The responsibilities of speech-language pathologists toward children with ADHD

A New Perspective of Attention Deficit Hyperactivity Disorder Associated With Delayed Language Development: An Egyptian Sample

OBJECTIVE

The current study aimed to get an easy objective method to detect attention deficit hyperactivity disorder (ADHD) by investigating the simple inflammatory blood ratios platelet/lymphocyte ratio (PRL), neutrophil/lymphocyte ratio (NLR) & the monocyte/lymphocyte ratio (MLR), for the sake of receiving early management to such cases and overcoming language affection as a comorbid symptom.

METHODS

This study was conducted on two groups: Group 1 (SG) consisted of 70 ADHD children who had delayed language development (DLD), freshly diagnosed, according to DSM-V criteria, and those patients were not on medical treatment. Group 2 healthy group (HG) consisted of 44 healthy control normal children that were both physically and mentally free of the same socio-demographic characters of the first group.

RESULTS

The PLR, NLR and MLR, were significantly higher in the ADHD group than the healthy control group (HG) group, although the simple blood indices were average.

CONCLUSION

Inflammation has a role as a comorbid cause of ADHD. Simple blood inflammatory mediators may be used as comorbid factors in ADHD. This study explained that the language abilities must be taken in consideration when assessing children with ADHD. The screening tools for inflammatory markers are important when dealing with ADHD children with/ without delayed language development (DLD). Also, working memory assessment is mandatory in ADHD with DLD to assign a special program in language therapy for each child.

Research Review: Language problems in children with Attention-Deficit Hyperactivity Disorder - a systematic meta-analytic review

BACKGROUND

Children with Attention-Deficit Hyperactivity Disorder (ADHD) appear to have a higher risk of language problems compared with typically developing children, although the types of language problems experienced are less clear. This review aims to establish the types of language problems experienced by children with ADHD according to systematically reviewed literature and determine the empirical evidence for language problems in children with ADHD compared with non-ADHD controls.

METHODS

A standardized search protocol was used on databases: CINAHL, Medline, and PsychINFO. We identified studies with the following inclusion criteria: (a) confirmed ADHD status at the time of the study, (b) inclusion of a non-ADHD control group, (c) use of a validated language measure, and (d) age ≤ 18. t-Tests, Pearson's r, and Hedges g effect sizes (ES) were calculated using summary statistics. Random effects meta-analyses were conducted for the language domain suitable for analysis. Publication bias was investigated using both the trim and fill and p-curve techniques.

RESULTS

Twenty-one studies were included in the systematic review (ADHD = 1,209; Control = 1,101), within which 60 of 68 separate analyses found significant differences between the ADHD and control group on the language measures (p < .05). Follow-up meta-analyses found evidence for large deficits in the ADHD groups overall (10/11 studies met p < .05; weighted mean ES [WMES]: 1.04); expressive (10/10 met p < .05; WMES: 1.23); receptive (12/14 met p < .05; WMES: 0.97), and pragmatic language (4/4 studies met p < .05; WMES: 0.98) compared with controls.

CONCLUSIONS

This study demonstrates that children with ADHD have poorer performance on measures of overall, expressive, receptive, and pragmatic language compared with controls. A screening of language functioning may be a valuable addition to the assessment of ADHD.

Family history interview of a broad phenotype in specific language impairment and matched controls

The aim was to study a broader phenotype of language-related diagnoses and problems in three generations of relatives of children with specific language impairment (SLI). Our study is based on a family history interview of the parents of 59 children with SLI and of 100 matched control children, exploring the prevalence of problems related to language, reading, attention, school achievement and social communication as well as diagnoses such as attention-deficit hyperactivity disorder (ADHD), autism, Asperger syndrome, dyslexia, mental retardation, cleft palate and stuttering. The results show a spectrum of language-related problems in families of SLI children. In all three generations of SLI relatives, we found significantly higher prevalence rates of language, literacy and social communication problems. The risk of one or both parents having language-related diagnoses or problems was approximately six times higher for the children with SLI (85%) than for the control children (13%) (odds ratio = 37.2). We did not find a significantly higher prevalence of the diagnoses ADHD, autism or Asperger syndrome in the relatives of the children with SLI. However, significantly more parents of the children with SLI had problems with attention/hyperactivity when compared with the parents of controls. Our findings suggest common underlying mechanisms for problems with language, literacy and social communication, and possibly also for attention/hyperactivity symptoms.

Cognitive Processing and Narrative Discourse Production in Children with ADHD

Children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) have cognitive processing difficulties due to their disinhibition and attention deficits, which influence their scholastic performance. Cognitive processing also impacts on the production of oral narratives, an essential skill required for academic success. Therefore the relationship between cognitive processing and oral narratives is investigated. Thirty males, aged 9–11 years, were selected from English medium remedial schools and were assessed on the Cognitive Assessment System (CAS). The results were correlated to their performance on two narrative tasks, involving a Picture Sequence and a Personal Narrative. Measures of Cohesion and Coherence were analysed quantitatively. Participants' low Planning and Attention scores in this study confirmed the validity of the CAS as a diagnostic device for ADHD but were not significantly related to their oral narrative production. However, their approach to the task indicated insufficient use of planning. The structured task (picture sequence) yielded more complex stories than the unstructured task (personal narrative), which may be reflective of the participants' attention deficits. The findings suggest that narrative measures are useful instruments for oral language evaluation in children with ADHD. In addition, the importance of understanding oral narratives within a therapeutic situation is important for both therapist and child.

Proposta de instrumento comportamental para avaliar a atenção auditiva sustentada

A atenção sustentada e vigilância são alguns dos processos que caracterizam a atenção e fundamentais para o desenvolvimento de algumas habilidades. OBJETIVO: Propor um instrumento comportamental simples, de fácil e rápida aplicação para auxiliar na avaliação da habilidade de atenção auditiva sustentada. Estudo prospectivo. MATERIAL E MÉTODO: Crianças voluntárias de 6 a 11 anos de idade, 139 do gênero feminino e 141 do masculino. O teste foi denominado Teste da Habilidade da Atenção Auditiva Sustentada e baseado no Teste de Desempenho Contínuo. Consiste na apresentação biaural e diótica, de uma lista de 100 palavras monossilábicas nas quais estão inclusas 20 vezes o monossílabo que deverá ser identificado. Esta lista é apresentada seis vezes sem interrupção. É realizado em cabina acústica, com auxílio de um CD player acoplado a um audiômetro de dois canais a 50 dBNS e tem uma duração média de 9 minutos.O resultado do teste é obtido pela pontuação total e pelo decréscimo de vigilância. RESULTADOS: A obtenção dos resultados mostrou-se fácil e rápida. Não foi encontrada significância estatística nos resultados para ambos os gêneros, porém significativa diferença foi encontrada entre as idades. CONCLUSÃO: O teste proposto não apresentou qualquer desconforto às crianças participantes e mostrou-se altamente sugestivo para avaliar a habilidade de atenção auditiva sustentada em crianças.

A proposed behavioral tool to assess sustained auditory attention

Sustained attention and vigilance are processeses that characterize attention, and are essential for the development of certain abilities

Aim

a prospective study to propose a simple, easy and quick behavioral tool to support the assessment of sustained auditory attention.

Material and methods

volunteer children aged between 6 and 11 years (139 female and 141 male) were selected. The test was named Sustained Auditory Attention Ability Test, and is based on the Continuous Performance Test. It consist of a binaural and diotic presentation of a list of 100 monosyllabic words in which a target monosyllable is included 20 times. This list was presented six times with no breaks. The test was carried out in a soundproofed room, using a CD player attached to a two-channel audiometer at 50 dBSL during 9 minutes. The test resulted in a total score and a vigilance decrement.

Results

There was no statistically significant difference between genders, but a significant difference was found between ages.

Conclusion

The proposed test had no discomfort for the participants, and was shown to be extremely promising to assess the sustained auditory attention ability in children.

Cognitive functioning in children with and without Attention-deficit/Hyperactivity Disorder with and without comorbid learning disabilities

This study attempted to determine whether children with the combined subtype of attention-deficit/hyperactivity disorder (ADHD) have impairments in cognitive functioning and motor skills. The specific effect of the comorbidity of learning disabilities (LD) was also investigated. A battery of cognitive tests was administered to 26 children with a clinical diagnosis of ADHD-combined subtype (ADHD/C), to 24 children with ADHD/C with a comorbid diagnosis of LD (ADHD/C+LD), and to 102 participants without disabilities, all between ages 7 and 10. The testing battery consisted of tasks assessing memory, visuospatial and verbal abilities, and fine motor skills. In general, the test results of children with ADHD/C were poorer than those of the control group but better than the results of children with a combined ADHD/C+LD diagnosis (with the exception of motor skills). The predictive accuracy of the testing battery tasks in children with ADHD/C and ADHD/C+LD was examined. The results of a standard procedure of discriminant function analyses revealed that the measures correctly classified 73.6% of the children.

ADHD and language impairment: A study of the parent questionnaire FTF (Five to Fifteen)

The parental questionnaire FTF (Five to Fifteen) was given to parents of 76 children (mean age 11 years) diagnosed with ADHD. About half of the children had at least once been referred to a speech- and language pathologist. Most of them had not received any intervention or follow-up. A factor analysis identified six problem areas, which explain close to 75% of the total variation: Cognitive Skills, Motor/Perception, Emotion/Socialisation/Behaviour, Attention, Literacy Skills and Activity Control. The majority of the children had pragmatic problems, which are associated with some of the core aspects of the ADHD symptoms, especially inattention and impulsiveness. Communication and language comprehension caused these children many more problems than expressive language. Problems of reading and writing were very frequent. IQ-score was associated with maths and reading/writing. Additional items reflecting language skills, in particular language comprehension and pragmatics, were also found in other domains in the FTF, mainly in Executive functions, Learning and Social skills. Problems with language and pragmatics thus seem to be associated with the typical problems with learning and social skills in children with ADHD.