Language and the ADHD child

All things need to be spelled out clearly to any child, but a child on the autistic spectrum needs things spelling out to them more than most. In a way they are like foreigners. (Jackson 2002)

Luke wrote this in his book Freaks, Geeks and Asperger Syndrome and while he wrote the book primarily about Asperger Syndrome, he does live with Joe and is aware of his needs too. As he says, the need to speak clearly and precisely is important for all of our colourful kids. Much misunderstanding and frustration could be alleviated at school if teachers realized a child's problems in these areas and adjusted the way they spoke to the child accordingly.

While children with autism are accepted to have problems with communication even if they have excellent spoken language, the speech and language problems of children with AD/HD are often overlooked. According to the speech and language pathologist, Philippa Greathead (Speech-Language-Learning Centre, Westmead, NSW, Australia), the child or adolescent with AD/HD will often present with a range of clinical problems in language that make learning even more difficult. Again these problems highlight the inextricable link between autism and AD/HD, and the overlap between these disorders should not be overlooked by teachers and professionals working with such children.

Although not all children with AD/HD have these problems and not all children with these problems have AD/HD, many children with AD/HD often have problems with the following.

• Metalinguistics - ambiguity, figurative language, metaphors and the ability to reflect on language objectively.

• Syntax - difficulties using and/or comprehending the structural components of sentences in both or either oral and written grammar.

• Semantics - problems with word meanings and organization, difficulties comprehending written and spoken language, word finding difficulties and difficulties linking context to reading comprehension.

• Pragmatics - problems with the ability to use language as a means of social interaction with others.

• Auditory processing - slow processing of spoken language, short-term memory problems, problems following instructions.

Children with AD/HD would benefit greatly at school and at home if teachers and parents recognized that often (not all the time) a child's language difficulty is not merely a result of inattentiveness. As with autistic children, those with AD/HD are also very visual learners so it is important to use lots of visual aids in the classroom as well as doing lots of 'hands on' work. Joe loves science because he is able to do experiments, whereas he drifts away or fidgets in lessons where he has to merely sit and listen.

Children on the autistic spectrum and particularly those with attention problems are unlikely to respond to generic instructions such as "Put your books away everyone". Moreover, to say "Put your book away Joe" is likely to cause Joe to respond to his name but as the name is at the end of the sentence, he will only have pricked up his ears at his name and of course, missed his instructions. When teachers (and parents - I forget this all the time!) learn to say the child's name first, check that he or she is attending to you, and then issue the instruction, this saves a lot of time and anxiety for everyone.

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