Auditory processing and executive functions in adolescents with ADHD–predominantly inattentive presentation

Background Adolescents with Attention-Deficit/Hyperactivity Disorder–Predominantly Inattentive Presentation (ADHD-I) often show deficits in executive functions, sustained attention, and auditory processing. This study evaluated auditory selective attention, reaction time, and auditory processing in adolescents with ADHD-I.Methods This cross-sectional study included adolescents aged 12–18 years with ADHD-I and age- and sex-matched controls. Auditory processing was assessed using a computerized experimental Auditory Selective Attention Test (ASAT), adapted into Turkish, with monaural and dichotic conditions measuring accuracy and reaction time (RT). Executive functions and symptom severity were evaluated using CPRS-R:L, BDEFS-CA, and SNAP-IV.Results Adolescents with ADHD-I showed lower accuracy and longer reaction times in both ASAT conditions compared to controls. Accuracy was negatively correlated with CPRS-R:L hyperactivity, inattention, global index, and restlessness/impulsivity scores, while reaction times were positively correlated. Higher BDEFS-CA scores—particularly in organization, impulse control, self-motivation, and ADHD index—were associated with poorer ASAT performance. Regression analysis indicated that SNAP-IV inattention was the only significant predictor of auditory selective attention.Conclusion Adolescents with ADHD-I demonstrate impairments in auditory selective attention and processing. Greater inattention severity is associated with reduced accuracy and prolonged reaction times, suggesting increased vulnerability to auditory distraction and reduced discrimination efficiency, with findings that may be considered preliminary.