Language Problems in Children with ADHD Linked to Poorer Academic Functioning

Children with attention deficit hyperactivity disorder (ADHD) have a higher prevalence of language problems, which contributes to poorer academic functioning, according to research published in Pediatrics.

Researchers from the Murdoch Childrens Research Institute in Australia studied 179 children with ADHD and 212 control subjects aged 6-8 years. For the study, ADHD was scaled using the Conners 3 ADHD Index and the Diagnostic Interview Schedule for Children (DISC) IV, while language skills were tested using the Clinical Evaluation of Language Fundamentals—Fourth Edition (CELF-4) screener.

The researchers also tested the children for academic functioning using direct assessments, such as the Wide Range Achievement Test 4 (WRAT-4). The children’s social functioning was measured using parental assessments, although teacher reports also contributed to measurements of both academic and social functioning.

Compared to the control group, those categorized in the ADHD group were more likely to have an internalizing and externalizing disorder, be diagnosed with ADHD, and take medication. The primary caregivers from the ADHD group were generally younger, more likely to be single parents, less likely to have completed high school, and reported higher levels of psychological distress.

Children in the ADHD group had significantly more language problems, totaling 40% in comparison to 17% of controls. However, medication use was similar between children with ADHD alone (42%) and those with both ADHD and language problems (38%). According to the researchers, 42% of children with ADHD and language problems had previously sought speech pathology services, while 57% were still seeing a speech pathologist. Only 6 control children (16%) with language problems had sought speech pathology services, and 3 children (50%) were currently seeing a speech pathologist.

“We are concerned that few children with ADHD and language problems are currently accessing speech pathology services, especially given that language problems are related to poorer academic outcomes,” lead researcher, Emma Sciberras, DPsych, said in a press release. “Routine assessments for ADHD do not generally include standardized language assessments, but given the strong association between language and academic underachievement, if children with ADHD are falling behind academically, they should be referred for a language assessment.”

The researchers also found children with both ADHD and language problems had poorer academic functioning than those with ADHD alone. However, social functioning did not appear to be affected in children with ADHD, as the differences between the social functioning scores of children with ADHD and language problems and ADHD alone were not statistically significant.

“Our findings suggest that the relationship between language problems and ADHD is not merely explained by other commonly occurring comorbidities (eg, autism spectrum disorder, internalizing or externalizing disorders) or sociodemographic factors,” the authors concluded. “Our study extends previous research by considering multiple factors, which may have accounted for this relationship within an inclusive, community-ascertained ADHD sample.”