presented by Sean Redmond
Financial: Sean Redmond receives compensation from MedBridge for this course. There is no financial interest beyond the production of this course.
Non-Financial: Sean Redmond has no non-financial interests or relationships with MedBridge.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
Sean Redmond, PhD, CCC-SLP
Sean Redmond received his B.A. in Speech and Hearing Sciences from the University of California, Santa Barbara in 1990, his M.A. in Speech Language Pathology from the University of Kansas in 1993, and his Ph.D. in Child Language from the University of Kansas in 1997. He teaches and conducts research in the Department of Communication…Read full bio
1. Cross Signals of Comorbidity in the Literature
This chapter starts by trying to answer the questions “are children with ADHD at increased risk for developing language impairments?” and shows that we cannot answer this question because the evidence has been inconclusive. Reports of ADHD+LI comorbidity have been highly unstable (7 % to 90%). Variability in this case cannot easily be attributed to the common culprits of noisy signals within comorbidity research. Measurement error is a likely contributor to the lack of clarity on this issue. In both the language and behavior domains, there are assessment instruments with very weak psychometric properties. These instruments are presented along with stronger alternatives.
2. Differential Diagnosis of ADHD and Language Impairment
This chapter divides up clinical symptoms into those that are diagnostically ambiguous, those that are supportive of an LI diagnosis, and those that are supportive of an ADHD diagnosis. Several difficulties are clinically ambiguous because they have been shown to be common in both ADHD and SLI: poor reading/academics, teacher rated behavior problems, peer difficulties, pragmatic deficits, poor performance on executive function and continuous performance tasks Some difficulties are specific to SLI and have not been found in samples of ADHD where comorbid LI has been ruled out: tense-marking, nonword repetition, sentence recall, verbal memory, narratives Some difficulties are specific to ADHD and have not been found in SLI when comorbid ADHD has been ruled out: parent rated behavior problems, visuospatial memory deficits, fast speaking rate, vocal abuse, and elevated levels of mazes in conversation.
3. Consequences of ADHD+LI Comorbidity
This chapter takes up the issue of the effects of ADHD comorbidity on children’s language development. Different kinds of comorbidity affect language impairments in different ways. For example, when LI is comorbid with low nonverbal IQ, there are more severe language symptoms and slower rates of growth. Relative to children with SLI, individuals with comorbid low nonverbal IQ are at increased risk for reading and behavioral problems – including ADHD. They also might be less responsive to interventions. In contrast, children with LI and co-occurring reading disabilities (LI+RD) have not presented with either more severe linguistic or severe reading difficulties. Comorbidity of ADHD+ LI appears to be similar to LI+RD based on the available evidence. There is some evidence that individuals with ADHD+LI might be getting preferential access to speech-language services. Additional research is needed to determine the impact of ADHD+LI comorbidity on children’s response to different treatments and how best to integrate linguistic and behavioral interventions. We also need clarity on the mechanisms behind ADHD+LI comorbidity that can only be achieved by longitudinal investigations. Understanding how comorbidity between these two common disorders arises introduces the possibility of eventually reducing rates of comorbidity.