No access
Research Article
18 September 2024

Links Among Attention-Deficit/Hyperactivity Disorder Symptoms and Psycholinguistic Abilities Are Different for Children With and Without Developmental Language Disorder

Publication: American Journal of Speech-Language Pathology
Volume 33, Number 5
Pages 2344-2363

Abstract

Purpose:

Both developmental language disorder (DLD) and attention-deficit/hyperactivity disorder (ADHD) represent relatively common and chronic neurodevelopmental conditions associated with increased risk for poor academic and interpersonal outcomes. Reports of common co-occurrence suggest these neurodevelopmental disruptions might also be linked. Most of the data available on the issue have been based on case–control studies vulnerable to ascertainment and other biases.

Method:

Seventy-eight children, representing four neurodevelopmental profiles (DLD, ADHD, co-occurring ADHD + DLD, and neurotypical development), were administered a battery of psycholinguistic tests. Parents provided standardized ratings of the severity of their children's inattention, hyperactivity/impulsivity, and executive function symptoms. Examiners were blinded to children's clinical status. Group differences, correlations, and best subset regression analyses were used to examine potential impacts of children's ADHD symptoms on their psycholinguistic abilities.

Results:

For children with DLD, significant links between their ADHD symptoms and psycholinguistic abilities were limited to the contributions of elevated hyperactivity/impulsivity symptoms to lower pragmatic abilities. For children without DLD, inattention symptoms contributed to lower levels of performance in pragmatic, sentence recall, receptive vocabulary, and narrative abilities.

Discussion:

Links among children's ADHD symptoms and their psycholinguistic abilities were different for children with and without DLD. Implications for the provision of clinical services are discussed.

Get full access to this article

View all available purchase options and get full access to this article.

References

Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms & profiles. University of Vermont, Research Center for Children, Youth, & Families.
Ahuja, A., Martin, J., Langley, K., & Thapar, A. (2013). Intellectual disability in children with attention deficit hyperactivity disorder. The Journal of Pediatrics, 163(3), 890–895.e1.
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
Ash, A. C., Redmond, S. M., Timler, G. R., & Kean, J. (2017). The influence of scale structure and sex on parental reports of children's social (pragmatic) communication symptoms. Clinical Linguistics & Phonetics, 31(4), 293–312.
Benasich, A. A., Thomas, J. J., Choudhury, N., & Leppanen, P.H.T. (2001). The importance of rapid auditory processing abilities to early language development: Evidence from converging methodologies. Developmental Psychobiology, 40, 278–292.
Betz, S. K., Eickhoff, J. R., & Sullivan, S. F. (2013). Factors influencing the selection of standardized tests for the diagnosis of specific language impairment. Language, Speech, and Hearing Services in Schools, 44(2), 133–146.
Bishop, D. V. M. (2006). The Children's Communication Checklist–Second Edition (CCC-2). Pearson.
Bishop, D. V. M., Snowling, M. J., Thompson, P. A., Greenhalgh, T., & CATALISE Consortium. (2016). CATALISE: A multinational and multidisciplinary Delphi consensus study. Identifying language impairments in children. PLOS ONE, 11(7), Article e0158753
Brown, T. E. (2000). Attention-deficit disorders and comorbidities in children, adolescents, and adults. American Psychiatric Press.
Cardy, J. E. O., Tannock, R., Johnson, A. M., & Johnson, C. J. (2010). The contribution of processing impairments to SLI: Insights from attention-deficit/hyperactivity disorder. Journal of Communication Disorders, 43(2), 77–91.
Carrow, E. (1974). Elicited language inventory. Learning Concepts.
Carruthers, S., Taylor, S., Sadiq, H., & Tripp, G. (2022). The profile of pragmatic language impairments in children with ADHD: A systematic review. Development and Psychopathology, 34(5), 1938–1960.
Conners, C. K. (2009). Conners Parent Scale–Third Edition. Multi-Health Systems.
Dale, P. S., Rice, M. L., Rimfield, K., & Haiyou-Thomas, M. E. (2018). Grammar clinical marker yields substantial heritability for language impairments in 16-year-old twins. Journal of Speech, Language, and Hearing Research, 61(1), 66–78.
Denman, D., Cordier, R., Kim, J.-H., Munro, N., & Speyer, R. (2021). What influences speech-language pathologists use of different types of language assessments for elementary school-age children? Language, Speech, and Hearing Services in Schools, 52(3), 776–793.
Dollaghan, C., & Campbell, T. F. (1998). Nonword repetition and child language impairment. Journal of Speech, Language, and Hearing Research, 41(5), 1136–1146.
Dunn, L. M., & Dunn, D. M. (2007). Peabody Picture Vocabulary Test–Fourth Edition (PPVT-4). Pearson.
Ellis Weismer, S., Tomblin, J. B., Durkin, M., Bolt, D., & Palta, M. (2021). A preliminary epidemiologic study of social (pragmatic) communication disorder in the context of developmental language disorder. International Journal of Language & Communication Disorder, 56(6), 1235–1248.
Gelman, A., Carlin, J. B., Stern, H. S., Dunson, D. B., Veharti, A., & Rubin, D. B. (2013). Bayesian data analysis (3rd ed.). Taylor & Francis.
Gillam, R. B., & Pearson, N. A. (2004). Test of Narrative Language. Pro-Ed.
Gillam, R. B., & Pearson, N. A. (2017). Test of Narrative Language–Second Edition (TNL-2). Pro-Ed.
Graf Estes, K., Evans, J. L., & Else-Quest, N. M. (2007). Differences in the nonword repetition performance of children with and without specific language impairment: A meta-analysis. Journal of Speech, Language, and Hearing Research, 50(1), 177–195.
Green, B. C., Johnson, K. A., & Bretherton, L. (2014). Pragmatic language difficulties in children with hyperactivity and attention problems: An integrated review. International Journal of Language & Communication Disorders, 49(1), 15–29.
Grier, J. B. (1971). Nonparametric indexes of sensitivity and bias: Computing formulas. Psychological Bulletin, 75(6), 424–429.
Helland, W. A., Helland, T., & Heimann, M. (2014). Language profiles and mental health problems in children with specific language impairment and children with ADHD. Journal of Attention Disorders, 18(3), 226–235.
Hosmer, D. W., & Lemeshow, S. (2000). Applied logistic regression (2nd ed.). Wiley.
Hutchinson, E., Bavin, E., Efron, D., & Sciberras, E. (2012). A comparison of working memory profiles in school-aged children with specific language impairment, attention deficit/hyperactivity disorder, comorbid SLI and ADHD and their typically developing peers. Child Neuropsychology, 18(2), 190–207.
Jepsen, I. B., Hougaard, E., Maththiesen, S. T., & Lambeck, R. (2022). A systematic review of narrative abilities in children with attention-deficit/hyperactivity disorder. Research on Child and Adolescent Psychopathology, 50, 747–751. https://doi.org/10.1007/s10802-021-00871-4
Johnson, C. J., Beitchman, J. H., Young, A., Escobar, M., Atkinson, L., Wilson, B., Brownlie, E. B., Douglas, L., Taback, N., & Wang, M. (1999). Fourteen-year follow-up of children with and without speech/language impairments: Speech/language stability and outcomes. Journal of Speech, Language, and Hearing Research, 42(3), 744–760.
Koepp, A. E., Watts, T. W., Gershoff, E. T., Ahmed, S. F., Davis-Kean, P., Duncan, G. J., Kuhfeld, M., & Vandell, D. L. (2023). Attention and behavior problems in childhood predict adult financial status, health, and criminal activity: A conceptual replication and extension of Moffitt et al. (2011) using cohorts from the United States and the United Kingdom. Developmental Psychology, 59(8), 1389–1406.
Korrel, H., Mueller, K., Silk, T., Anderson, V., & Sciberras E. (2017). Research review: Language problems in children with attention-deficit hyperactivity disorder—A systematic meta-analytic review. The Journal of Child Psychology and Psychiatry, 58(6), 640–654.
Korver, A. M., Smith, R. J., Van Camp, G., Schleiss, M. R., Bitner-Glindzicz, M. A., Lustig, L. R., Usami, S. I., & Boudewyns, A. N. (2017). Congenital hearing loss. Nature Reviews Disease Primers, 3, Article 16094.
Lange, K. W., Reichl, S., Lange, K. M., Tucha, L., & Tucha, O. (2010). The history of attention deficit hyperactivity disorder. Attention Deficit and Hyperactivity Disorder 2(4), 241–255.
Larson, K., Russ, S. A., Kahn, R. S., & Halfon, N. (2011). Patterns of comorbidity, functioning, and service use for U.S. children with ADHD, 2007. Pediatrics, 127(3), 462–470.
Law, J., Rush, R., Schoon, I., & Parson, S. (2009). Modeling developmental language difficulties from school entry into adulthood: Literacy, mental health, and employment outcomes. Journal of Speech, Language, and Hearing Research, 52(6), 1401–1416.
Lee, L. L. (1971). Northwestern Syntax Screening Test. Northwestern University Press.
Leonard, L. B. (2014). Children with specific language impairment (2nd ed.). MIT Press.
Leonard, L. B. (2019). A 200-year history of the study of childhood language disorders of unknown origin: Changes in terminology. Perspectives of the ASHA Special Interest Groups, 5(1), 6–11.
Ludlow, C. L., Cudahy, E. A., Bassich, C., & Brown, G. L. (1983). Auditory processing skills of hyperactive, language-impaired, and reading disabled boys. In E. Z. Lasky & J. Katz (Eds.), Central auditory processing disorders: Problems of speech, language, and learning (pp. 163–184). University Press.
Lum, J. A., Conti-Ramsden, G., Morgan, A. T., & Ullman, M. T. (2014). Procedural learning deficits in specific language impairment (SLI): A meta-analysis of serial reaction time task performance. Cortex, 51(100), 1–10.
Luo, F., & Timler, G. R. (2008). Narrative organization skills in children with attention deficit hyperactivity disorder and language impairment: Application of the causal network model. Clinical Linguistics and Phonetics, 22(1), 25–46.
Maenner, M. J., Warren, Z., Williams, A. R., Amoakohene, E., Bakian, A. V., Bilder, D. A., Durkin, M. S., Fitzgerald, R. T., Furnier, S. M., Hughes, M. M., Ladd-Acosta, C. M., McArthur, D., Pas, E. T., Salinas, A., Vehorn, A., Williams, S., Esler, A., Grzybowski, A., Hall-Lande, J., … Shaw, K. A. (2023). Prevalence and characteristics of autism spectrum disorder among children aged 8 years—Autism and developmental disabilities monitoring network, 11 sites, United States, 2020. Morbidity and Mortality Weekly Report Surveillance Summaries, 72(2), 1–14.
McDermott, S., Sweeney, K., & Jacobson, L. A. (2023). Does assessment format matter? A comparison of in-person versus teletesting scores for youth with ADHD. Journal of Attention Disorders, 27(2), 152–158.
McGregor, K. K., Ohlmna, N., Eden, N., Arbisi-Kelm, T., & Young, A. (2023). Abilities and disabilities among children with developmental language disorder. Language, Speech, and Hearing Services in Schools, 54(3), 927–951.
Miller, C. A., Kail, R., Leonard, L., & Tomblin, J. B. (2001). Speed of processing in children with specific language impairment. Journal of Speech, Language, and Hearing Research, 44(2), 416–433.
Mueller, K. L., & Tomblin, J. B. (2012). Examining the comorbidity of language impairment and attention-deficit/hyperactivity disorder. Topics in Language Disorders, 32(3), 228–246.
Naglieri, J. A. (2003). Naglieri Nonverbal Ability Tests: NNAT and MAT-EF. In R. S. McCallumr (Ed.), Handbook of nonverbal assessment (pp. 175–189). Harcourt Assessment.
Norbury, C. F. (2014). Atypical pragmatic development. In D. Matthews (Ed.), Pragmatic development in first language acquisition (pp. 343–362). John Benjamins.
Norbury, C. F., Gooch, D., Wray, C., Baird, G., Charman, T., Simonoff, E., Vamvakas, G., & Pickles, A. (2016). The impact of nonverbal ability on prevalence and clinical presentation of language disorder: Evidence from a population study. The Journal of Child Psychology and Psychiatry, 57(11), 1247–1257.
Oetting, J. B., McDonald, J. L., & Vaughn, L. E. (2023). Grammaticality Judgments of tense and agreement by children with and without developmental language disorder across dialects of English. Journal of Speech, Language, and Hearing Research, 66(12), 4996–5010.
Oram, J., Fine, J., Okamoto, C., & Tannock, R. (1999). Assessing the language of children with attention deficit hyperactivity disorder. American Journal of Speech-Language Pathology, 8(1), 72–80.
Parigger, E. (2012). Language and executive functioning in children with ADHD. University of Amsterdam Press.
Parks, K. M. A., Oram Cardy, J. E., Woynaroski, T. G., Sehl, C. G., & Stevenson, R. A. (2021). Investigating the role of inattention and/or hyperactivity/impulsivity in language and social functioning using a dimensional approach. Journal of Communication Disorders, 89, Article 1060366.
Pawłowska, M. (2014). Evaluation of three proposed markers for language impairment in English: A meta-analysis of diagnostic accuracy studies. Journal of Speech, Language, and Hearing Research, 57(6), 2261–2273.
Pelahm, W. E., Foster, M., & Robb, J. A. (2007). The economic impact of attention-deficit/hyperactivity disorder in children and adolescents. Journal of Pediatric Psychology, 32(6), 711–727.
Perkins, M. (2007). Pragmatic impairment. Cambridge University Press.
Pratt, A. S., Anaya, J. B., Ramos, M., Pham, G., Muñoz, M., Bedore, L. M., & Peña, E. D. (2022). From a distance: Comparison of in-person and virtual assessments with adult-child dyads from linguistically diverse backgrounds. Language, Speech, and Hearing Services in Schools, 53(2), 360–375.
Redmond, S. M. (2005). Differentiating SLI from ADHD using children's sentence recall and production of past tense morphology. Clinical Linguistics & Phonetics, 19(2), 109–127.
Redmond, S. M. (2016a). Language impairment in the attention-deficit/hyperactivity disorder context. Journal of Speech, Language, and Hearing Research, 59(1), 133–142.
Redmond, S. M. (2016b). Markers, models, and measurement error: Exploring the links between attention deficits and language impairments. Journal of Speech, Language, and Hearing Research, 59(1), 62–71.
Redmond, S. M., Ash, A. C., Christopulos, T. T., & Pfaff, T. (2019). Diagnostic accuracy of sentence recall and past tense measures for identifying children's language impairments. Journal of Speech, Language, and Hearing Research, 62(7), 2438–2454.
Redmond, S. M., Ash, A. C., & Hogan, T. P. (2015). Consequences of co-occurring attention-deficit/hyperactivity disorder on children's language impairments. Language, Speech, and Hearing Services in Schools, 46(2), 68–80.
Redmond, S. M., Thompson, H. L., & Goldstein, S. (2011). Psycholinguistic profiling differentiates specific language impairment from typical development and from attention-deficit/hyperactivity disorder. Journal of Speech, Language, and Hearing Research, 54(1), 99–117.
Rice, M. L. (2004). Growth models of developmental language disorders. In M. L. Rice & S. F. Warren (Eds.), Developmental language disorders: From phenotypes to etiologies (pp. 207–240). Erlbaum.
Rice, M. L., Earnest, K. K., & Hoffman, L. (2023). Longitudinal grammaticality judgments of tense marking in complex questions in children with and without specific language impairment, ages 5–18 years. Journal of Speech, Language, and Hearing Research, 66(10), 3882–3906.
Rice, M. L., Hoffman, L., & Wexler, K. (2009). Judgments of omitted BE and DO in questions as extended finiteness clinical markers of specific language impairment (SLI) to 15 years: A study of growth and asymptote. Journal of Speech, Language, and Hearing Research, 52(6), 1417–1433.
Rice, M. L., Redmond, S. M., & Wexler, K. (1999). Grammaticality judgments of an extended optional infinitive grammar: Evidence from English-speaking children with specific language impairment. Journal of Speech, Language, and Hearing Research, 42(4), 943–961.
Rice, M. L., & Wexler, K. (1996). Toward tense as a clinical marker of specific language impairment in English-speaking children. Journal of Speech and Hearing Research, 39(6), 1239–1257.
Rice, M. L., & Wexler, K. (2001). Test of Early Grammatical Impairment (TEGI). The Psychological Corporation.
Rogers, M. A., & MacLean, J. (2023). ADHD symptoms increased during the COVID-19 pandemic: A meta-analysis. Journal of Attention Disorders, 27(8), 800–811.
Scheres, A., Oosterlaan, J., & Seregeant, J. A. (2001). Response execution and inhibition in children with AD/HD and other disruptive disorders: The role of behavioural activation. Journal of Child Psychology and Psychiatry and Allied Disciplines, 42(3), 347–357.
Schriberg, L. D. (1993). Four new speech and prosody-voice measures for Genetics research and other studies in developmental phonological disorders. Journal of Speech and Hearing Research, 36(1), 105–140.
Schwartz, R. G. (2009). Specific language impairment. In R. G. Schwartz (Ed.), Handbook of child language disorders (pp. 3–42). The Psychology Press.
Sciberras, E., Westrupp, E. M., Wake, M., Nicholson, J. M., Lucas, N., Mensah, F., Gold, L., & Reily, S. (2015). Healthcare costs associated with language difficulties up to 9 years of age: Australian population-based study. International Journal of Speech-Language Pathology, 17(1), 41–52.
Shriberg, L. D., & Lohmeier, H. L. (2008). The syllable repetition task. (Tech Report No. 14). Phonology Project, Waismen Center, University of Wisconsin–Madison.
Shriberg, L. D., Tomblin, J. B., & McSweeny, J. L. (1999). Prevalence of speech delay in 6-year-old children and comorbidity with language impairment. Journal of Speech, Language, and Hearing Research, 42(6), 1461–1481.
Stanford, E., & Delage, H. (2020). Executive functions and morphosyntax: Distinguishing DLD from ADHD in French-speaking children. Frontiers in Psychology, 15(11), Article 551824. https://doi.org/10.3389/fpsyg.2020.551824
Wachs, T. D. (2000). Necessary but not sufficient: The respective roles of single and multiple influences on individual development. American Psychological Association.
Waite, M. C., Theodoros, D. G., Russell, T. G., & Cahill, L. M. (2010). Internet-based telehealth assessment of language using the CELF-4. Language, Speech, and Hearing Services in Schools, 41(4), 445–458.
Westby, C., & Watson, S. M. R. (2021). ADHD and communication disorders. In J. S. Damico, N. Muller, & M. J. Ball (Eds.), The handbook of language and speech disorders (2nd ed., pp. 531–570). Wiley.
Wiig, E. H., Semel, E., & Secord, W. A. (2013). Clinical Evaluation of Language Fundamentals–Fifth Edition (CELF-5). Pearson.

Information & Authors

Information

Published In

American Journal of Speech-Language Pathology
Volume 33Number 518 September 2024
Pages: 2344-2363
PubMed: 38980144

History

  • Received: Oct 19, 2023
  • Revised: Mar 4, 2024
  • Accepted: May 6, 2024
  • Published online: Jul 9, 2024
  • Published in issue: Sep 18, 2024

Permissions

Request permissions for this article.

Authors

Affiliations

Andrea C. Ash
The University of Utah, Salt Lake City
Haojia Li
The University of Utah, Salt Lake City
Yue Zhang
The University of Utah, Salt Lake City

Notes

Disclosure: The authors have declared that no competing financial or nonfinancial interests existed at the time of publication.
Correspondence to Sean M. Redmond: [email protected]
Editor-in-Chief: Erinn H. Finke

Metrics & Citations

Metrics

Article Metrics
View all metrics



Citations

If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download.

For more information or tips please see 'Downloading to a citation manager' in the Help menu.

Citing Literature

  • Multilingual Learners With Attention-Deficit/Hyperactivity Disorder and Developmental Language Disorder: Assessing an Underserved Population of Learners, Perspectives of the ASHA Special Interest Groups, 10.1044/2024_PERSP-24-00034, 10, 1, (44-60), (2025).

View Options

Sign In Options

ASHA member? If so, log in with your ASHA website credentials for full access.

Member Login

View options

PDF

View PDF

Full Text

View Full Text

Figures

Tables

Media

Share

Share

Copy the content Link

Share