Sluggish Cognitive Tempo is Under Recognized

Sluggish Cognitive Tempo is Under Recognized and Under treated

I promised to write about other recent studies that have been performed on people with Sluggish Cognitive Tempo (SCT) symptoms. The question that psychiatrists and psychologists are trying to answer relates to the difference between inattention with sluggish symptoms and and inattention without SCT symptoms and if inattention with sluggish symptoms constitutes a new medical condition that is sufficiently different from ADHD to warrant a separate diagnosis.

Most of the studies that have looked at this question, such as the Barkley study that I reported on a couple of posts ago, have found that there is considerable overlap in the symptoms of these two conditions. A study published in the Journal of Attention Disorders almost a year ago reported that kids with inattention and SCT had fewer sustained attention problems than kids diagnosed with ADHD and that they had greater problems with self monitoring, one of the executive functions that gives people the ability to monitor one's own performance and to measure it against some standard of what is needed or expected. The kids in this study, as Barkley’s study also found, seemed to also have more depression related problems.

Self monitoring is a meta-cognition executive function. It requires thinking and monitoring how you think. Recent studies have found that kids and adults with ADHD have a wide variety of executive funtion problems but kids and adults with SCT have specific executive function problems that relate mostly to decreased procession speeds, decreased self monitoring/self regulation skills and decreased arousal levels.

These specific findings have led these researchers to believe that SCT is sufficiently different from ADHD to warrant a diagnosis all its own. People with SCT will not have their symptoms properly addressed and treatment studies will not be initiated unless psychiatrists come to see SCT as a problem that is distinct from ADHD. As more studies are published indicating, as these have, that SCT is not ADHD, researchers will begin their investigations into how best to treat this condition. Until then, people with SCT will go under treated and under-served.


Capdevila-Brophy C, Artigas-Pallarés J, Navarro-Pastor JB, García-Nonell K, Rigau-Ratera E, Obiols JE. ADHD Predominantly Inattentive Subtype With High Sluggish Cognitive Tempo: A New Clinical Entity? Journal of Attention Disorder. 2012 May 31
Becker SP, Langberg JM. Attention-Deficit/Hyperactivity Disorder and Sluggish Cognitive Tempo Dimensions in Relation to Executive Functioning in Adolescents with ADHD. Child Psychiatry Hum Dev. 2013 Feb 27.
Langberg JM, Becker SP, Dvorsky MR. The Association Between Sluggish Cognitive Tempo and Academic Functioning in Youth with Attention-Deficit/Hyperactivity Disorder (ADHD). J Abnorm Child Psychol. 2013 Jan 29.