1 Esther Parigger' 130407'

1
The relation between Attention
Deficit Hyperactivity Disorder (ADHD) and
(Specific) Language Impairment ((S)LI)
Esther Parigger LEXEF 2007
2
Overview

• Diagnoses ADHD and SLI
• Discussion (part 1)
• Comorbidity ADHD and (S)LI / (S)LI and ADHD
• Discussion (part 2)
• Possible relationships
• Discussion (part 3)

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ADHD

• APA, 2000

Problem diagnosed on the basis of clinical
evaluation.
Problem (?) language items are included in the
symptom list.

• 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

Symptoms of inattention Symptoms of
hyperactivity/impulsivity
Predominantly inattentive subtype Predominantly
hyperactive/impulsive subtype Combined subtype
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ADHD

• Hoffmann, 1845

• Filip de Schommelaar
• ?Hyperactivity
• ?Impulsivity
• Hans Kijk-in-de-Lucht
• Inattention

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SLI

• Stark and Tallal, 1981
• Bishop, 1994 Botting, 2005

Impaired hearing Emotional and behavioral
problems PIQ lt 85 Neurological deficits/
lesions Speech motor skill deficiencies Low
reading age

• Diagnosis
• ?Exclusion
• ?Severity

LA Receptive lt MAP/CA (6 mo.) LA Expressive lt
MAP/CA (12 mo.) LA Overall lt MAP/CA (6 mo.)
Problem diagnosed on the basis of exclusion.
Problem no behavioral problems allowed..
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SLI
Mayer, 1969

• Video of Jan
• ?711.21
• Frog-story

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Discussion (part 1)

• What do you think about the ADHD and SLI
  diagnoses?

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Comorbidity
Wittchen, 1996 Burke et al., 1990

• Problems
• ?Used descriptively
• ?(A)symptomatic overlap
• ?Assessment
• Definition (for now) the presence of more than
  one specific disorder in a person in a defined
  period of time

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Comorbidity with ADHD
Cantwell, 1996 Jónsdottír, 2006 Cohen et al.,
1998 Blankenstijn en Scheper, 2003

• Conduct disorder, oppositional defiant disorder
• Mood disorders, anxiety disorders
• Tourettes syndrome, chronic tics
• Language problems, learning disorders
• Prevalence rates vary!

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Comorbidity with ADHD ADHD and language
problems

• Parigger and Baker, 2005

• Subtle problems in language comprehension
• More robust problems in language production
• ?Syntax
• ?Pragmatics

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Comorbidity with ADHD ADHD and language
problems
Parigger, in prep (a) Blankenstijn and Scheper,
2003 Tannock 1993 Trabasso and Rodkin (in
Berman and Slobin), 1994

• Percentage of worded plot elements in
  Frog-stories
• ?Total score
• -effect of diagnosis ADHDltN
• -effect of age 7lt8lt9

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Comorbidity with SLI
Webster 2004 473

• E.g. motor abnormalities, reading disabilities,
  nonverbal IQs 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

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Comorbidity with SLISLI and ADHD symptoms

• Botting, 2006 (poster)

• 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

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Discussion (part 2)

• Are ADHD en (S)LI comorbid disorders or is (S)LI
  secondary to ADHD (or vice versa)?

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Possible relationshipsbetween PI and LI
Blankenstijn en Scheper, 2003 20

• Unicausal comorbidity
• ?(third risk factors) ? PI ? LI
• ?(third risk factors) ? LI ? PI
• Dependent causal comorbidity
• ?(third risk factors) ? LI/PI ?? LI/PI

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Possible relationship between ADHD and
language problems
Tannock and Schachar, 1996 147

• 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).

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Main study
Parigger, in prep (b).

• Comparison of language profiles and cognitive
  profiles of children with ADHD, SLI and normally
  developing children (7 and 8 years of age)

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Discussion (part 3)

• Is it plausible to think that a specific
  executive functioning profile can be related to a
  specific language profile in ADHD?

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More information
Thanks for this discussion!

• E e.m.parigger_at_uva.nl
• W http//home.medewerker.uva.nl/e.m.parigger
• T 0031-20-5253811

Ill upload a hand-out for you!