Published March 2016
Journal of the American Academy of Child and Adolescent Psychiatry

Since the 1980s, behavioral medicine specialists have debated whether a set of attention-related difficulties in children—known as “sluggish cognitive tempo” (SCT)—were part of attention-deficit/hyperactivity disorder (ADHD).

Stephen Becker, PhD, a clinical psychologist in Behavioral Medicine and Clinical Psychology, conducted a meta-analysis of 73 SCT studies covering 19,000 participants. His team’s study concludes that "at least a subset of SCT symptoms is statistically distinct from the ADHD symptom dimensions and inattention specifically."

Unlike overactive children with ADHD, the estimated 5 percent of children with SCT behaviors tend to be sluggish, underactive, slow processors. They are often described as drowsy, spacy, or "in a fog.” They are daydreamers who get lost in their thoughts or stare blankly into space, Becker says.

"SCT is a very untapped area of research, and increasingly study after study shows that these symptoms are directly related to issues that matter, issues we care about in children: academic function, relationships with peers, sleep functioning," Becker says. "This analysis is the strongest evidence to date to show that the attention-related symptoms in this construct are not the same thing as ADHD. They're something different, and they're significantly associated with impairment.”

Further studies could explore:

  • SCT’s impact on academic performance
  • The potential benefits of social skills training
  • And whether treatments other than stimulants are better suited for children with SCT behaviors

"With SCT, we are where ADHD was 30 to 40 years ago," Becker says. “As research unfolds, we hope to have a better idea of what these symptoms mean for assessment and treatment.”