LANGUAGE, CO MMUNICATION, LE ARNING AND ADHD  – A DEVELOP MENTAL APP ROACH

ABSTRACT: 

Development of language is an essential tool for proper understanding of social contexts,  communication, development of social skills and learning. The core symptoms of the attention  deficit hyperactivity disorder (ADHD) include difficulties in sustaining attention and in listening,  forgetfulness, poor task completion, poor organizing and mistakes with tasks that require attention;  on the other hand, development of attention span is the background for basic and complex language  skills (fluent speech, writing, reading, conversation, grammar, phonetics, topic and syntax). This  may be the explanation for language disorders in children diagnosed with ADHD, ranging from  delays in speech (the so-called “late talkers”) to improper use of syntax, topics or grammar rules,  lack of coherence in stories or writing, and also the cornerstone for a comprehensive assessment  and management (based on needs) in children with ADHD.

1. Language and ADHD

Although speech and learning disorders  are common in children with ADHD (about  20% have reading difficulties and 60% have  serious handwriting problems), the disorder  does not affect intelligence. People with the  problem span the same IQ range as the general  population. It was suggested, however, that  90% of ADHD children were underachievers  and that half were held back at least once.

The child or adolescent with ADHD and  learning problems will often present to the  Speech Language Pathologist with a complex  range of clinical problems, covering all the  modalities of language, that are contributing  to the learning disorder. Typically problems  are experienced in:

• Syntax: Disorders of oral and written.  grammar, difficulties using and / or  comprehending the structural components of  sentences.
• Semantics: Problems with word  meanings and organization, including  difficulties comprehending written and spoken  language, poor vocabulary, word-finding  difficulties and difficulties using context to help  with the comprehension of reading.
• Pragmatics: The social use of language  – the ability to use language as a means to  interact with others socially or for a specific  purpose ( requesting information, expressing  feelings, holding a conversation with people  of different age levels).
• Metalinguistics: The ability to reflect on  language objectively, to understand language  as a rule-bound code, to use humour,  multimeaning in words, ambiguity, figurative  language (metaphors), ability to segment  words into syllables or sounds.
• Auditory processing: Related problems  in the areas of speed of processing, auditory  memory, auditory attention, processing of  auditory information, auditory analysis and  auditory discrimination, with subsequent  difficulties in tasks such as following directions or  getting information from reading and listening.
• Metacognition: Difficulties in the ability  to think about thinking in general, to know  what you know and to understand what you  need to know in order to learn effectively,  with subsequent impairment in the strategies  involved in problem solving.

What makes the ADHD child with a  language problem different to other children  with language problems? The child with ADHD  is more likely to have language processing  difficulties than a simple language delay.  There may be no early developmental history  of speech and language problems, and the  language problems may only become apparent  during school years, especially in the clever,  gifted students with subtle language problems  and ADHD. In particular, the ADHD child with  language problems can experience:

• Auditory processing difficulties such  as: short-term auditory memory weakness,  problems following instructions, slow speed  of processing written and spoken language,  difficulties listening in distracting environments  (the classroom), problems in listening for  information when someone is talking or  reading expecting them to listen, missing out  on details, or getting the details but without  grasping the ‘main idea’, problems in reading  comprehension
• Language difficulties related to  impulsivity and poor organizational skills  resulting in: problems with classroom discourse,  poor writing skills, tangential narratives  and conversations, word-finding problems,  difficulties inferring meaning – ‘looking beyond  the obvious’, problems with generative  language, social language problems

1. Learning strategies and ADHD

The student with ADHD is likely to have  difficulties with the learning style supported  by the school system – that of being a good  listener, being able to sit and focus for extended  periods of time and of having good reading and  oral language skills. Children learn by their  individual learning styles and teachers tend to  teach in a way that complements their own  learning style. This is one reason children may  learn well with one teacher and not another.  Children with language difficulties are often  unaware of their own thinking and learning  processes; they either do not know that there  are certain strategies that can be used to help  their learning or they use the wrong strategies  for their particular learning style.

The use of learning styles as a diagnostic  tool gives an added dimension to the role of  the Speech Language Pathologist working  with school-aged children and adolescents.

Considering learning styles broadens the  the development of strategies for the general  management of language-related problems.  Analyzing the child’s learning style can give  invaluable information to help you understand  how best to support the child’s learning. Some  common characteristics of these learning  styles are:

Visual learners

• Learn best by looking, watching and  observing, seeing how things are done
• Enjoy poster, visual overhead, colours  and videos
• Doodle and draw, use information  mapping systems, visualize inside their heads

Auditory learners

• Learn well by listening and  communicating with others, from audiotapes
• Learn through rhythm and rhyme
• Have good auditory discrimination and  auditory attack skills for reading
• Learn languages easily

Kinaesthetic learners

• Use their hands, feelings and whole  bodies to learn
• Create things, make things, pull things  apart and rebuild them

Print-orientated learners

• Read and write to learn and for  pleasure, have good reading comprehension  Interactive learners
• Learn well by interacting with others,  from discussion and dialogue
• Group work and co-operative learning,  social flexibility, ability to lead/ follow

Children with school-based learning  difficulties are often deficient in one or more  of these learning modalities and need to  focus their learning on the area that is their  greatest strength – as well as building up the  weaker areas. Typically, the child with ADHD  and language problems struggles with the  auditory and print-orientated styles of learning.

Interestingly, some who struggle with visual  learning also have language-based problems  – usually related to organization, planning  and overall ‘whole picture’ understanding of  language-based skills.

Strategies to help children with  language processing problems

• ‘Pulse style’ approach to learning: this  is very useful in children with ADHD, can be  applied to any learning task and is a great  way to get optimal learning happening (see  also Picture 1)
• Classroom and parent management  strategies
• Teaching to learn styles. If the ADHD  student with a language disorder has problems  with a particular style of learning e.g. auditory  learning, try to work with their most successful  learning style in order to support the weaker  style. For example, a student with weak  auditory learning skills and strong kinaesthetic  skills benefits from being physically involved  in the learning process. If the class if doing a  ‘listening type task’ it would be helpful if the  ADHD child was demonstrating something or  holding something rather than just ‘listening’.

It is also very difficult for the poor listener to  cope with comments like ‘I am only going to  say this once!’ – the added anxiety this causes  makes the learning even harder.

This means doing things like: …Read for 10  minutes, move around for 2 minutes, then  write for 10 minutes…

References:

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