Mean fixation duration reflects the stability of visual focus on the target. Proportion of trial on the ball indicates sustained attentional engagement, expressed as the percentage of total trial time spent fixating on the target. Latency to return gaze to the ball after distractor onset represents the efficiency of attentional reorientation following distraction (measured only under interference conditions). Higher fixation duration and proportion values, along with lower reorientation latencies, indicate better attentional control. *: p < 0.05 vs. TD.
The authors declare that they have no conflicts of interest.
Ethical approval
Approval for this study was obtained from the Ethics Committee for Psychological Research of the University of Messina (protocol n. 314/25). All procedures were conducted in accordance with the ethical standards of the 1964 Declaration of Helsinki and its later amendments.
Consent to participate
Informed consent to participation in the study was obtained from the parents/legal guardians of all participants prior to testing.
Consent to publication
Not applicable.
Availability of data and materials
The data supporting the findings of this study are available from the corresponding author upon reasonable request.
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References
Monteiro EM, Rosenau KA, Kuo AA, Stein DS, Harstad EB, Barbaresi WJ. Attention-Deficit/Hyperactivity Disorder (ADHD). In: Kuo AA, Pilapil M, DeLaet DE, Peacock C, Sharma N, editors. Care of Adults with Chronic Childhood Conditions: A Practical Guide. Cham: Springer International Publishing; 2024. pp. 279–92. [DOI]
American Psychiatric Association Division of Research. Highlights of Changes from DSM-IV to DSM-5: Somatic Symptom and Related Disorders.Focus. 2013;11:525–7. [DOI]
Capri T, Santoddi E, Fabio RA. Multi-Source Interference Task paradigm to enhance automatic and controlled processes in ADHD.Res Dev Disabil. 2020;97:103542. [DOI] [PubMed]
Fabio RA, Urso M. The analysis of Attention Network in ADHD, attention problems and typically developing subjects.Life Span Disabil. 2014;17:199–221.
Kooij JJS, Bijlenga D, Salerno L, Jaeschke R, Bitter I, Balázs J, et al. Updated European Consensus Statement on diagnosis and treatment of adult ADHD.Eur Psychiatry. 2019;56:14–34. [DOI] [PubMed]
Yüksel AE, Doğan N, Tahıllıoğlu A, Bilaç Ö, Uysal T, Ercan ES. ADHD and its associations with pregnancy, birth, developmental and medical-related characteristics.Curr Psychol. 2023;42:4705–18. [DOI]
Balázs J, Keresztény A. Subthreshold attention deficit hyperactivity in children and adolescents: a systematic review.Eur Child Adolesc Psychiatry. 2014;23:393–408. [DOI] [PubMed]
Cho SC, Kim BN, Kim JW, Rohde LA, Hwang JW, Chungh DS, et al. Full syndrome and subthreshold attention-deficit/hyperactivity disorder in a Korean community sample: comorbidity and temperament findings.Eur Child Adolesc Psychiatry. 2009;18:447–57. [DOI] [PubMed]
Cortese S, Song M, Farhat LC, Yon DK, Lee SW, Kim MS, et al. Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: data, with critical re-analysis, from the Global Burden of Disease study.Mol Psychiatry. 2023;28:4823–30. [DOI] [PubMed]
Kirova AM, Kelberman C, Storch B, DiSalvo M, Woodworth KY, Faraone SV, et al. Are subsyndromal manifestations of attention deficit hyperactivity disorder morbid in children? A systematic qualitative review of the literature with meta-analysis.Psychiatry Res. 2019;274:75–90. [DOI] [PubMed] [PMC]
Hong SB, Dwyer D, Kim JW, Park EJ, Shin MS, Kim BN, et al. Subthreshold attention-deficit/hyperactivity disorder is associated with functional impairments across domains: a comprehensive analysis in a large-scale community study.Eur Child Adolesc Psychiatry. 2014;23:627–36. [DOI] [PubMed]
Lewinsohn PM, Shankman SA, Gau JM, Klein DN. The prevalence and co-morbidity of subthreshold psychiatric conditions.Psychol Med. 2004;34:613–22. [DOI] [PubMed]
Malmberg K, Edbom T, Wargelius HL, Larsson JO. Psychiatric problems associated with subthreshold ADHD and disruptive behaviour diagnoses in teenagers.Acta Paediatr. 2011;100:1468–75. [DOI] [PubMed]
He L, Zhao Y, Gong JX, Zhao L, Ma ZR, Xiong QW, et al. Contrasting presentations of children with ADHD and subthreshold ADHD.Pediatr Res. 2024;[Epub ahead of print]. [DOI] [PubMed]
Schiavone N, Virta M, Leppämäki S, Launes J, Vanninen R, Tuulio-Henriksson A, et al. Childhood ADHD and subthreshold symptoms are associated with cognitive functioning at age 40—a cohort study on perinatal birth risks.Front Psychol. 2024;15:1393642. [DOI] [PubMed] [PMC]
Begum AJ. Cognitive Control Skills. In: Begum AJ, editor. Cognitive Control Skills for Educational Success: Theory and Practice. Singapore: Springer Nature Singapore; 2025. pp. 1–38. [DOI]
Fan J. An information theory account of cognitive control.Front Hum Neurosci. 2014;8:680. [DOI] [PubMed] [PMC]
Miller EK, Cohen JD. An integrative theory of prefrontal cortex function.Annu Rev Neurosci. 2001;24:167–202. [DOI] [PubMed]
Mackie MA, Van Dam NT, Fan J. Cognitive control and attentional functions.Brain Cogn. 2013;82:301–12. [DOI] [PubMed] [PMC]
Weng Y, Wu T, Wei Y, Chen L, Liu X, Cai K, et al. Unified and distinct cognitive control deficits in adolescents with cognitive disengagement syndrome and learning burnout.Front Psychiatry. 2024;15:1399122. [DOI] [PubMed] [PMC]
Xuan B, Mackie MA, Spagna A, Wu T, Tian Y, Hof PR, et al. The activation of interactive attentional networks.Neuroimage. 2016;129:308–19. [DOI] [PubMed] [PMC]
Giovannoli J, Martella D, Casagrande M. Assessing the Three Attentional Networks and Vigilance in the Adolescence Stages.Brain Sci. 2021;11:503. [DOI] [PubMed] [PMC]
Spagna A, Mackie MA, Fan J. Supramodal executive control of attention.Front Psychol. 2015;6:65. [DOI] [PubMed] [PMC]
Barkley RA, Fischer M. Time Reproduction Deficits at Young Adult Follow-Up in Childhood ADHD: The Role of Persistence of Disorder and Executive Functioning.Dev Neuropsychol. 2019;44:50–70. [DOI] [PubMed]
Fabio RA, Orsino C, Lecciso F, Levante A, Suriano R. Atypical sensory processing in adolescents with Attention Deficit Hyperactivity Disorder: A comparative study.Res Dev Disabil. 2024;146:104674. [DOI] [PubMed]
Wangkawan T, Lai C, Munkhetvit P, Yung T, Chinchai S. Effects of Auditory and Visual Interference Control on Visuospatial Working Memory in Children with ADHD.J Med Sci. 2021;41:265–72. [DOI]
Zhang J, Dong M, Liu L, Qiu S, Pan M, Zhou X, et al. The Role of Executive Function in the Co-occurrence of ADHD and Developmental Dyscalculia in Chinese Children.Alpha Psychiatry. 2025;26:42712. [DOI] [PubMed] [PMC]
Chen C, Li Z, Liu X, Pan Y, Wu T. Cognitive Control Deficits in Children With Subthreshold Attention-Deficit/Hyperactivity Disorder.Front Hum Neurosci. 2022;16:835544. [DOI] [PubMed] [PMC]
Bourgeois A, Neveu R, Vuilleumier P. How Does Awareness Modulate Goal-Directed and Stimulus-Driven Shifts of Attention Triggered by Value Learning?PLoS One. 2016;11:e0160469. [DOI] [PubMed] [PMC]
Albrecht B, Rothenberger A, Sergeant J, Tannock R, Uebel H, Banaschewski T. Interference control in attention-deficit/hyperactivity disorder: differential Stroop effects for colour-naming versus counting.J Neural Transm (Vienna). 2008;115:241–7. [DOI] [PubMed]
Mullane JC, Corkum PV, Klein RM, McLaughlin E. Interference control in children with and without ADHD: a systematic review of Flanker and Simon task performance.Child Neuropsychol. 2009;15:321–42. [DOI] [PubMed]
Villemonteix T, Marx I, Septier M, Berger C, Hacker T, Bahadori S, et al. Attentional control of emotional interference in children with ADHD and typically developing children: An emotional N-back study.Psychiatry Res. 2017;254:1–7. [DOI] [PubMed]
Fabio RA. The study of automatic and controlled processes in ADHD: a reread and a new proposal.Mediterr J Clin Psychol. 2017;5:1–33. [DOI]
Fabio RA, Suriano R. The Role of Smartphone Use in Sensory Processing: Differences Between Adolescents with ADHD and Typical Development.Int J Environ Res Public Health. 2024;21:1705. [DOI] [PubMed] [PMC]
Nigg JT. Annual Research Review: On the relations among self-regulation, self-control, executive functioning, effortful control, cognitive control, impulsivity, risk-taking, and inhibition for developmental psychopathology.J Child Psychol Psychiatry. 2017;58:361–83. [DOI] [PubMed] [PMC]
Kofler MJ, Groves NB, Chan ESM, Marsh CL, Cole AM, Gaye F, et al. Working memory and inhibitory control deficits in children with ADHD: an experimental evaluation of competing model predictions.Front Psychiatry. 2024;15:1277583. [DOI] [PubMed] [PMC]
McAuley T, Chen S, Goos L, Schachar R, Crosbie J. Is the behavior rating inventory of executive function more strongly associated with measures of impairment or executive function?J Int Neuropsychol Soc. 2010;16:495–505. [DOI] [PubMed]
Nejati V, Jamshidifar A, Borhani K, Fathabadi J. Comparison of Cold and Cool Cognition in Children With and Without Attention Deficit-Hyperactivity Disorder (ADHD).Dev Neuropsychol. 2024;49:280–93. [DOI] [PubMed]
Marzocchi GM, Cornoldi C. Una scala di facile uso per la rilevazione dei comportamenti problematici dei bambini con Deficit di Attenzione e Iperattività.Psicol Clin dello Sviluppo. 2000:43–64. Italian. [DOI]
Marzocchi GM, Oosterlaan J, De Meo T, Di Pietro M, Pezzica S, Cavolina P, et al. Scala di valutazione dei Comportamenti Dirompenti per insegnanti (SCOD-I): validazione e standardizzazione di un questionario per la valutazione dei comportamenti dirompenti a scuola.Giorn Neuropsichiatr Età Evol. 2001;21:378–93. Italian.
Raven JC. Coloured Progressive Matrices, Sets A, A_B, B. H. K. Lewis; 1962.
Raven J. The Raven’s progressive matrices: change and stability over culture and time.Cogn Psychol. 2000;41:1–48. [DOI] [PubMed]
DuPaul GJ, Power TJ, Anastopoulos AD, Reid R. ADHD Rating Scale–5 for Children and Adolescents: Checklists, Norms, and Clinical Interpretation. The Guilford Press; 2016.
Willcutt EG, Doyle AE, Nigg JT, Faraone SV, Pennington BF. Validity of the executive function theory of attention-deficit/hyperactivity disorder: a meta-analytic review.Biol Psychiatry. 2005;57:1336–46. [DOI] [PubMed]
Achenbach TM, Rescorla LA. Manual for the ASEBA school-age forms & profiles: an integrated system of multi-informant assessment. Burlington, VT: ASEBA; 2001.
Fabio RA, Pergolizzi G, Nucita A, Iannizzotto G, Caprì T. The role of a virtual avatar in attention and memory tasks in Rett syndrome.BMC Neurol. 2021;21:223. [DOI] [PubMed] [PMC]
Shaw P, Stringaris A, Nigg J, Leibenluft E. Emotion dysregulation in attention deficit hyperactivity disorder.Am J Psychiatry. 2014;171:276–93. [DOI] [PubMed] [PMC]
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences.Behav Res Methods. 2007;39:175–91. [DOI] [PubMed]
Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. New York: Routledge; 1988. [DOI]
Shaffer D, Fisher P, Lucas CP, Dulcan MK, Schwab-Stone ME. NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses.J Am Acad Child Adolesc Psychiatry. 2000;39:28–38. [DOI] [PubMed]
Tobii AB. Tobii Studio user’s manual. Version 3.4.5. Stockholm: Tobii AB; 2016.
Lev A, Braw Y, Elbaum T, Wagner M, Rassovsky Y. Eye Tracking During a Continuous Performance Test: Utility for Assessing ADHD Patients.J Atten Disord. 2020;26:245–55. [DOI] [PubMed]
Dziemian S, Bujia G, Prasse P, Barańczuk-Turska Z, Jäger LA, Kamienkowski JE, et al. Saliency Models Reveal Reduced Top-Down Attention in Attention-Deficit/Hyperactivity Disorder: A Naturalistic Eye-Tracking Study.JAACAP Open. 2025;3:192–204. [DOI] [PubMed] [PMC]
Janmohammadi S, Haghgoo HA, Farahbod M, Overton PG, Pishyareh E. Effect of a visual tracking intervention on attention and behavior of children with Attention Deficit Hyperactivity Disorder.J Eye Mov Res. 2019;12:1–11. [DOI] [PubMed] [PMC]
Stokes JD, Rizzo A, Geng JJ, Schweitzer JB. Measuring Attentional Distraction in Children With ADHD Using Virtual Reality Technology With Eye-Tracking.Front Virtual Real. 2022;3:855895. [DOI] [PubMed] [PMC]
Holmqvist K, Nyström M, Andersson R, Dewhurst R, Jarodzka H, van de Weijer J. Eye Tracking: A comprehensive guide to methods and measures. Oxford University Press; 2011.
Fabio RA, Giannatiempo S, Semino M, Caprì T. Longitudinal cognitive rehabilitation applied with eye-tracker for patients with Rett Syndrome.Res Dev Disabil. 2021;111:103891. [DOI] [PubMed]
Christ A, Laiho K, Eckstein A, Cassemiro KN, Silberhorn C. Probing multimode squeezing with correlation functions.New J Phys. 2011;13:033027. [DOI]
Mohammadhasani N, Caprì T, Nucita A, Iannizzotto G, Fabio RA. Atypical Visual Scan Path Affects Remembering in ADHD.J Int Neuropsychol Soc. 2020;26:557–66. [DOI] [PubMed]
