To go or not to go: Inhibitory control in 'hard to manage' children

This study is an age-7 follow-up of 40 children who at age 4 were identified as 'hard to manage' and were compared to 40 age and sex matched typically developing peers on a set of simple, manually administered executive function tasks. At age 4, the 'hard to manage' group showed marked deficits in inhibitory control and planning, but showed intact set-shifting and working memory (Hughes et al., 1998). The present study assessed the continuity of executive function deficits among these 'hard to manage' children, using computerized tests of planning, working memory and set-shifting (from the Cambridge Neuropsychological Test Automated Battery (CANTAB)) and a computerized Go-No-Go test of inhibitory control (from the Maudsley Attention and Response Suppression task battery (MARS)). In addition, real-time observational ratings were made via a questionnaire checklist. Compared with controls, children in the 'hard to manage' group showed impaired inhibitory control but intact planning, working memory and set-shifting. Observational ratings confirmed the group difference in inhibitory control, as the 'hard to manage' group showed significantly more perseverative errors and rule violations. These findings raise important methodological issues concerning effects of task format and highlight the importance of combining experimental and observational approaches to assessing problems in executive control. Copyright (C) 2002 John Wiley Sons, Ltd.