Understanding Reading / Writing Problems of Students with ADHD

1
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

2
Session Outline

• 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

3
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.
4
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.
5
Attention and Executive FunctionM. Levine, MD

• MENTAL EFFORT
• Ability to mobilize
• Ability to appropriately allocate
• Ability to maintain/sustain

Nancy Cushen White, Ed.D.
5
6
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
7
Attention and Executive FunctionM. Levine, MD

• INTENTION/IMPULSIVITY/HYPERACTIVITY
• 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 a task

Nancy Cushen White, Ed.D.
7
8
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

9
ADHD reading

• Im 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 readI 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

10
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)

11
Impact of ADHD on Reading

• Phonological processing OK maybe problem
  inattentive type
• Rapid Automatised Naming Slow
• Reading fluency Slow
• Reading Comprehension Weak
• Factual OK
• Inferential - Weak
• Comprehension Strategies - Weak

12
Literacy and ADHD Comprehension

• Comprehension requires the student to
• 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 understandinginferences
  error monitoring, but not with recalling factual
  information (McInnes et al., 2003)

13
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

14
ADHD Written Expression

• Students with ADHD
• Write less
• Make more spelling, punctuation, and grammatical
  errors
• Written work is poorly organized
• Handwriting is often illegible

15
ADHD co-existing Reading Diability
25 to 50
Reading Disabilities
ADHD
16
ADHD DYSLEXIA
Dyslexia ADHD
Phonological processing X OK
Verbal STM X OK
Working memory X (auditory-verbal) X (visual-spatial)
Rapid automatised naming X (letters, digits) X (colors, objects)
Orthographic processing X X
Listening comprehension OK (generally) X
Reading comprehension Sometimes OK Reading poorer than listening X (inferential) Listening poorer than reading
17
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