1 Esther Parigger' 310306'

1
Narrative abilities in children
with Attention Deficit Hyperactivity Disorder
(ADHD) and normally developing children
Esther Parigger ACLC/ILLC seminar 2006

2
Introduction
Blankenstijn and Scheper 2003, Gezondheidsraad
2000, Jensen e.a. 1997, Love and Thompson 1988

• ADHD
• ?Diagnosed in 2-6 of Dutch children
• ?More often in boys (80) than in girls (20)
• Comorbid disorders
• ?Psychiatric disorders 43-95
• ?Speech/language disorders 75-100

3
Introduction

• APA, 2000

• Diagnosis
• ?Symptoms (division in subtypes)
• -present before 7 years of age
• -present in two or more settings
• -significant impairment in functioning
• -not accounted for by another disorder

symptoms of inattention symptoms of
hyperactivity/impulsivity
predominantly inattentive subtype predominantly
hyperactive/impulsive subtype combined subtype
4
Introduction

• Parigger and Baker 2005

• Language problems in children with ADHD?
• ?Subtle problems in language comprehension
• ?More robust problems in language production
• -pragmatics
• -syntax

5
Introduction
Tannock and Schachar 1996 147

• Hypothetical cause of language problems in ADHD?
• ?Executive Dysfunction Theory
• We theorize that the core behavioral
  symptoms of ADHD () and the pragmatic
  difficulties that these children exhibit ()
  are related to deficits in executive function
  (i.e. higher-order cognitive processes).

6
Method
Aarssen 1996, v/d Meulen 2001, Roelofs 1998

• Groups
• ? ADHD (n26)
• -7, 8, 9 years of age (mean 83)
• -88,5 boys 11,5 girls
• ?N (n34)
• -7, 8, 9 years of age (mean 83)
• -61,8 boys 38,2 girls

comorbidity 84,6 medication 92,3
7 n5 8 n8 9 n13
7 n6 8 n11 9 n17
7
Method
Mayer 1969, McWhinney 2000
ADHD child, aged 700.21, narrating first
picture of frog, where are you CHI d'r zit
al een kikker in de kom (01-01).
(theres already a frog in the bowl) CHI en ze
zitten allebei te kijken (01-02). (and
they are both looking)

• Data collection
• ?Frog-story
• -content
• -procedure
• -transcription with CHAT

8
Method
Trabasso and Rodkin in Berman and Slobin 1994
Ssetting Eevent IRinternal response G1goal
1get the frog back G2goal 2find the
frog G3goal 3search frog in part.
locations Aattempt Ooutcome ( or -)

• Frog-story
• ?Hierarchical
• goal plan
• ?GAO-unit

9
Method
Baker e.a. in Gillis and Schaerlaekens
2000 Berman and Slobin 1994, Blankenstijn and
Scheper 2003, Roelofs 1998
PLOT ELEMENTS (PE) Setting (S) (2x) introduction
boy, dog and frog possession of frog Initiating
events (IE) (6x) boy sleeps frog escapes boy
wakes up (boy finds jar) jar is empty frog is
gone Internal responses (IR) (2x) boy is sad
boy is happy Search attempts (SA) (7x) in the
room out of window outside in hole in ground
in hole in tree from rock behind trunk Higher
order goals (HG) (2x) find frog take frog

• Frog-story
• ?Plot elements

ADHD child, aged 9,03.00, narrating last
picture of frog, where are you CHI en toen
nam de jongen een andere kikker mee
(24-33). (and then the boy took another
frog)
10
Method
Blankenstijn and Scheper 2003, Roelofs 1998

• Plot analysis
• ? plot elements
• - setting
• - initiating events
• - internal responses
• - search attempts (1/2/3/4GAO)
• - higher order goals

unianova
11
Results
Barkley et al. 1983, Zentall 1983, 1986

• MLU
• F (1,59) 0.862, ns
• MLUL
• F (1,59) 0.983, ns

12
Results

• Analysis pragmatics
• ?Plot analysis
• - setting (S)
• - SDIAGNOSIS
• F(1,59) 2.319, ns
• - SAGE
• F(2,59) 3.310, plt.05

13
Results

• Analysis pragmatics
• ?Plot analysis
• - initiating events (IE)
• - IEDIAGNOSIS
• F(1,59) 3.647, p.06
• - IEAGE
• F(2,59) 2.323, ns

14
Results

• Analysis pragmatics
• ?Plot analysis
• - internal responses (IR)
• - IRDIAGNOSIS
• F(1,59) 1.783, ns
• - IRAGE
• F(2,59) 0.291, ns

15
Results

• Analysis pragmatics
• ?Plot analysis
• - search attempts (SA)
• - SADIAGNOSIS
• F(1,59) 2,068, ns
• - SAAGE
• F(2,59) 0,262, ns

16
Results
Action boy (and dog) verb like call or
look for Location f.e. hole in tree,
behind trunk Goal frog Outcome failures or
success in finding frog

• Analysis pragmatics
• ?Plot analysis further division search
  attempts
• SA1 action -loc., -goal, -outcome
• SA2 action loc., /-goal, /-outcome
• SA3 action /-loc., goal, /-outcome
• SA4 action /-loc., /-goal, outcome

17
Results

• Analysis pragmatics
• ?Plot analysis
• - search attempts 1 (SA1)
• action -loc, -goal, -outcome
• - SA1DIAGNOSIS
• F(1,59) 0,500, ns
• - SA1AGE
• F(2,59) 1,325, ns

18
Results

• Analysis pragmatics
• ?Plot analysis
• - search attempts 2 (SA2)
• action loc, /-goal, /-outcome
  - SA2DIAGNOSIS
• F(1,59) 4,374, plt.05
• - SA2AGE
• F(2,59) 1,271, ns

19
Results

• Analysis pragmatics
• ?Plot analysis
• - search attempts 3 (SA3)
• action /-loc, goal, /-outcome
• - SA3DIAGNOSIS
• F(1,59) 1,052, ns
• - SA3AGE
• F(2,59) 1,517, ns

20
Results

• Analysis pragmatics
• ?Plot analysis
• - search attempts 4 (SA4)
• action /-loc, /-goal, outcome
• - SA4DIAGNOSIS
• F(1,59) 4,232, plt.05
• - SA4AGE
• F(2,59) 2,108, ns

21
Results

• Analysis pragmatics
• ?Plot analysis
• - GAO-units
• action loc. goal, outcome
• - GAODIAGNOSIS
• F(1,59) 0,683, ns
• - GAOAGE
• F(2,59) 0,779, ns

22
Results

• Analysis pragmatics
• ?Plot analysis
• - higher order goals (HG)
• - GDIAGNOSIS
• F(1,59) 3.433, plt.05
• - GAGE
• F(2,59) 3.310, p.07

23
Results

• Analysis pragmatics
• ?Plot analysis
• - plot elements (PE)
• - PEDIAGNOSIS
• F(1,59) 8.543, plt.05
• - PEAGE
• F(2,59) 5.664, plt.05

interreliability 94,86
24
Discussion
Blankenstijn and Scheper 2003, Roelofs 1998

• Percentage of worded plot elements
• ?Partial scores
• -(marginally) significant effects of diagnosis
  

25
Discussion
Blankenstijn and Scheper 2003, Roelofs 1998

• Percentage of worded plot elements
• ?Partial scores
• -significant effects of age

26
Discussion
Blankenstijn and Scheper 2003, Tannock 1993,
Trabasso and Rodkin in Berman and Slobin 1994

• Percentage of worded plot elements
• ?Total score
• -effect of diagnosis ADHDltN
• -effect of age 7lt8lt9

27
Discussion

• Children with ADHD produce less plot elements
  when narrating the Frog-story than normally
  developing control children (7, 8, 9 years of
  age). This has a detrimental effect on the
  coherence of this story and can be exlplained on
  the basis of the Executive Dysfunction Theory.

28
Discussion

• Preliminary investigation until August 2006
• Additional analyses on Frog-stories of
  children with ADHD and normally developing
  control children (7, 8, 9 years of age) to
  generate more specific hypotheses for main
  study.

29
Discussion

• Main investigation from September 2006
• Comparison of language profiles and cognitive
  profiles of children with ADHD, SLI and normally
  developing children (7, 8 years of age)

30
More information and questions

• E e.m.parigger_at_uva.nl
• W http//home.medewerker.uva.nl/ e.m.parigger
• T 0031-20-5253811

Ill upload a hand-out for you!