Cognitive Functioning and Academic Performance in Elementary School Children with Anxious/Depressed and Withdrawn Symptoms

Shannon M. Lundy1, Graciela E. Silva2, Kristine L. Kaemingk3, James L. Goodwin4, *, Stuart F. Quan4, 5
1 Department of Special Education, Rehabilitation, and School Psychology, University of Arizona, Tucson, AZ, USA
2 College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
3 Department of Pediatrics, University of Arizona, Tucson, AZ, USA
4 Arizona Respiratory Center, University of Arizona, Tucson, AZ, USA
5 Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA

© 2010 Lundy et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Arizona Respiratory Center, University of Arizona College of Medicine, 1501 N. Campbell Ave., Tucson, AZ 85724, USA; Tel: 520-626-5001; Fax: 520-626-6970; E-mail:



Few studies have evaluated the relationship between depressive symptomatology and neuropsychological performance in children without symptomatic depression.


This study determined the relationship between anxious/depressed and withdrawn symptoms and performance on cognitive and academic achievement measures.


335 Caucasian and Hispanic children aged 6 to 11 years who participated in the Tucson Children’s Assessment of Sleep Apnea (TuCASA) study were administered a comprehensive neuropsychological battery measuring cognitive functioning and academic achievement. Their parents completed the Child Behavior Checklist (CBCL). Correlations between performance on the cognitive and academic achievement measures and two Internalizing scales from the CBCL were calculated. Comparisons were made between a “Clinical” referral group (using a T-score of ≥ 60 from the CBCL scales) and a “Normal” group, as well as between Caucasians and Hispanics.


No differences were found between those participants with increased anxious/depressed or withdrawn symptoms on the CBCL and those without increased symptoms with respect to age, gender, ethnicity, or parental education level. However, significant negative correlations were found between these symptoms and general intellectual function, language, visual construction skills, attention, processing speed, executive functioning abilities, aspects of learning and memory, psychomotor speed and coordination, and basic academic skills.


These findings support the hypothesis that depressive symptomatology negatively impacts performance on cognitive and academic achievement measures in school-aged children and these findings are not affected by ethnicity. The findings also reinforce the concept that the presence of anxious/depressed or withdrawn symptoms needs to be considered when evaluating poor neuropsychological performance in children.

Keywords: Cognitive, anxious, depressed.