The Potential Clinical Relevance of the WISC-V in ADHD Assessment: An Analysis of Structural Models and Within- Subject Cognitive Discrepancies

Abstract

<title>Abstract</title> <bold>Background</bold> : The current study examined the clinical utility of the Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V) as a valid tool for the evaluation of Attention-Deficit/Hyperactivity Disorder (ADHD) in children and adolescents. The primary objectives were to explore the convergent validity of the WISC-V based on its original factor structure and alternative structural models, including hierarchical and bifactorial models. Additionally, the study aimed to investigate whether significant differences between primary and complementary indices could reveal a cognitive pattern associated with ADHD. <bold>Methods</bold> : A total of 241 participants, aged 6 to 17 years and recently diagnosed with ADHD, were included in the study. Confirmatory factor analyses were conducted to evaluate the fit of different models. <bold>Results</bold> : Results indicated that four-factor models, both hierarchical and bifactorial, showed superior fit compared to five-factor models. However, the original hierarchical five-factor model proposed by Wechsler, while demonstrating a poorer fit compared to alternative models, was still adequate for use in clinical settings. Moreover, scores on the Working Memory and Processing Speed indices were significantly lower, with medium to large effect sizes, than those on Verbal Comprehension, Visual-Spatial Reasoning, and Fluid Reasoning indices. Additionally, the Cognitive Proficiency Index was significantly lower than the General Ability Index. <bold>Conclusions</bold> : These findings suggest that these discrepancies may help identify ADHD cognitive profiles. However, while these patterns may hold clinical relevance, they should not be overinterpreted as diagnostic markers. The study highlights the need for further research to validate the WISC-V's clinical utility as a supplementary tool in ADHD assessment.