Voice features in paediatric ADHD: baseline group differences and longitudinal change under methylphenidate
European Child & Adolescent Psychiatry
Abstract
Diagnosis and treatment monitoring of attention-deficit/hyperactivity disorder (ADHD) largely rely on subjective assessments, highlighting the need for objective markers. Voice features and speech embeddings represent promising candidates, as they may offer an objective, scalable and clinically valuable complement to current practice. Yet it remains largely unclear which features are most informative for distinguishing ADHD and monitoring treatment effects, and which speech tasks best elicit these differences. Twenty-seven children with ADHD and 27 age-matched neurotypical controls completed six speech tasks across two study visits. Children with ADHD were unmedicated at baseline and were assessed under prescribed methylphenidate treatment at follow-up, whereas controls underwent repeated assessment without intervention. Established acoustic voice features and high-dimensional speech embeddings were extracted and analysed using linear mixed models to examine baseline group differences and group-by-time interaction effects reflecting medication-associated change patterns. At baseline, children with ADHD showed a lower and more variable pitch (F0 mean, F0 variability), altered spectral properties (MFCC1/MFCC2 variability), and reduced rhythmic stability (variability of voiced-segment length) compared to controls. Group-by-time interaction effects indicated medication-associated modulation in the ADHD group, including reduced loudness variability and normalization of first formant bandwidth toward control values. Speech embeddings (Whisper but not WavLM) showed FDR-significant baseline and interaction effects. Free speech tasks, particularly picture description, yielded the most robust and consistent effects. These findings support further investigation of speech-based measures as potential digital biomarkers in ADHD, with picture description emerging as a particularly promising task for future clinical assessment protocols.Clinical trial registration: German Clinical Trials Registry, registration no. DRKS00030766, Registration Date: 12 December 2022. Available: https://drks.de/search/en/trial/DRKS00030766.
Authors 9
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Rachel Bamberger corresponding Aachen Department of Child and Adolescent Psychiatry Institute of Medical Psychology and Medical Sociology Faculty of Medicine
Forschungszentrum Jülich · Universitätsklinikum Aachen · Heinrich Heine University Düsseldorf · RWTH Aachen University
Affiliation as printed
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany. r.bamberger@fz-juelich.de
Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany. r.bamberger@fz-juelich.de
Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany. r.bamberger@fz-juelich.de
Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. r.bamberger@fz-juelich.de
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Forschungszentrum Jülich · Heinrich Heine University Düsseldorf
Affiliation as printed
Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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Forschungszentrum Jülich · Max Planck Institute for Human Cognitive and Brain Sciences · Heinrich Heine University Düsseldorf
Affiliation as printed
Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
Max Planck School of Cognition, Stephanstrasse 1A, 04103, Leipzig, Germany
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Forschungszentrum Jülich · Heinrich Heine University Düsseldorf
Affiliation as printed
Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany
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Forschungszentrum Jülich · Jülich Aachen Research Alliance · RWTH Aachen University
Affiliation as printed
Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
Institute of Neuroscience and Medicine, Translational Neuroscience (INM-10), Research Centre Jülich, Jülich, Germany
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Thomas Günther Aachen Department of Psychological Assessment and Intervention Institute of Psychology
Affiliation as printed
Department of Psychological Assessment and Intervention, Institute of Psychology, RWTH Aachen University, Aachen, Germany
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Universitätsklinikum Aachen · RWTH Aachen University
Affiliation as printed
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany
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Affiliation as printed
Section of Phoniatrics and Audiology, Department of Otorhinolaryngology, University Hospital Leipzig, Leipzig, Germany
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Universitätsklinikum Aachen · University Hospital Leipzig
Affiliation as printed
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital Leipzig, Leipzig, Germany. Georg.vonPolier@medizin.uni-leipzig.de
Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Hospital RWTH Aachen, Aachen, Germany. Georg.vonPolier@medizin.uni-leipzig.de
Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany. Georg.vonPolier@medizin.uni-leipzig.de