Language and reading in attention-deficit/hyperactivity disorder and comorbid attention-deficit/hyperactivity disorder + developmental language disorder.

Background: The current study sought to examine whether psycholinguistic assessments could discriminate children and adolescents with developmental language disorder (DLD) from those with attention-deficit/hyperactivity disorder (ADHD; combined or inattentive subtype) and comorbid DLD + ADHD. Methods: The Clinical Evaluation of Language Fundamentals-Screening Test (CELFST; Wiig et al., 2013), the Comprehensive Test of Phonological Processing (nonword repetition subtest; Wagner et al., 2013), and the Test of Word Reading Efficiency (sight word and phonemic decoding subtests; Torgesen et al., 2012) were examined in 441 children and adolescents between 6 and 16 years of age. Results: The presence of a language disorder (with or without ADHD) predicted poor performance across tasks. Children and adolescents with ADHD (combined vs. inattentive) only significantly differed in sight word reading, in favor of those with combined type. Measures of reading efficiency could distinguish between the two types of ADHD, but not between other groups. Interestingly, scores on the standard language screener were no worse for children with ADHD + DLD than children with DLD only. Conclusions: The combination of comorbid ADHD + DLD did not appear to be associated with lower language abilities, sight word reading, or phonemic decoding relative to DLD alone. Reading efficiency was effective in discriminating between ADHD subtypes. These findings offer valuable insights into differential diagnosis and the identification of comorbidity.

Language abilities in children and adolescents with DLD and ADHD: A scoping review.

PURPOSE: There is an emerging view that attention-deficit/hyperactivity disorder (ADHD) is marked by problems with language difficulties, an idea reinforced by the fact that ADHD is highly comorbid with developmental language disorder (DLD). This scoping review provides an overview of literature on language abilities in children with DLD and ADHD while highlighting similarities and differences. METHOD: A comprehensive search was performed to examine the literature on language abilities in the two disorders, yielding a total of 18 articles that met the inclusion criteria for the present review. Qualitative summaries are provided based on the language domain assessed. RESULTS: The current literature suggests children and adolescents with ADHD have better morphosyntax/grammar, general/core language abilities, receptive, and expressive abilities than those with DLD. Further, that performance is comparable on assessments of semantic and figurative language but varies by sample on assessments of phonological processing, syntax, narrative language, and vocabulary. CONCLUSION: Evidence presented points to children and adolescents with DLD as having greater language difficulties compared to those with ADHD, but with some important caveats. Despite limitations related to the paucity of studies and inconsistencies in how the two types of disorders are identified, our review provides a necessary and vital step in better understanding the language profiles of these two highly prevalent childhood disorders. These findings are useful in optimizing language outcomes and treatment efficacy for children and adolescents with ADHD and DLD.

The Task Matters: A Scoping Review on Reading Comprehension Abilities in ADHD.

OBJECTIVE: A broad range of tasks have been used to classify individuals with ADHD with reading comprehension difficulties. However, the inconsistency in the literature warrants a scoping review of current knowledge about the relationship between ADHD diagnosis and reading comprehension ability. METHOD: A comprehensive search strategy was performed to identify relevant articles on the topic. Thirty-four articles met inclusion criteria for the current review. RESULTS: The evidence as a whole suggests reading comprehension is impaired in ADHD. The most prominent effect was found in studies where participants retell or pick out central ideas in stories. On these tasks, participants with ADHD performed consistently worse than typically developing controls. However, some studies found that performance in ADHD improved when reading comprehension task demands were low. CONCLUSION: Results suggest that performance in ADHD depends on the way reading comprehension is measured and further guide future work clarifying why there are such discrepant findings across studies.

Investigating the Role of Inattention and/or Hyperactivity/impulsivity in Language and Social Functioning Using a Dimensional Approach.

The current study parsed out the distinct components of attention-deficit/hyperactivity disorder (ADHD) symptomatology to examine differential relations with language and social ability. Using a research domain criteria (RDoC) framework, we administered standardized tests and previously developed and validated questionnaires to assess levels of inattention and/or hyperactivity/impulsivity symptomatology, language, social responsivity and social competency in 98 young adults. Those with higher inattention and/or hyperactivity/impulsivity symptomatology had reduced language comprehension, social responsivity, and social competency. Inattention and hyperactivity/impulsivity both predicted language comprehension, but not language production. Interestingly, inattention uniquely contributed to social responsiveness and social competency, but hyperactivity/impulsivity did not. Findings suggest that inattention and/or hyperactivity/impulsivity symptoms, inattention in particular, may be especially important for social skills programs geared towards individuals with attention limitations.

Factor Structure of Repetitive Behaviors Across Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder.

Restricted interests and repetitive behaviors (RRBs) are core symptoms of autism spectrum disorder (ASD), and commonly occur in attention-deficit/hyperactivity disorder (ADHD). Little is known about how RRBs manifest in ADHD. We quantified and compared factor structures of RRBs in children with ASD (n = 634) or ADHD (n = 448), and related factors to sex and IQ. A four-factor solution emerged, including Stereotypy, Self-Injury, Compulsions, and Ritualistic/Sameness. Factor structures were equivalent across diagnoses, though symptoms were more severe in ASD. IQ negatively correlated with Stereotypy, Self-Injury, and Compulsions in ASD, and negatively correlated with Compulsions and Ritualistic/Sameness behaviors in ADHD. In ASD only, females exhibited higher Self-Injury. Thus, patterns of RRBs are preserved across ASD and ADHD, but severity and relationship with IQ differed.

Statistical Learning and Social Competency: The Mediating Role of Language.

The current study sought to examine the contribution of auditory and visual statistical learning on language and social competency abilities as well as whether decreased statistical learning abilities are related to increased autistic traits. To answer these questions, participants' (N = 95) auditory and visual statistical learning abilities, language, social competency, and level of autistic traits were assessed. Although the relationships observed were relatively small in magnitude, our results demonstrated that visual statistical learning related to language and social competency abilities and that auditory learning was more related to autism symptomatology than visual statistical learning. Furthermore, the relationship between visual statistical learning and social competency was mediated by language comprehension abilities, suggesting that impairments in statistical learning may cascade into impairments in language and social abilities.

Auditory and Visual Statistical Learning Are Not Related to ADHD Symptomatology: Evidence From a Research Domain Criteria (RDoC) Approach.

Statistical learning is an implicit process that allows individuals to track and predict incoming events from their environment. Given that information is highly structured over time, events become predictable, allowing these individuals to make better sense of their environment. Among the studies that have examined statistical learning in attention deficit/hyperactivity disorder (ADHD), findings have been mixed. Our goal was to examine whether increased ADHD symptomatology related to decreased auditory and visual statistical learning abilities. To investigate this, we examined the entire range of ADHD symptomatology using a Research Domain Criteria approach with a clinically reliable questionnaire in addition to well-established auditory and visual statistical learning paradigms. Total ADHD symptomatology was not related to auditory and visual statistical learning. An identical pattern emerged when inattention and hyperactivity components were separated, indicating that neither of these distinct behavioral symptoms of ADHD are related to statistical learning abilities. Findings from the current study converge with other studies but go beyond finding a lack of a significant relationship - through Bayesian analyses, these data provide novel evidence directly supporting the hypothesis that ADHD symptomatology and statistical learning are decoupled. This finding held for overall levels of ADHD symptomatology as well as the subdomains of inattention and hyperactivity, suggesting that the ability to pick up on patterns in both auditory and visual domains is intact in ADHD. Future work should consider investigating statistical learning in ADHD across ages and beyond auditory and visual domains.