EEG-based Word Association Paradigm for Adult ADHD Screening: An Exploratory Pilot Study

Abstract

With the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) over the past decades, healthcare systems across the globe face critical diagnostic challenges due to long diagnostic waiting times and a reliance on subjective behavioural assessments that cannot distinguish ADHD from comorbid psychiatric disorders, especially for adult patients. This exploratory study investigates whether EEG-based word association paradigms show promise as a complementary approach to screening for ADHD in adults. Using a mixed-method approach, the study examines neurological and cognitive differences between neurotypical individuals (NT), clinically diagnosed ADHD participants (ND), and self-reported ADHD cases awaiting formal diagnosis (SR) across three word association tasks. While established EEG biomarkers (ERP N400, Theta/Beta Ratio, and Alpha Suppression) show no significant group differences, semantic distance analysis reveals a statistically significant main effect ($p=0.003$), with the SR group showing the most divergent associations. These preliminary findings suggest that word association paradigms may capture cognitive differences not detected by standard EEG metrics and encourage further large-scale investigation as a potential complement to existing adult ADHD screening tools.