Language Abilities of Children With ADHD
Condition: ADHD
MeSH terms: Attention Deficit Disorder with Hyperactivity
Study type: Observational

Summary: 
      BACKGROUND: Attention-Deficit/Hyperactivity-Disorder (ADHD) is associated with language
      difficulties within expressive, receptive and pragmatic areas of language.Telling stories is
      a particularly interesting language task as is provides the possibility of investigating how
      children use their language in everyday interactions. Thus, investigating how children with
      ADHD tell stories provides a more naturalistic impression of their language abilities.
      However, the extent, causes, and clinical relevance of language and narrative difficulties in
      ADHD remain largely unknown. Language may be the key to understanding and improving the
      functional impairments associated with ADHD such as social and academic function.

      AIM: The overall aim of the current study was to investigate the association between
      language, narrative ability and ADHD, what contributes to this association, as well as the
      clinical relevance of language difficulties in ADHD in relation to academic and social
      function.

      METHOD: Children between 7-11 years old with ADHD will be recruited from Aarhus University
      Hospital in Skejby and compared to children without ADHD recruited from schools in the
      community. All children will be assessed at two separate meetings at the Department of
      Psychology, Aarhus University. The total number of participants in each group will depend on
      the intake of patients at Aarhus University Hospital, but a maximum of 100 children will be
      sampled in each group.
    

Detailed description: 
      BACKGROUND:

      Up to 40% of children with the ADHD are suggested to have language difficulties. Other than
      language difficulties being debilitating in their own right, language difficulties in
      childhood ADHD are problematic because they likely enhance the social and academic
      difficulties often present in children with this disorder. Children with ADHD also appear to
      have narrative difficulties; i.e. they have problems telling a coherent, understandable
      story. Telling stories is a particularly interesting language task as the investigation of
      how children use their language in an unstructured task is similar to how they use their
      language in everyday interactions.

      However, the extent, causes, and clinical relevance of language and narrative difficulties in
      ADHD remain largely unknown. Studies are scarce and fraught with problems warranting
      investigations of language abilities in children with ADHD that measure language as well as
      executive function (EF) and that investigate the clinical relevance of these language
      difficulties. This is necessary in order to tease apart and gain knowledge of the association
      between language, EF and ADHD. Ultimately, such an investigation can inspire future
      assessment and treatment of language difficulties in children with ADHD.

      AIMS AND HYPOTHESES

        1. The first aim is to examine narrative abilities in children with ADHD. This is done by
           investigating whether children with and without ADHD differ with respect to their
           narratives.

        2. The second aim is to examine whether language, EF and/or ADHD symptoms can explain
           narrative function in children with and without ADHD.

        3. The third aim is to investigate which specific domains of language children with ADHD
           have the most difficulty within.

        4. The fourth aim is to investigate whether the language difficulties as well as the
           narrative difficulties identified are associated with academic and social function in
           ADHD.

      PARTICIPANTS AND PROCEDURES Up to 100 children with ADHD, age 7-11, consecutively referred
      from Aarhus University Hospital, Denmark, will be compared to up to 100 typically developing
      children, age 7-11, recruited from schools in the same community as the hospital.

      After initial screening by telephone, informed consent has been obtained from both custodians
      and verbal assent has been given by the child, all children (ADHD and control) will be
      assessed at two separate meetings at the University of Aarhus by a member of the project
      group. The parents will receive questionnaires about their child and if the families give
      their consent, questionnaires will also be sent to the children's primary teacher. The
      parents and teachers receive questionnaires about the child's behavior, language and social
      and academic abilities.

      All hypotheses will be investigated with appropriate statistical analyses. The role of IQ,
      parental educational level etc. is also examined in the analyses. If an adequate sample size
      is obtained, confirmatory factor analysis (CFA) will be applied to handle data, and if a
      factor solution is supported, factor scores will be included in all analyses, thereby
      reducing the number of variables in the analyses.

      REGISTRATION DETAILS The study record reported at clinical trials.gov is completely
      consistent with the protocol approved by the Central Region Committee on Health Research
      Ethics in Denmark. The study was registered at clinical trials.gov after enrollment had
      begun, but no changes have been made in any procedures, recruitment etc., and as such it was
      assessed to be feasible to include the few participants that had been enrolled before
      registration in clinical trials.
    

Intervention name(s): Language and neuropsychological tests
Intervention type(s): Other
Intervention description(s): Tests related to language, narrative and specific and general cognitive function
Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        The clinical group of children with ADHD will be recruited from the Aarhus University
        Hospital and the typical developing control group will be recruited from schools in the
        community.