Understanding Reading / Writing
Problems of Students with ADHD
Workshop on Students who are gifted
and /or have ADHD
Rudolf Stockling MSc (Psych) MAPS
Lexicon Reading Center 7/12/2010
Session Outline
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1. Definition of ADHD
2. Types of ADHD
3. Executive Functions and Reading
4. ADHD and Reading
5. Children with ADHD and Dyslexia
6. Activity: Case Study
Definition of ADHD
“ADHD consists of developmental
deficiencies in the regulation and
maintenance of behavior by rules
and consequences. These
deficiencies give rise to problems
with inhibiting, initiating, or
sustaining responses to tasks or
stimuli and adhering to rules of
instructions….”
Barkley, R. (1990). Attention-deficit hyperactivity disorder: A Handbook for diagnosis and treatment. New York:
Guilford, p.71.
Three types of ADHD
ADHD, Predominantly Hyperactive-Impulsive
ADHD, Predominantly Inattentive Type
ADHD, Combined Type:
DSM-IV, Text Revision. Washington, DC, American Psychiatric Association, 2000.
Attention and Executive Function
M. Levine, MD
MENTAL EFFORT
 Ability to mobilize
 Ability to appropriately allocate
 Ability to maintain/sustain
Nancy Cushen White, Ed.D.
5
Attention and Executive Function
SELECTIVE FOCUS AND CONCENTRATION
 Filtering out irrelevant stimuli
 Focusing actively and deliberately on relevant
stimuli
 Resisting distractions
 Shifting attention as required
Nancy Cushen White, Ed.D.
6
Attention and Executive Function
M. Levine, MD
INTENTION/IMPULSIVITY/HYPERACTIVIT
Y
 Thinking about and analyzing demands of
a task
 Making decisions about appropriate strategies
for accomplishing a task
 Acting purposefully, at optimal pace, while
monitoring efforts throughout
Nancy Cushen White, Ed.D.a task
7
ADHD and Other Disorders
• Associated disorders: disorders
that are a direct result of the ADHD
– A result of the deficits in executive
function
– General Learning Problems
• Co-morbid disorders: disorders
that exist in addition to the ADHD
– Specific Learning Disability
ADHD & reading
• I’m a very slow reader. In high school &
middle school I really hated to read because
it took me a long time & I would have to read
things over and over again.
• I would find myself at the end of the chapter
& not remember anything I had just read…I
realized would have to go back and read it all
over again.
• It got to the point in middle school where I
was sick of school already & I hated going.”
Knowles (2006): Grant, a 21-yr-old college student
ADHD and Co-morbid Disorders
• Externalizing disorders (Type One)
– Conduct disorder
– Oppositional defiant disorder
– Learning Difficulties (including reading)
• Internalizing disorders (Type Two)
– Anxiety/depression
– Speech/language disorders affecting
phonology, syntax, semantics
– Dyslexia (deficits in decoding)
Impact of ADHD on Reading
Text
Comprehension
DEEP UNDERSTANDING
Fluency
 Phonological processing:
OK maybe problem inattentive
type
 Rapid Automatised Naming:
Slow
• Reading fluency:
Slow
• Reading Comprehension:
Weak
– Factual –
OK
– Inferential Weak
Literacy and ADHD:
Comprehension
• Comprehension requires the student to
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Attend to input
Organize information
Comprehend vocabulary
Identify main ideas & their connections
(Caplan et al., 2007 for review)
• Students with ADHD
– have significant weaknesses in comprehension across a
range of tasks
(Keenan et al. 2008)
– show weaknesses with understanding
inferences & error monitoring,
but not with recalling factual information
(McInnes et al., 2003)
Literacy and ADHD
Written Expression
Written Expression Requires:
• Transcription skills
– Legible and fluent handwriting
– Encoding Skills
– Spelling
• Text generation
– Thinking of ideas
– Organization/coherence of text
– Monitoring
– Revising text
Juggling these tasks concurrently requires WORKING
MEMORY and self-regulation
ADHD: Written Expression
• Students with ADHD”
– Write less
– Make more spelling, punctuation, and
grammatical errors
– Written work is poorly organized
– Handwriting is often illegible
ADHD & co-existing Reading
Diability
ADHD
25%
to
50%
Reading
Disabilities
ADHD & DYSLEXIA
Phonological
processing
Verbal STM
Working memory
Rapid
automatised
naming
Orthographic
processing
Listening
comprehension
Dyslexia
ADHD
X
OK
X
X
(auditory-verbal)
OK
X
(visual-spatial)
X
(letters, digits)
X
(colors, objects)
X
X
OK
(generally)
X
INTERVENTION
• If Reading Problems are associated with
ADHD
– General ADHD Support and Accommodation
– Medication likely to lessen literacy problems
– Still need to teach specific skills
• Reading problems are due to Dyslexia
comorbidity
– Specific Multi-sensory Dyslexia Intervention