Impaired emotional multimodal integration in inhibition of return in children with attention-deficit/hyperactivity disorder

Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder in children. Previous studies have shown that children with ADHD have impaired processing of emotional stimuli, but it is unclear whether their ability to integrate multimodal emotional stimuli is impaired and at which processing pathway this impairment exists. The present study investigated the ability of children with ADHD to integrate emotional audiovisual stimuli under different emotional conditions, and the effect of audiovisual integration on IOR to reveal the impaired processing pathway of their emotional audiovisual integration. Fifty-eight school-age children (29 with ADHD and 29 matched typically developing (TD) children) performed an emotional valence discrimination task with a cue-target paradigm. The results showed that children with ADHD did not exhibit audiovisual integration of emotional stimuli in all experimental conditions. In addition, the IOR effect was significantly smaller for audiovisual targets than for visual targets under the negative but not the neutral emotion condition in children with ADHD, whereas this effect was present in all emotion conditions in TD children. These results indicate that the ability to integrate emotional audiovisual information is impaired in children with ADHD and this impairment exists in both bottom-up and top-down pathways. Additionally, although presenting emotional auditory stimuli at the same time as emotional faces reduced IOR both in children with ADHD and TD, the manner of reduction differed. These findings provide new evidence of emotional processing deficits and multimodal integration deficits in children with ADHD, and help provide support for children in educational settings.