Academic journal article School Psychology Review

Story Comprehension and Academic Deficits in Children with Attention Deficit Hyperactivity Disorder: What Is the Connection?

Academic journal article School Psychology Review

Story Comprehension and Academic Deficits in Children with Attention Deficit Hyperactivity Disorder: What Is the Connection?

Article excerpt

Abstract. Based on the reliable findings that children with attention deficit hyperactivity disorder (ADHD) have both attentional and academic difficulties, it is assumed that the attentional deficit contributes to the academic problems. In this article, existing support for a link between the attentional and academic difficulties experienced by children with ADHD is reviewed, and questions for future research are identified. This article goes beyond a discussion of visual attention problems to an investigation of the more complex processing deficits that may contribute to academic difficulties. It is suggested that current interventions for children with ADHD that focus on decreasing disruptive behavior and increasing simple attention to tasks may not address deficits in story comprehension skills such as those required for many school tasks. This article draws from the educational literature to explore possibilities for creating academic interventions that are more effective at remedying the story comprehension deficits experienced by children with ADHD.


The combined type of attention deficit hyperactivity disorder (ADHD) is one of the most common behavioral disorders among children of elementary school age (Barkley, 1997). Core symptoms include inattention, hyperactivity, and impulsivity (American Psychiatric Association, 1994), and each of these can have a significant impact on children's academic functioning. Stimulant medications and behavior management have proven efficacious in treating the core symptoms of ADHD; however, at the present time, there is little evidence suggesting that these treatments positively influence academic achievement. Thus, it is imperative that we identify why children with ADHD exhibit academic problems so we can create interventions that more specifically address those areas of difficulty.

Currently, there are three subtypes of ADHD recognized by the American Psychiatric Association (1994). The predominantly inattentive type is characterized by significant inattention and distractibility but fewer than six symptoms of hyperactivity or impulsivity. Children with the predominantly hyperactive-impulsive type of the disorder experience considerable difficulty inhibiting excessive behaviors but do not have substantial attentional problems. The combined type of ADHD differs from the other subtypes in that significant levels of hyperactivity, impulsivity, and inattention are all present (American Psychiatric Association, 1994). Recent research suggests that the combined type diagnosis also may be associated with a different set of cognitive deficits (Milich, Balentine, & Lynam, 2001). This article will focus on children with the combined type of the disorder and it is likely that the findings reviewed here do not apply to children with ADHD, predominantly inattentive or predominantly hyperactive types. Because relatively little is known about how symptom presentation differs for males and females with ADHD, gender effects in the ADHD samples are discussed when possible. However, ADHD is less commonly diagnosed in girls and many studies have not examined gender differences.

ADHD Symptoms and Associated Difficulties

Because of the disruptive nature of the disorder, children with the combined type of ADHD experience a variety of difficulties in multiple settings. One area where the symptoms of ADHD are likely to have a significant impact is in the classroom. Evidence suggests that children with ADHD typically experience chronic underachievement and have high rates of school failure and grade retention (Barkley, 2006). Once thought to decline after childhood, difficulties associated with ADHD have been shown to continue into adulthood and have long-lasting repercussions (Barkley, 2006). Clearly, early academic intervention is a necessary step towards improving the prognoses of children with ADHD. …

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