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Attention deficit hyperactivity disorder (ADHD) involves, according to theory, an underlying impairment of executive function-the cognitively based control system that regulates behavior. It is possible that this executive dysfunction interferes with performance on certain tasks used to identify language impairment (LI). We compared the performance of 3 groups of children aged 7 to 11 years: ADHD-- only (n = 25), ADHD+LI (n = 28), and non-- ADHD controls (n = 24), on 18 tasks within 3 language measures (Test of Word Finding, Rosner's Auditory Analysis Test, Clinical Evaluation of Language Fundamentals
Revised). Children with ADHD-only performed like those without the disorder on most tasks examined. However, the CELF-R Formulated Sentences subtest was particularly difficult for children with ADHD-only. In-depth error analysis indicated that aspects of the executive dysfunction in ADHD such as impulsivity and pragmatic deficits may have influenced performance on this subtest. Clinical implications for testing children with ADHD are discussed.
Key Words: attention deficit hyperactivity disorder, language impairment, assessment, executive function
Attention deficit hyperactivity disorder (ADHD) is the most prevalent psychiatric disorder of childhood, affecting 3% to 5% of school-aged children (American Psychiatric Association, 1994). Children with ADHD present with one or more of three characteristic behavioral symptoms: inattention, impulsivity, and hyperactivity. Inattention, or problems in sustaining attention, may be manifested as frequent distractibility, failure to follow through on or frequent shifting of activities, and failure to listen to others (or at least giving the impression of such). Impulsivity or disinhibition can appear in forms such as accident-prone behavior, failure to consider consequences before acting, intrusiveness, and difficulties in taking turns (conversationally or otherwise). Finally, hyperactivity or restlessness can be characterized by frequent twisting and wiggling while seated, excessively noisy play or talkativeness, and inappropriate jumping or running around. Most important, these symptoms are demonstrated at a frequency and severity that is judged to be inappropriate for the child's level of development (American Psychiatric Association, 1994).
Barkley ( 1997) recently proposed that one critical cognitive deficit in ADHD is a dysfunction of behavioral inhibition. This deficit presumably interferes with executive function, the cognitively based control system that regulates behavior in a manner analogous to that of executives in a company, by selecting information and setting priorities, generating strategies, allocating resources,...