Sluggish Cognitive Tempo - Prognosis

Prognosis

The prognosis of SCT is unknown. In contrast, ADHD is a developmental disorder, meaning that certain traits (inhibition, sustained attention, working memory) will be delayed in the ADHD individual. These traits can and usually do develop across time in people with ADHD, but just at a much slower rate than the average person. Even so, many people with ADHD may never reach normal levels of adult development in these areas. With ADHD, it has been estimated that this lag could be as high as thirty to forty percent. The symptoms of ADHD are often seen by the time a child enters school in nearly half of all cases. Those with SCT symptoms typically show a later onset of their symptoms than do those with ADHD, perhaps by as much as a year or two later on average. They have as much or more difficulty with academic tasks and far fewer social difficulties than do people having ADHD. However, unlike ADHD, there are no longitudinal studies of children with SCT that can shed light on the developmental course and adolescent or adult outcomes of these individuals. Even so, the 2012 study by Barkley of adults noted above suggests that the disorder is present in the adult population and can be quite impairing in educational and occupational settings, even if it is not as pervasively impairing as ADHD in adults.

SCT is believed to involve difficulties with selective attention difficulties or the capacity to distinguish important from unimportant information rapidly. In contrast, people with ADHD have more difficulties with persistence of attention and action toward goals coupled with impaired resistance to responding to distractions. Both disorders interfere significantly with academic performance but may do so by different means. SCT may be more problematic with the accuracy of the work a child does in school while ADHD may more adversely affect productivity, or the amount of work done in a particular time interval. Also, children with SCT may have difficulty with verbal retrieval from long term memory than children with ADHD. They also have a more disorganized thought process, a greater degree of sloppiness, and lose things more easily. They tend to have as high a risk for comorbid learning disabilities as do people with ADHD (23-50%). Yet there is some evidence that the type of learning disorders may differ in SCT, perhaps with a higher prevalence of math disorders than seen in those with ADHD. Instead of having greater difficulty selecting and filtering sensory input, as is in the case of SCT, people with ADHD have problems with inhibition. The comorbid psychiatric problems often associated with SCT are more often of the internalizing types, such as anxiety, depression, and social withdrawal. Their typically shy nature and slow response time has often been misinterpreted as aloofness or disinterest by others. In social group interactions, those with SCT may be ignored. Those with the other types of ADHD are more likely to be rejected in social situations, because of more intrusive or aggressive behavior. Those with classic ADHD also show externalizing problems such as substance abuse, oppositional-defiant disorder, and, to a lesser degree, conduct disorder.