Language Problems and ADHD Symptoms: How Specific Are the Links?

Susan Gathercole,Erin Hawkins,Duncan Astle,Joni Holmes

doi:10.3390/brainsci6040050

Abstract

Symptoms of inattention and hyperactivity frequently co-occur with language difficulties in both clinical and community samples. We explore the specificity and strength of these associations in a heterogeneous sample of 254 children aged 5 to 15 years identified by education and health professionals as having problems with attention, learning and/or memory. Parents/carers rated pragmatic and structural communication skills and behaviour, and children completed standardised assessments of reading, spelling, vocabulary, and phonological awareness. A single dimension of behavioural difficulties including both hyperactivity and inattention captured behaviour problems. This was strongly and negatively associated with pragmatic communication skills. There was less evidence for a relationship between behaviour and language structure: behaviour ratings were more weakly associated with the use of structural language in communication, and there were no links with direct measures of literacy. These behaviour problems and pragmatic communication difficulties co-occur in this sample, but impairments in the more formal use of language that impact on literacy and structural communication skills are tied less strongly to behavioural difficulties. One interpretation is that impairments in executive function give rise to both behavioural and social communication problems, and additional or alternative deficits in other cognitive abilities impact on the development of structural language skills.

Highlights

Symptoms of inattention and hyperactivity typically co-occur with poor communication skills [1,2] and low levels of literacy [3,4,5] in children with attention deficit hyperactivity disorder (ADHD)
The language measures were entered into two separate exploratory factor analysis (EFA), one for the parent/carer ratings of communication and another for the direct assessments of literacy
Parents’ views of their children’s learning abilities, as measured by a subscale of the behaviour checklist, correlated with the direct measures of literacy despite there being no other relationships between these measures and other scales on the behaviour checklist. The specificity of these links speaks against a common variance in the parent measures underpinning the results. The phenotype of these children with problems in attention, learning or memory was characterised by a broad dimension of inattentive and hyperactive behaviour that was strongly associated with pragmatic language difficulties, and more weakly associated with difficulties in the use of language structure

Summary

Introduction

Symptoms of inattention and hyperactivity typically co-occur with poor communication skills [1,2] and low levels of literacy [3,4,5] in children with attention deficit hyperactivity disorder (ADHD). The same comorbidities are found in the general school population [6,7] and in other neurodevelopmental conditions including autism spectrum disorder (ASD) [8], specific language impairment (SLI) [9], and dyslexia [10,11]. These overlapping symptom profiles may reflect dimensions of inattentive and hyperactive behaviour and cognitive difficulties that cut across traditional diagnostic categories [12,13,14]. The atypical and heterogeneous nature of the sample enabled us to investigate the extent to which impairments in language and behaviour co-occurred in children with problems related to educational progress

Results

Discussion

Conclusion