Children with ADHD recruit perceptual over meaningful memory

Memory is formed through two distinct forms: reactivation of perceptual traces and meaningful reconstruction into conceptual representations. How memory diverges across development remains unclear in humans. Here, we applied representational similarity analysis (RSA) to electroencephalography (EEG) data from 114 children with attention deficit/hyperactivity disorder (ADHD) and 109 typically developing (TD) children (aged 6–12 years) while they performed a recognition memory task. We revealed distinct neural mechanisms for perceptual memory and meaningful memory. Specifically, children with ADHD predominantly engaged in sensory reactivation in parietal‒occipital regions, whereas TD children engaged prefrontal areas to support meaningful memory transformation. Deep neural networks (DNN) further revealed that memory transformation occurred during encoding through semanticization of images. Further, intersubject correlation (ISC) revealed differences in memory patterns between both groups of children, providing potential neurobiological evidence for impaired memory transformation in children with ADHD. Our findings reveal that children with ADHD recruit perceptual reactivation over meaningful memory, highlighting the critical role of semantic transformation in the developmental emergence of meaningful memory.