Children with attention-deficit/hyperactivity disorder (ADHD) have difficulties filtering irrelevant information, particularly when faced with competing inputs. These challenges may affect auditory distraction processing, especially under varying demands on visual attention. This study investigated the neural mechanisms underlying auditory distraction processing under these conditions in ADHD.

We recorded electroencephalography (EEG) signals from 51 children with ADHD and 48 typically developing (TD) children during the performance of a visual detection task with simultaneous irrelevant auditory stimuli under varying demands on visual attention.

TD children presented a significant decrease in mismatch negativity (MMN) amplitude with increasing visual attention demands. However, this effect was absent in children with ADHD, who instead exhibited an enhanced P3a response and earlier MMN and P3a latencies in response to auditory changes. Moreover, a shorter MMN latency predicted more severe inattention symptoms, whereas a larger MMN amplitude predicted more severe hyperactivity/impulsivity symptoms in children with ADHD. Time–frequency analysis revealed greater frontal theta intertrial phase coherence (ITPC) and power in response to task-irrelevant auditory changes in children with ADHD than in TD children.

The absence of attention–demand modulation in MMN amplitude and an increased P3a response indicate atypical auditory distractibility in children with ADHD, with earlier MMN and P3a latencies suggesting excessive sensitivity to auditory distractions. Increased frontal theta ITPC and power reflect stronger neural synchronization and response to auditory distractions. Importantly, MMN amplitude and latency are linked to different aspects of ADHD symptoms. These findings provide new neurophysiological insights into altered auditory distraction processing in children with ADHD.

We worked to ensure sex and gender balance in the recruitment of human participants. We worked to ensure race, ethnic, and/or other types of diversity in the recruitment of human participants. We worked to ensure that the study questionnaires were prepared in an inclusive way. Diverse cell lines and/or genomic datasets were not available. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote sex and gender balance in our reference list. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.