Age-Related Neurodevelopmental Patterns of Visuospatial Attention Deficits in Children and Adolescents with ADHD: ERP Evidence for Late-Stage Cognitive Control Impairment

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity, and impulsivity. This study used high-temporal-resolution event-related potentials (ERPs) to investigate visuospatial attention allocation across early perceptual and late cognitive control stages in 62 children and adolescents with ADHD and 62 typically developing (TD) controls (total N = 124), using a dual-task paradigm under a varying cognitive load. Behaviorally, the ADHD group showed significantly lower accuracy and marginally prolonged reaction times relative to TD controls. Electrophysiologically, the P2 component exhibited significant age effects, with shorter latency in the ADHD group than in the TD group under high load. N2 showed no significant group differences. The P3 component displayed significantly enhanced amplitude and prolonged latency in the ADHD group, especially under high load, indicating impaired late-stage cognitive control and working memory maintenance. These findings reveal that high-symptom (ADHD-screened) visuospatial attention deficits are more pronounced during late cognitive control stages; however, early perceptual processing also shows load-dependent alterations, with P3 abnormalities may represent candidate neural correlates of late-stage cognitive control deficits, although their clinical utility requires further evaluation. These results clarify the age-related patterns of attentional dysfunction in children and adolescents with ADHD and provide electrophysiological evidence for its neural mechanisms.