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1 Esther Parigger. 13-04-07.
The relation between Attention Deficit Hyperactivity Disorder (ADHD) and
(Specific) Language Impairment ((S)LI)
Esther Parigger
LEXEF 2007
2 Esther Parigger. 13-04-07.
Overview Diagnoses ADHD and SLIDiscussion (part 1)
Comorbidity: ADHD and (S)LI / (S)LI and ADHDDiscussion (part 2)
Possible relationships Discussion (part 3)
3 Esther Parigger. 13-04-07.
ADHD Diagnosis
Symptoms (division in subtypes)-present before 7 years of age-present in two or more settings-significant impairment in functioning-not accounted for by another disorder
APA, 2000
Symptoms of inattentionSymptoms of hyperactivity/impulsivity Predominantly inattentive subtype
Predominantly hyperactive/impulsive subtype Combined subtype
Problem: diagnosed on the basis of clinical evaluation.
Problem (?): language items are included in the symptom list.
4 Esther Parigger. 13-04-07.
ADHD
Hoffmann, 1845
‘Filip de Schommelaar’
Hyperactivity
Impulsivity
‘Hans Kijk-in-de-Lucht’
•Inattention
5 Esther Parigger. 13-04-07.
SLI Diagnosis
ExclusionSeverity
Impaired hearingEmotional and behavioral problemsPIQ < 85Neurological deficits/ lesionsSpeech motor skill deficienciesLow reading age
LA Receptive < MAP/CA (6 mo.) LA Expressive < MAP/CA (12 mo.)LA Overall < MAP/CA (6 mo.)
Problem: diagnosed on the basis of exclusion.
Stark and Tallal, 1981Bishop, 1994; Botting, 2005
Problem: no behavioral problems allowed..
7 Esther Parigger. 13-04-07.
Discussion (part 1)
What do you think about the ADHD and SLI diagnoses?
8 Esther Parigger. 13-04-07.
Comorbidity Problems
Used descriptively(A)symptomatic overlapAssessment
Definition (for now): “the presence of more than one specific disorder in a person in a defined period of time”
Wittchen, 1996; Burke et al., 1990
9 Esther Parigger. 13-04-07.
Comorbidity with ADHD Conduct disorder, oppositional defiant disorder Mood disorders, anxiety disordersTourette’s syndrome, chronic tics Language problems, learning disorders
Prevalence rates vary!
Cantwell, 1996; Jónsdottír, 2006;Cohen et al., 1998; Blankenstijn en Scheper, 2003
10 Esther Parigger. 13-04-07.
Comorbidity with ADHD: ADHD and language problems
Subtle problems in language comprehension
More robust problems in language productionSyntaxPragmatics
Parigger and Baker, 2005
11 Esther Parigger. 13-04-07.
Comorbidity with ADHD: ADHD and language problems Percentage of worded plot elements in Frog-stories
Total score-effect of diagnosis: ADHD<N-effect of age: 7<8<9
Parigger, in prep (a); Blankenstijn and Scheper, 2003; Tannock; 1993; Trabasso and Rodkin (in Berman and Slobin), 1994
12 Esther Parigger. 13-04-07.
Comorbidity with SLI E.g. motor abnormalities, reading disabilities, nonverbal IQ’s at the lower end of the normal range, social problems, attention deficit disorders etc.
”SLI is thus rarely specific, and for this reason, it has been argued that there is a need for a change in terminology”
Webster 2004: 473
13 Esther Parigger. 13-04-07.
Comorbidity with SLI:SLI and ADHD symptoms
23% of 200 children with SLI (11 years old) scored in the atypical range of the ADHD scale of the SDQ
SLI group without and SLI group with ADHD symptoms differed, mainly in expressive language tasks with semantic (pragmatic?) content
Botting, 2006 (poster)
14 Esther Parigger. 13-04-07.
Discussion (part 2)
Are ADHD en (S)LI comorbid disorders or is (S)LI secondary to ADHD (or vice versa)?
15 Esther Parigger. 13-04-07.
Possible relationshipsbetween PI and LI
Unicausal comorbidity:(third risk factors) PI LI (third risk factors) LI PI
Dependent causal comorbidity:(third risk factors) LI/PI LI/PI
Blankenstijn en Scheper, 2003: 20
16 Esther Parigger. 13-04-07.
Possible relationship between ADHD and language problems
Executive Dysfunction Theory
“We theorize that the core behavioral symptoms of ADHD (…) and the pragmatic difficulties that these children exhibit (…) are related to deficits in executive function (i.e. higher-order cognitive processes).”
Tannock and Schachar, 1996: 147
17 Esther Parigger. 13-04-07.
Main study
Comparison of language profiles and cognitive profiles of children with ADHD, SLI and normally developing children (7 and 8 years of age)
Parigger, in prep (b).
18 Esther Parigger. 13-04-07.
Discussion (part 3)
Is it plausible to think that a specific executive functioning profile can be related to a specific language profile in ADHD?
19 Esther Parigger. 13-04-07.
More information:
E: [email protected] W: http://home.medewerker.uva.nl/e.m.pariggerT: 0031-20-5253811
I’ll upload a hand-out for you!
Thanks for this discussion!