Pragmatic language difficulties in children with hyperactivity and attention problems: an integrated review

Cognitive and behavioural predictors of adolescents' communicative perspective-taking and social relationships

Given the pivotal role that social interactions play for adolescents' well-being, understanding the factors that influence communication is key. The present study examined relations between adolescents' communicative perspective-taking, executive function skills, and ADHD traits and explored the role communicative perspective-taking plays in peer relations. Data was collected from a community sample of 15 to 19-years-olds (N = 46) in Waterloo, Canada. Two communicative perspective-taking tasks required participants to infer speakers' communicative intentions. A battery of tasks assessed adolescents' working memory and inhibitory control. Elevated ADHD traits were associated with weaker working memory, inhibitory control, and communicative perspective-taking. Working memory was the strongest predictor of communicative perspective-taking. Highlighting the importance of communicative perspective-taking for social interactions, adolescents with weaker skills in this area reported worse peer relations. Findings underscore the importance of communicative perspective-taking for adolescents' social relations and have relevance for understanding the social difficulties faced by adolescents with elevated ADHD traits.

Disfluency characteristics of children with attention-deficit/hyperactivity disorder symptoms

The purpose of the current study was to investigate the characteristics of speech disfluency in 15 children with attention-deficit/hyperactivity disorder (ADHD) symptoms and 15 age-matched control children. Reading, story retelling, and picture description tasks were used to elicit utterances from the participants. The findings indicated that children with ADHD symptoms produced significantly more stuttering-like disfluencies (SLD) and other disfluencies (OD) when compared to the control group during all three tasks. Further statistical analysis showed that children with ADHD symptoms produced more OD during the story retelling task than the other two tasks, whereas no significant differences in OD were observed among the three tasks in the control children. Finally, children with ADHD symptoms exhibited a higher proportion of SLD in total disfluencies (TD) than the control children. These results are consistent with previous studies that children with ADHD are disfluent in their verbal production. Furthermore, children with ADHD symptoms seem to be more vulnerable to a speaking task that places greater demands on their attentional resources for language production, resulting in increased speech disfluencies.

Language Problems and ADHD Symptoms: How Specific Are the Links?

Symptoms of inattention and hyperactivity frequently co-occur with language difficulties in both clinical and community samples. We explore the specificity and strength of these associations in a heterogeneous sample of 254 children aged 5 to 15 years identified by education and health professionals as having problems with attention, learning and/or memory. Parents/carers rated pragmatic and structural communication skills and behaviour, and children completed standardised assessments of reading, spelling, vocabulary, and phonological awareness. A single dimension of behavioural difficulties including both hyperactivity and inattention captured behaviour problems. This was strongly and negatively associated with pragmatic communication skills. There was less evidence for a relationship between behaviour and language structure: behaviour ratings were more weakly associated with the use of structural language in communication, and there were no links with direct measures of literacy. These behaviour problems and pragmatic communication difficulties co-occur in this sample, but impairments in the more formal use of language that impact on literacy and structural communication skills are tied less strongly to behavioural difficulties. One interpretation is that impairments in executive function give rise to both behavioural and social communication problems, and additional or alternative deficits in other cognitive abilities impact on the development of structural language skills.

Mother-Child Communication: The Influence of ADHD Symptomatology and Executive Functioning on Paralinguistic Style

Paralinguistic style, involving features of speech such as pitch and volume, is an important aspect of one's communicative competence. However, little is known about the behavioral traits and cognitive skills that relate to these aspects of speech. This study examined the extent to which ADHD traits and executive functioning (EF) related to the paralinguistic styles of 8- to 12-year-old children and their mothers. Data was collected via parent report (ADHD traits), independent laboratory tasks of EF (working memory, inhibitory control, and cognitive flexibility), and an interactive problem-solving task (completed by mothers and children jointly) which was coded for paralinguistic speech elements (i.e., pitch level/variability; volume level/variability). Dyadic data analyses revealed that elevated ADHD traits in children were associated with a more exaggerated paralinguistic style (i.e., elevated and more variable pitch/volume) for both mothers and children. Mothers' paralinguistic style was additionally predicted by an interaction of mothers' and children's ADHD traits, such that mothers with elevated ADHD traits showed exaggerated paralinguistic styles particularly when their children also had elevated ADHD traits. Highlighting a cognitive mechanism, children with weaker inhibitory control showed more exaggerated paralinguistic styles.

Psychosoziale Belastungen bei Sprachentwicklungsstörungen

Zusammenfassung. Die umschriebenen Entwicklungsstörungen des Sprechens und der Sprache gehören zu den häufigsten Entwicklungsstörungen. Aufgrund der zentralen Bedeutung sprachlicher Kompetenzen für verschiedene Lebensbereiche beeinträchtigen Sprachentwicklungsstörungen nicht nur die schulische, sondern auch die soziale und emotionale Entwicklung eines Kindes und wirken bis ins Jugend- und Erwachsenenalter hinein. Es folgt eine Übersicht über die psychosozialen Belastungen bei betroffenen Kindern und Jugendlichen sowie ihren Angehörigen. Kinder mit Sprachentwicklungsstörungen tragen ein erhöhtes Risiko für komorbide internalisierende und externalisierende Störungen sowie für Schwierigkeiten mit Gleichaltrigen, die im Jugendalter zunehmend an Bedeutung gewinnen. Eltern von Kindern mit Sprachentwicklungsstörungen weisen im Vergleich zur Allgemeinbevölkerung höhere Stress- und Depressionswerte auf, die insbesondere durch die mangelnde Akzeptanz und Unterstützung durch das soziale Umfeld beeinflusst werden. Es existieren zu wenig therapeutische Angebote, die auf die besondere Situation der Betroffenen angepasst sind. Die Implikationen für Forschung und klinische Praxis werden diskutiert.

Evaluating the pragmatic language skills of children with ADHD and typically developing playmates following a pilot parent-delivered play-based intervention

BACKGROUND/AIM

Children with attention deficit hyperactivity disorder (ADHD) often present with pragmatic language deficits and difficulties with peer-peer friendships. Parents and typically developing peers (TDPs) may be able to assist via parent and peer-mediated intervention approaches when adequately supported by trained adult facilitators. This study investigated whether a parent-delivered play-based intervention supported by occupational therapists and speech language pathologists was feasible and improved the pragmatic language skills of children with ADHD and their TDPs.

METHODS

Nine children with ADHD paired with nine TDPs (mean age = 8.2 years) participated. The seven-week intervention was delivered by parents of children with ADHD at their home and consisted of weekly assigned home-based modules, supported play-dates between the pairs of children and supplemented by three clinic visits. Parent adherence to intervention activity was monitored on a weekly basis. Blinded ratings of observed peer-peer play interactions were used to detect changes in pragmatic language from pre-post intervention and one month follow-up using the Pragmatic Observation Measure (POM).

RESULTS

All parents reported completing the seven weekly home-based modules and attended all clinic visits. Significant improvements in observed pragmatic language skills were found from pre-follow-up for both the ADHD and TDP children and pre-post for the ADHD children.

CONCLUSION

The preliminary findings suggest that using parents to facilitate their child's pragmatic language skills was a feasible intervention approach with parents acting as agents of change to improve the pragmatic language of their children. This exploratory study identifies the need for further large-scale research to address the pragmatic language skills of children with ADHD using parent-delivery in a play-based, peer-peer context.

Does Information About Neuropsychiatric Diagnoses Influence Evaluation of Child Sexual Abuse Allegations?

This study aimed at investigating if attitudes toward children with neuropsychiatric disorders influence evaluations concerning allegations of child sexual abuse. Law students (n = 107) at Stockholm University, Sweden, were presented a transcript of a mock police interview with a girl, 11 years of age. This interview was based on a real case, selected as a "typical" example from these years concerning contributions from the interviewer and the alleged victim. After having read the transcript, the students responded to a questionnaire concerning degree of credibility, if the girl talked about events that had really occurred, richness of details, and if the narrations were considered truthful and age-adequate. Fifty-four of the students were also told that the girl had been given the diagnoses of attention deficit/hyperactivity disorder and Asperger syndrome. Students who were informed about the diagnoses gave significantly lower scores concerning credibility of the interviewee. To a lesser degree they regarded her narrations as expressions of what had really occurred and considered her statements less truthful. Furthermore, they found that the narrations contained fewer details. Finally, they found the girl less competent to tell about abuse. We conclude that a neuropsychiatric disorder may infer risks of unjustified skeptical attitudes concerning trustworthiness and cognitive capacity.

Kognitive Kompetenzen und Sprachentwicklung bei Kindern im Alter zwischen vier und fünf Jahren

Zusammenfassung. Ziel der vorliegenden Studie ist es den Zusammenhang von verschiedenen kognitiven Basiskompetenzen und sprachlichen Fähigkeiten bei Vorschülern zu untersuchen. Verglichen werden die kognitiven Kompetenzen von Kindern mit niedrigen Leistungen im Wortschatz und/oder in der Grammatik (n = 69) und einer sprachlich unbeeinträchtigten Vergleichsgruppe (n = 69). Weiter wird eine multiple hierarchische Regressionsanalyse gerechnet um die Bedeutung von kognitiven Basiskompetenzen für die Pragmatik zu untersuchen. Insgesamt zeigt sich, dass die Vergleichsgruppe über bessere kognitive Fähigkeiten verfügt als die Risikogruppe, insbesondere in der Verarbeitungsgeschwindigkeit. Im Bereich Pragmatik konnte das Arbeitsgedächtnis als wichtiger Prädiktor identifiziert werden. Anhand der Analysen wird deutlich, dass kognitive Basiskompetenzen für verschiedene sprachliche Bereiche von Bedeutung sind.

When Is EEG Indicated in Attention-Deficit/Hyperactivity Disorder?

The authors investigated the parameters for predicting epileptiform abnormalities in a group of children diagnosed with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 148 subjects aged between 6 and 13 (8.76 ± 1.26; 25.7% female) years. Subtypes of ADHD and comorbid psychiatric disorders were defined according to DSM-IV criteria. The Wechsler Intelligence Scale for Children-Revised was applied to all patients. Most of the subjects (89.2%) had wakefulness and sleep electroencephalography examinations lasting about one hour. The authors found out that the coexistence of speech sound disorder (odds ratio [OR] 3.90, 95% confidence interval [CI]: 1.61-9.48) and higher Digit Span test performance (OR 1.24, 95% CI: 1.06-1.44) predicted the presence of accompanying epileptiform abnormalities. The prevalence of epileptiform abnormalities was 26.4%, and they were frequently localized in the frontal (41%) and centrotemporal (28.2%) regions. Higher percentage of speech sound disorder co-occurrence (64%) in subjects with rolandic spikes suggests that epileptiform abnormalities associated with ADHD can be determined genetically at least in some cases. Pathophysiology of epileptiform abnormalities in ADHD might have complex genetic and maturational background.

Social Communication is Predicted by Inhibitory Ability and ADHD Traits in Preschool-Aged Children: A Mediation Model

OBJECTIVE

Given the role inhibitory control plays in both ADHD and communication, this study examined whether inattentive and hyperactive-impulsive traits mediate the impact of weak inhibitory ability upon the knowledge and application of pragmatic rules early in development.

METHOD

Participants were 36 typically developing preschoolers and their caregivers. ADHD traits were assessed per caregiver report. Inhibition was assessed in children using a distraction task. Pragmatic language was assessed by asking children about hypothetical social situations (knowledge) and by asking caregivers to report on children's actual communicative behaviors (application).

RESULTS

Individual differences in inhibition predicted both facets of pragmatic language development. Hyperactive-impulsive behaviors were a significant mediator of this relationship-but only with regard to children's ability to effectively apply pragmatic rules in everyday life.

CONCLUSION

Our findings suggest that social communication difficulties in some young children are a downstream consequence of hyperactive-impulsive behaviors that arise from poorly developed inhibitory control.

Psychological-behavioral characteristics and fractures in children are closely related

This work aimed to study the relationship between psychological-behavioral characteristics and fractures in children to provide a basis for development of preventive strategies. The study included 84 children hospitalized for fractures (fracture group) and 78 children without fractures (control group). The following questionnaires were utilized: temperament questionnaire, Eysenck Personality Questionnaire, and the Achenbach Child Behavior Checklist (CBCL). There were more children with problem behaviors in the fracture group than in the control group (P<0.01). Furthermore, level of activity and attention dispersion showed a significant relationship with fractures (P<0.05). Scores for the psychoticism, extroversion, and neuroticism subscales of the Eysenck Personality Questionnaire were higher for the fracture group than the control group (P<0.05 or <0.01). For the Achenbach Child Behavior Checklist, the average score for boys and/or girls was higher in the fracture group than the control group in 4-5-year and/or 6-11-year olds. In addition, in 6-11-year olds, boys in the fracture group had higher scores for restlessness, aggression, and violation of discipline and girls in the fracture group had higher scores for aggression and depression than those in the control group (P<0.05). Children with fractures had more psychological and behavioral problems. Psychological intervention measures could be adopted to reduce the occurrence of fractures in children.