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Language Disorders and Attention Deficit Hyperactivity Disorder
Philippa Greathead Speech Language Pathologist Speech-Language-Learning Centre Westmead, NSW, Australia The child or adolescent with ADHD and learning problems will often present to the Speech Language Pathologist with a range of clinical problems in language that are contributing to the learning disorder. The types of language problems experienced by children with ADHD are varied and can cover all the modalities of language. Typically problems are seen in: Syntax: Disorders of syntax (oral and written grammar) are difficulties using and/or comprehending the structural components of sentences. Semantics: Semantic difficulties in language involve problems with word meanings and organization. School problems include difficulties comprehending written and spoken language, poor vocabulary, word-finding difficulties and difficulties using context to help with the comprehension of reading. Pragmatics: Pragmatics is the term used for the social use of language - i.e. the ability to use language as a means to interact with others socially or for a specific purpose (e.g. requesting information, expressing feelings, holding a conversation with people of different age levels). Metalinguistics: This is the ability to reflect on language objectively - to know and understand that language is a rule-bound code - e.g. humour, multimeaning in words, ambiguity, figurative language (metaphors etc), ability to segment words into syllables or phonemes (sounds). Related areas of difficulty Auditory processing: Children with language problems often have related auditory processing difficulties - particularly in the ADHD population. Problems can be found in the areas of speed of processing, auditory memory, auditory attention, processing of auditory information, auditory analysis and auditory discrimination. Following directions or getting information from reading and listening can be a nightmare for such children. Metacognition: This is the ability to think about thinking in general. To know what you know and to understand what you need to know in order to learn effectively. Students with difficulties in this area cannot easily deal with the strategies involved in problem solving. What makes the ADHD child with a language problem different to other children with language problems? The child with ADHD is more likely to have language processing difficulties than a simple language delay. There may be no early developmental history of speech and language problems - the language problems may only become apparent as the child progresses through the school system. This is particularly relevant in the clever, even gifted, student with subtle language problems and ADHD. In particular, the ADHD child with language problems can have auditory processing difficulties such as:
Learning styles and ADHD The student with ADHD is likely to have difficulties with the learning style supported by the school system - that of being a good listener, being able to sit and focus for extended periods of time and of having good reading and oral language skills. The use of learning styles as a therapeutics and diagnostic tool gives an added dimension to the role of the Speech Language Pathologist working with school-aged children and adolescents. Considering learning styles broadens the approaches taken in intervention and helps in the development of strategies for the general management of language-related problems. Children with language difficulties are often unaware of their own thinking and learning processes - they have poorly developed metacognition. They either do not know that there are certain strategies that can be used to help their learning or they use the wrong strategies for their particular learning style. Analyzing the child's learning style can give invaluable information to help you understand how best to support the child's learning. One method of describing that learning style is the Visual - Auditory - Kinaesthetic - Print-Orientated - Interactive (VAK POINT) model developed by Glenn Capelli. Some common characteristics of these learning styles are: Visual learners
Children with school-based learning difficulties are often deficient in one or more of these learning modalities and need to focus their learning on the area that is their greatest strength - as well as building up the weaker areas. Typically, the child with ADHD and language problems struggles with the auditory and print-orientated styles of learning. Interestingly, some who struggle with visual learning also have language-based problems - usually related to organization, planning and overall 'whole picture' understanding of language-based skills. Strategies to help children with language processing problems The 'pulse style' approach to learning One strategy that is useful in dealing with the ADHD child with language processing problems is recommending a 'pulse style' approach to learning. This can be applied to any learning task and is a great way to get optimal learning happening. See Diffused learning patterns. Classroom and parent management strategies See Strategies for students with auditory processing difficulties. Teaching to learn styles If the ADHD student with a language disorder has problems with a particular style of learning e.g. auditory learning, try to work with their most successful learning style, say kinaesthetic, in order to support the weaker style. For example, a student with weak auditory learning skills and strong kinaesthetic skills benefits from being physically involved in the learning process. If the class if doing a 'listening type task' it would be helpful if the ADHD child was demonstrating something or holding something rather than just 'listening'. It is also very difficult for the poor listener to cope with comments like 'I am only going to say this once!' - the added anxiety this causes makes the learning even harder. Summary Not all students with ADHD have language problems - and the types of language problems seen in ADHD can also be seen in children without ADHD. However, problems with information processing frequently include language-related difficulties and these have to be dealt with at home, school, socially and in a learning environment. Back to top of page Click to view information on: Diffused learning patterns Strategies for students with auditory processing difficulties Strategies for children who have confused story-telling skills Visual learning strategies Diffused learning patterns Have you ever wondered why you might start to fall asleep when listening to someone lecturing or why your child gets restless after a few minutes of concentrated work? It seems our brains need 'time out' from concentrated learning (diffusion) so that they can keep focused on the task in hand - see the diagram below… Optimal learning pattern for 10-year-old students  This means doing things like: ...Read for 10 minutes, move around for 2 minutes, then write for 10 minutes... Younger children can concentrate for shorter periods before spacing out or becoming agitated. Add 2 minutes to your child's age, up to a maximum of 20 minutes, and that's the limit for optimal concentration. For example, a 5-year-old can work for about 7 minutes before becoming 'brain tired' and starting to lose concentration. An ADHD student will need even less time between breaks - experiment with your child! Breaks can be simple e.g. run to the toilet and back, stretch and bend several times, throw and catch a soft ball, use an indoor basketball hoop, swap to asking questions instead of reading. Homework, study and project activities can be completed with fewer tears, raised voices and family upsets when breaks are regular and often. Your children will also feel more confident in their ability to work well! Strategies for students with auditory processing difficulties Students with auditory processing difficulties may have problems in some or all of the following areas:
Strategies for children who have confused story-telling skills Children with poor story-telling skills may have problems in some or all of the following areas:
Visual Learning Strategies Visual learning strategies are great for students with oral and reading comprehension difficulties. These include: Memory mapping (Mind Maps, Learning Maps etc)  Visualization techniques These can include the Visualizing and Verbalizing Programme, simple visualization exercises that you may devise, and using strong visual representation in your teaching. Remember - these students may be slower to process information than others - so keep the visual information around until they have finished with it. Instructions for class work, assignments etc need to be clearly written down. These students often find it difficult to translate verbal instructions accurately - and may end up doing the wrong work. Use Post-it pads for multiple purposes - great for quick memory jogs! Comprehension passages
As well as memory mapping, try the following:
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