Diminished visual dominance in adults with attention deficit-hyperactivity disorder in the Colavita paradigm

BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) has been linked to atypical sensory processing and altered multisensory integration, yet sensory dominance under audiovisual competition has not been characterized in adults. We therefore examined modality prioritization in adults with ADHD using the Colavita visual dominance paradigm. METHODS: Twenty-six adults with ADHD and 18 controls completed a two-choice Colavita task comprising auditory-only (A), visual-only (V), and simultaneous audiovisual trials (AV). Reaction times (RT) and intraindividual RT variability were analyzed with linear mixed-effects models including Group, Condition, their interaction, age, and sex. Visual dominance on AV trials (proportion of visual responses) was analyzed using bias-reduced logistic regression with age and sex covariates, with false discovery rate correction applied. RESULTS: Adults with ADHD exhibited significantly reduced visual dominance on AV trials (43.4% [40.1-46.7]) relative to controls (68.8% [64.9-72.4]; OR = 0.35, 95% CI [0.28, 0.44], q < 0.001). RTs were slower in ADHD than controls overall, including a significant between-group difference on AV trials. RT variability was higher on AV than unimodal trials in both groups, with a significant Group × Condition interaction but no significant between-group difference within individual conditions. CONCLUSION: Adult ADHD is characterized by attenuated Colavita visual dominance and increased behavioral costs under audiovisual competition, consistent with an auditory-weighted sensory selection profile and less efficient top-down regulation during cross-modal conflict.