2007 Revista sNpcAR Vol. 10 NR.

2 9
1. language and ADHD
Although speech and learning disorders
are common in children with ADHD (about
20% have reading diffculties and 60% have
serious handwriting problems), the disorder
does not affect intelligence. People with the
problem span the same IQ range as the general
population. It was suggested, however, that
lIMbAj, coMuNIcARe, NVARe I ADHD
o AboRDARe DeVelopMeNTAl
lANGuAGe, coMMuNIcATIoN, leARNING AND ADHD
A DeVelopMeNTAl AppRoAcH
Dana cristina Hera, Felicia Iftene
1,2 - UMPh Iuliu Haieganu Cluj-Napoca
90% of ADHD children were underachievers
and that half were held back at least once.
The child or adolescent with ADHD and
learning problems will often present to the
Speech Language Pathologist with a complex
range of clinical problems, covering all the
modalities of language, that are contributing
to the learning disorder. Typically problems
are experienced in:
Abstract
Development of language is an essential tool for proper understanding of social contexts,
communication, development of social skills and learning. The core symptoms of the attention
defcit hyperactivity disorder (ADHD) include diffculties in sustaining attention and in listening,
forgetfulness, poor task completion, poor organizing and mistakes with tasks that require attention;
on the other hand, development of attention span is the background for basic and complex language
skills (fuent speech, writing, reading, conversation, grammar, phonetics, topic and syntax). This
may be the explanation for language disorders in children diagnosed with ADHD, ranging from
delays in speech (the so-called late talkers) to improper use of syntax, topics or grammar rules,
lack of coherence in stories or writing, and also the cornerstone for a comprehensive assessment
and management (based on needs) in children with ADHD.
Rezumat
Dezvoltarea limbajului este un instrument esenial n nelegerea contextelor sociale,
comunicare, abiliti de socializare, nvare. Simptomele de nucleu ale tulburrii hiperkinetice cu
defcit atenional (ADHD) include difculti de meninere a ateniei, de ascultare, uitare, probleme
de organizare, fnalizare i greeli n sarcinile ce necesit atenie susinut; pe de alt parte,
dezvoltarea ateniei este fundalul pentru achizitionarea abilitilor fundamentale i complexe de
limbaj (vorbire, fuen, scris, citit, conversaie, gramatic, fonetic, topic i sintax). Aceasta ar
putea explica problemele de limbaj la copiii diagnosticai cu ADHD, de la ntrziere n achiziia
limbajului expresiv (aa-numiii late talkers) pn la utilizare neadecvat a sintaxei, topicii sau
regulilor gramaticale, coerena sczut n naraiune sau exprimarea scris, i n acelai timp
temelia pentru o evaluare i intervenie complex (bazat pe nevoi) la copiii cu ADHD.

10 Revista sNpcAR Vol. 10 NR. 2 2007
syntax: Disorders of oral and written
grammar, diffculties using and / or
comprehending the structural components of
sentences.
semantics: Problems with word
meanings and organization, including
diffculties comprehending written and spoken
language, poor vocabulary, word-fnding
diffculties and diffculties using context to help
with the comprehension of reading.
Pragmatics: The social use of language
- the ability to use language as a means to
interact with others socially or for a specifc
purpose ( requesting information, expressing
feelings, holding a conversation with people
of different age levels).
Metalinguistics: The ability to refect on
language objectively, to understand language
as a rule-bound code, to use humour,
multimeaning in words, ambiguity, fgurative
language (metaphors), ability to segment
words into syllables or sounds.
Auditory processing: Related problems
in the areas of speed of processing, auditory
memory, auditory attention, processing of
auditory information, auditory analysis and
auditory discrimination, with subsequent
diffculties in tasks such as following directions or
getting information from reading and listening.
Metacognition: Diffculties in 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,
with subsequent impairment in 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
diffculties than a simple language delay.
There may be no early developmental history
of speech and language problems, and the
language problems may only become apparent
during school years, especially in the clever,
gifted students with subtle language problems
and ADHD. In particular, the ADHD child with
language problems can experience:
Auditory processing diffculties such
as: short-term auditory memory weakness,
problems following instructions, slow speed
of processing written and spoken language,
diffculties listening in distracting environments
(the classroom), problems in listening for
information when someone is talking or
reading expecting them to listen, missing out
on details, or getting the details but without
grasping the main idea, problems in reading
comprehension
Language diffculties related to
impulsivity and poor organizational skills
resulting in: problems with classroom discourse,
poor writing skills, tangential narratives
and conversations, word-fnding problems,
diffculties inferring meaning - looking beyond
the obvious, problems with generative
language, social language problems
1. learning strategies and ADHD
The student with ADHD is likely to have
diffculties 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. Children learn by their
individual learning styles and teachers tend to
teach in a way that complements their own
learning style. This is one reason children may
learn well with one teacher and not another.
Children with language diffculties are often
unaware of their own thinking and learning
processes; 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.
The use of learning styles as a 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
2007 Revista sNpcAR Vol. 10 NR. 2 11
approaches taken in intervention and helps in
the development of strategies for the general
management of language-related problems.
Analyzing the childs learning style can give
invaluable information to help you understand
how best to support the childs learning. Some
common characteristics of these learning
styles are:
Visual learners
Learn best by looking, watching and
observing, seeing how things are done
Enjoy poster, visual overhead, colours
and videos
Doodle and draw, use information
mapping systems, visualize inside their heads
Auditory learners
Learn well by listening and
communicating with others, from audiotapes
Learn through rhythm and rhyme
Have good auditory discrimination and
auditory attack skills for reading
Learn languages easily
Kinaesthetic learners
Use their hands, feelings and whole
bodies to learn
Create things, make things, pull things
apart and rebuild them
print-orientated learners
Read and write to learn and for
pleasure, have good reading comprehension
Interactive learners
Learn well by interacting with others,
from discussion and dialogue
Group work and co-operative learning,
social fexibility, ability to lead/ follow
Children with school-based learning
diffculties are often defcient 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
- Pulse style approach to learning: this
is very useful in children with ADHD, can be
applied to any learning task and is a great
way to get optimal learning happening (see
also Picture 1)
- Classroom and parent management
strategies
- 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 in order to support the weaker
style. For example, a student with weak
auditory learning skills and strong kinaesthetic
skills benefts 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 diffcult 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.
Picture 1: 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...

12 Revista sNpcAR Vol. 10 NR. 2 2007
References:
1. American psychiatric Association:
Manual de diagnostic i statistic a tulburrilor
mentale, DSM-IV-TR, 2000, ediia a patra
revizuit, editura Asociaiei psihiatrilor liberi
din Romnia, Bucureti 2003
2. Mircea, T.: Tratat de psihopatologie i
sntate mental a copilului i adolescentului,
Vol. I, Artpress, Timioara 2004
3. Mircea, T.: Tratat de psihopatologie i
sntate mental a copilului i adolescentului,
Vol. II, Artpress, Timioara 2006
4. Rowland, As, lesesne, cA, &
Abramowitz, AJ. (2002). The epidemiology
of attention-defcit/hyperactivity disorder
(ADHD): a public health view. Ment Retard
Dev Disabil Res Rev, 8(3): 162-170.
5. sadock, benjamin j., sadock,
Virginia A.: Manual de buzunar de psihiatrie
clinic, ediia a III-a, Lippincott Williams
Wilkins, Editura Medical, 2001
6. semple D., smyth R., burns j.,
Darjee R., McIntosh A.: Oxford Handbook of
Psychiatry, Oxford University Press, Oxford
2005
7. Weiss M, Worling D, Wasdell M.:
A chart review study of the inattentive and
combined types of ADHD, J Atten Disord.
2003 Sep;7(1):1-9.