Identifying demographic and language profiles of children with a primary diagnosis of attention deficit hyperactivity disorder

Task difficulty and private speech in typically developing and at-risk preschool children

Private speech is a cognitive tool to guide thinking and behavior, yet its regulatory use in atypical development remains equivocal. This study investigated the influence of task difficulty on private speech in preschool children with attention or language difficulties. Measures of private speech use, form and content were obtained while 52 typically developing and 25 developmentally at-risk three- to four-year-old children completed Duplo construction and card sort tasks, each comprising two levels of challenge. In line with previous research, developmentally at-risk children used less internalized private speech than typically developing peers. However, both typically developing and at-risk children demonstrated a similar regulatory private speech response to difficulty with no systematic evidence of group difference. This was captured by an increase in all utterances, reduced private speech internalization, and more frequent forethought and self-reflective content. Results support the hypothesis of delayed private speech internalization but not regulatory deviance in atypical development.

Clinical Intersections Among Idiopathic Language Disorder, Social (Pragmatic) Communication Disorder, and Attention-Deficit/Hyperactivity Disorder

Purpose Estimates of the expected co-occurrence rates of idiopathic language disorder and attention-deficit/hyperactivity disorder (ADHD) provide a confusing and inconsistent picture. Potential sources for discrepancies considered so far include measurement and ascertainment biases (Redmond, 2016a, 2016b). In this research symposium forum article, the potential impact of applying different criteria to the observed co-occurrence rate is examined through an appraisal of the literature and an empirical demonstration. Method Eighty-five cases were selected from the Redmond, Ash, et al. (2019) study sample. Standard scores from clinical measures collected on K-3rd grade students were used to assign language impairment status, nonverbal impairment status, social (pragmatic) communication disorder status, and ADHD status. Criteria extrapolated from the specific language impairment (Stark & Tallal, 1981), developmental language disorder (Bishop et al., 2017), and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder (American Psychiatric Association, 2013) designations were applied. Results The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition language disorder designation and its separation of language disorder from the social (pragmatic) communication disorder designation provided the clearest segregation of idiopathic language deficits from elevated ADHD symptoms, showing only a 2% co-occurrence rate. In contrast, applying the broader developmental language disorder designation raised the observed co-occurrence rate to 22.3%. The specific language impairment designation yielded an intermediate value of 16.9%. Conclusions Co-occurrence rates varied as a function of designation adopted. The presence of pragmatic symptoms exerted a stronger influence on observed co-occurrence rates than low nonverbal abilities. Impacts on clinical management and research priorities are discussed. Presentation Video https://doi.org/10.23641/asha.13063751.

Self-directed speech and self-regulation in childhood neurodevelopmental disorders: Current findings and future directions

Self-directed speech is considered an important developmental achievement as a self-regulatory mediator of thinking and behavior. Atypical self-directed speech is often implicated in the self-regulatory challenges characteristic of children with neurodevelopmental disorders. A growing body of evidence provides snapshots across age-levels and diagnoses, often presenting conflicting results. This systematic review is undertaken to impose clarity on the nature, extent, and self-regulatory implications of self-directed speech interruption in children with developmental language disorder (DLD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD).A rigorous search process of relevant databases (i.e., PsychInfo, PubMed, CINAHL, ERIC) uncovered 19 relevant peer-reviewed articles that investigate self-directed speech in children with neurodevelopmental disorders. Consistent across the research, children with DLD, ASD, and ADHD present with differential development and use of self-directed speech.In its synthesis of findings, this systematic review clearly explicates the differential ontogenesis of self-directed speech in neurodevelopmental disorders and interprets the self-regulatory implications for children with DLD, ASD, and ADHD. Furthermore, the review spotlights important future research directions to better understand the mechanistic relationship between self-directed speech and self-regulation.

Language Impairment in the Attention-Deficit/Hyperactivity Disorder Context

PURPOSE

Attention-deficit/hyperactivity disorder (ADHD) is a ubiquitous designation that affects the identification, assessment, treatment, and study of pediatric language impairments (LIs).

METHOD

Current literature is reviewed in 4 areas: (a) the capacity of psycholinguistic, neuropsychological, and socioemotional behavioral indices to differentiate cases of LI from ADHD; (b) the impact of co-occurring ADHD on children's LI; (c) cross-etiology comparisons of the nonlinguistic abilities of children with ADHD and specific LI (SLI); and (d) the extent to which ADHD contributes to educational and health disparities among individuals with LI.

RESULTS

Evidence is presented demonstrating the value of using adjusted parent ratings of ADHD symptoms and targeted assessments of children's tense marking, nonword repetition, and sentence recall for differential diagnosis and the identification of comorbidity. Reports suggest that the presence of ADHD does not aggravate children's LI. The potential value of cross-etiology comparisons testing the necessity and sufficiency of proposed nonlinguistic contributors to the etiology of SLI is demonstrated through key studies. Reports suggest that children with comorbid ADHD+LI receive speech-language services at a higher rate than children with SLI.

CONCLUSION

The ADHD context is multifaceted and provides the management and study of LI with both opportunities and obstacles.

Markers, Models, and Measurement Error: Exploring the Links Between Attention Deficits and Language Impairments

PURPOSE

The empirical record regarding the expected co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and specific language impairment is confusing and contradictory. A research plan is presented that has the potential to untangle links between these 2 common neurodevelopmental disorders.

METHOD

Data from completed and ongoing research projects examining the relative value of different clinical markers for separating cases of specific language impairment from ADHD are presented.

RESULTS

The best option for measuring core language impairments in a manner that does not potentially penalize individuals with ADHD is to focus assessment on key grammatical and verbal memory skills. Likewise, assessment of ADHD symptoms through standardized informant rating scales is optimized when they are adjusted for overlapping language and academic symptoms.

CONCLUSION

As a collection, these clinical metrics set the stage for further examination of potential linkages between attention deficits and language impairments.