work was supported by National Institutes of Health grants R01HL063772, M01 RR10732, and C06 RR016499.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Health, Penn State College of Medicine, Hershey, Pennsylvania, USA

    Susan D. Mayes, Susan L. Calhoun & Daniel A. Waschbusch

  2. Division of Behavioral Medicine and Clinical Psychology, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, USA

    Stephen P. Becker

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All authors contributed to the literature search, analysis and interpretation of the data, and writing of the manuscript.

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Correspondence to Daniel A. Waschbusch.

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The Institutional Review Board waived informed consent for the retrospective analysis of existing clinical data for the autism and ADHD groups. Parent written consent and child assent were obtained for the elementary school children.

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Mayes, S.D., Becker, S.P., Calhoun, S.L. et al. Comparison of the Cognitive Disengagement and Hypoactivity Components of Sluggish Cognitive Tempo in Autism, ADHD, and Population-Based Samples of Children. Res Child Adolesc Psychopathol 51, 47–54 (2023). https://doi.org/10.1007/s10802-022-00969-3

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