Objective: Central executive training (CET) is a “Level 2” evidence-based treatment for improving ADHD-related executive dysfunction and behavioral symptoms, but the extent to which these gains extend to the disorder’s well-documented academic difficulties is unknown. Method: Across two clinical trials, 108 children with attention-deficit/hyperactivity disorder (ADHD) 8–13 years old (M = 10.29, SD = 1.50; 32 girls; 75% White/Non-Hispanic) were treated with CET (n = 52), inhibitory control training (ICT; n = 29), or gold-standard behavioral parent training (BPT; n = 27). Results: CET was superior to BPT and ICT (d = 0.62–0.88) for improving masked teacher perceptions of academic success, impulse control, and academic productivity at 1–2 months posttreatment. At 2–4-month follow-up, CET (d = 0.76) and ICT (d = 0.54) were superior to BPT for improving objectively-tested academic achievement overall (reading comprehension, math problem-solving, language comprehension), and CET was superior to ICT (d = 0.56) for improving math problem-solving. The significant benefits of CET on academic success, academic productivity, reading comprehension, and math problem-solving replicated across both trials and were clinically significant as evidenced by low number needed to treat estimates (Needed to Treat; NNT = 3–7) and significantly higher proportions of individual cases demonstrating reliable improvements in academic success/productivity (33%–36% vs. 0%–18%) and achievement (38%–72% vs. 18%–54%) across outcomes (all p ≤ .01). Conclusions: Results across the two trials provide strong support for the efficacy of CET for ADHD, and are consistent with model-driven hypotheses that academic difficulties in ADHD are due, in part, to these children’s underdeveloped executive functioning abilities.

Objective: Utilizing a multi-level meta-analytic approach, this review is the first to systematically quantify the efficacy of reading interventions for school-aged children with ADHD and identify potential factors that may increase the success of reading-related interventions for these children. Method: 18 studies (15 peer-reviewed articles, 3 dissertations) published from 1986 to 2020 ( N = 564) were meta-analyzed. Results: Findings revealed reading interventions are highly effective for improving reading skills based on both study-developed/curriculum-based measures ( g = 1.91) and standardized/norm-referenced achievement tests ( g = 1.11) in high-quality studies of children with rigorously-diagnosed ADHD. Reading interventions that include at least 30 hours of intervention targeting decoding/phonemic awareness meet all benchmarks to be considered a Level 1 (Well-Established) Evidence-Based Practice with Strong Research Support for children with ADHD based on clinical and special education criteria. Conclusions: Our findings collectively indicate that reading interventions should be the first-line treatment for reading difficulties among at-risk readers with ADHD.

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The "simple view of reading" is an influential model of reading comprehension that asserts that children's reading comprehension performance can be explained entirely by their decoding and language comprehension skills. Children with attention-deficit/hyperactivity disorder (ADHD) often exhibit difficulty across all three of these reading domains on standardized achievement tests, yet it is unclear whether the simple view of reading is sufficient to explain reading comprehension performance for these children. The current study is the first to use multiple indicators and latent estimates to examine the veracity of key predictions from the simple view of reading in a clinically evaluated sample of 250 children with and without ADHD (ages 8-13, M age = 10.29, SD = 1.47; 93 girls; 70% White/non-Hispanic). Results of the full-sample structural equation model revealed that decoding and language comprehension explained all (R 2 = .99) of the variance in reading comprehension for children with and without ADHD. Further, multigroup modeling (ADHD, non-ADHD) indicated that there was no difference in the quantity of variance explained for children with ADHD versus clinically evaluated children without ADHD and that the quantity of explained variance did not differ from 100% for either group. Sensitivity analyses indicated that these effects were generally robust to control for monomethod bias, time sampling error, and IQ. These findings are consistent with "simple view" predictions that decoding and language comprehension are both necessary and together sufficient for explaining children's reading comprehension skills. The findings extend prior work by indicating that the "simple view" holds for both children with ADHD and clinically evaluated children without ADHD. Educational Impact and Implications StatementThe current findings indicate that the "simple view of reading" is helpful for understanding reading comprehension difficulties in children with ADHD. We found that reading comprehension performance is fully explained by skill at converting printed words to speech sounds (decoding) and skill at understanding spoken language (language comprehension) among children with ADHD. Future studies are needed to understand why children with ADHD have difficulties with decoding and language comprehension.

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