Differentiating ADHD from oral language difficulties in children: role of movements and effects of stimulant medication.

Carroll W Hughes,Kristi Baker,Joyce Pickering,Gina Bolanos,Cheryl Silver

doi:10.1186/s12888-014-0370-0

Carroll W Hughes, Kristi Baker + Show 3 more

Open Access

https://doi.org/10.1186/s12888-014-0370-0

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Abstract

BackgroundThe current study was designed to test if an objective measure of both attention and movement would differentiate children with Oral Language Disorders (OLD) from those with comorbid Attention Deficit/Hyperactivity Disorder (ADHD) and if stimulant medication improved performance when both disorders were present.MethodsThe sample consisted of thirty-three children with an identified oral language disorder (of which 22 had comorbid ADHD) ages 6 to 13 who were enrolled in a yearlong intensive learning intervention program. Those on a stimulant medication were tested at baseline and again a year later on and off medication.ResultsObjective measures that included an infrared motion analysis system which tracked and recorded subtle movements discriminated children with OLD from those with a comorbid ADHD disorder whereas classic attention measures did not. There were better attention scores and fewer movements in children while on-medication.ConclusionsUse of an objective measurement that includes movement detection improves objective diagnostic differential for OLD and ADHD and provides quantifiable changes in performance related to medication for both OLD and ADHD.

Highlights

The current study was designed to test if an objective measure of both attention and movement would differentiate children with Oral Language Disorders (OLD) from those with comorbid Attention Deficit/ Hyperactivity Disorder (ADHD) and if stimulant medication improved performance when both disorders were present
The diagnostic dilemma becomes that these inattention symptoms and behavior control difficulties in children with OLD can appear quite similar to inattention and hyperactivity symptoms seen in children with ADHD and some with OLD only may be prescribed medication without established efficacy
To assess if the OLD and OLD/ADHD groups were equivalent in overall functioning and severity with regard to language and cognitive functioning, independentsamples t tests indicated no group differences with respect to language functioning (Clinical Evaluation of Language Fundamentals – CELF), verbal cognitive ability (Slosson Intelligence Test-Revised), and nonverbal cognitive ability (Wechsler Nonverbal Scale of Ability)

Summary

Introduction

The current study was designed to test if an objective measure of both attention and movement would differentiate children with Oral Language Disorders (OLD) from those with comorbid Attention Deficit/ Hyperactivity Disorder (ADHD) and if stimulant medication improved performance when both disorders were present. A language impairment (LI) or language disorder is a deficit or delay in receptive language (the understanding of spoken language by others) and/or expressive language (the sharing of thoughts, ideas, and feelings). Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common comorbid diagnoses for children with an expressive language disorder or mixed receptiveexpressive language disorder There are those with OLD and comorbid ADHD where an accurate language disorder diagnosis fails to identify the concomitant ADHD where the addition of a medication intervention may prove beneficial

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