Pragmatic aspects of communication and language comprehension in groups of children differentiated by teacher ratings of inattention and hyperactivity

Abstract

Please contact Kate Cain for a copy of this paper.Inattention, hyperactivity and pragmatic language skills page 2 AbstractChildren with attention deficit hyperactivity disorder (ADHD) experience pragmatic language deficits, but it is not known whether these difficulties are primarily associated with high levels of inattention, hyperactivity, or both. We investigated pragmatic aspects of communication and language comprehension in relation to poor attention and/or high hyperactivity in a nondiagnosed population of 7-11-year-olds. Classroom teachers rated their pupils' attention and hyperactivity/impulsivity on the ADD-H Comprehensive TeacherRating Scale (ACTeRS). The three groups were formed: children with poor attention and low hyperactivity (poor attention group), children with good attention and high hyperactivity (high hyperactivity group), children with both poor attention and high hyperactivity (poor attention/high hyperactivity group). Their performance was compared with that of same-age controls in two studies: Study One (N=94) investigated the comprehension of figurative language in and out of context; Study Two (N=100) investigated pragmatic aspects of communication using the Children's Communication Checklist -Second Edition.Two groups, the poor attention and the poor attention/high hyperactivity groups, were impaired in both their comprehension of figurative language and their communication skills.The high hyperactivity group was impaired in their comprehension of figurative language but they did not exhibit communication impairments. The findings extend work with clinical populations of children with ADHD: Even in a nondiagnosed sample of children, poor attention and elevated levels of hyperactivity are associated with pragmatic language weaknesses.Inattention, hyperactivity and pragmatic language skills page 3 Pragmatic aspects of communication and language comprehension in groups of children differentiated by teacher ratings of inattention and hyperactivityPragmatics is defined as how language is used to convey meaning (e.g. Adams, 2002).Pragmatic language difficulties are specific to the use and comprehension of language in context, rather than problems with semantic or structural aspects of language. Difficulties in language use include poor turn taking and an inability to stay on topic in conversation; difficulties in language comprehension include a tendency to interpret figurative language literally. We report an investigation of these two aspects of pragmatic language in groups of 7-11-year-olds differentiated by teacher ratings of inattention and hyperactivity.ADHD is a behavioural disorder, in which individuals exhibit levels of inattention and/or hyperactivity and impulsivity that are inappropriate for their age (DSM-IV, AmericanPsychiatric Association, 1994). DSM-IV distinguishes between the inattentive and hyperactivity/impulsivity elements of the disorder, which may occur together or separately, resulting in three subtypes: predominantly inattentive, predominantly hyperactive-impulsive,...

Thinking outside the executive functions box: Theory of mind and pragmatic abilities in attention deficit/hyperactivity disorder

“…The extent of pragmatic language difficulties was related to the hyperactivity characteristics, but not to the attention difficulties the parents reported. These findings were in line with the findings of Bignell and Cain (2007). These authors reported pragmatic language deficits in each of the three AD/ HD subtypes, but the deficits were more profound in those children that were hyperactive and impulsive (irrespective of whether they also had attention deficits as for both groups large effect sizes were obtained) than in the children that had attention deficits only (as only small effect sizes were obtained).…”

“…A striking finding was that children with AD/HD hardly differed from children with autism. These observed pragmatic difficulties in AD/HD children have been replicated in various other studies (Bignell & Cain, 2007;Bruce, Thernlund, & Nettelbladt, 2006;Geurts & Embrechts, 2008;Geurts et al, 2004b;Norbury, Nash, Baird, & Bishop, 2004). The pragmatic difficulties in children with ADHD were, in general, less profound compared to those observed in children with autism for whom pragmatic language deficits are a key characteristic (American Psychiatric Association, 2000).…”

“…We introduced AD/HD as a disorder that is associated with EF deficits, and we hypothesized, based on the suggested link between EF, ToM, and pragmatic abilities in the autism literature (e.g., Hughes & Ensor, 2007;Pellicano, 2007), that children with AD/HD would encounter deficits in ToM and pragmatic language use. However, no clear evidence for ToM deficits has been reported (e.g., Charman et al, 2001;Dyck et al, 2001;Perner et al, 2002), although children with AD/HD do show pragmatic deficits (Bignell & Cain, 2007;Bruce et al, 2006;Geurts & Embrechts, 2008;Geurts et al, 2004b;Norbury et al, 2004). From the current review we can conclude that EF deficits do not automatically lead to ToM deficits (which is in contrast with Hughes, 1998;Russell, 1997).…”

“…If the earlier SST findings are interpreted as such we must conclude that children with AD/HD are not challenged on this advanced type of ToM. If we interpret the SST as a direct measure of pragmatic abilities, this would suggest that the findings are in contrast with the findings based on parent reports (Bignell & Cain, 2007;Bruce et al, 2006;Geurts & Embrechts, 2008;Geurts et al, 2004b;Norbury et al, 2004). A common finding in clinical language research is that the informant agreement between parents and other informants, even when very similar measures are used, is notoriously low (e.g., Bishop, 1998;Embrechts, Mugge, & Van Bon, 2005;Massa, Gomes, Tartter, Wolfson, & Halperin, 2008).…”

The Effect of a Multi-Component Consultation Intervention on the Pragmatic Language Skills of Students with Symptoms of Attention Deficit Hyperactivity Disorder

“…For example, teachers and parents of children with ADHD sometimes report that these children incorrectly interpret figurative language, such as expressions, in a literal manner. However, children with ADHD do not differ from controls on formal tests of semantic knowledge, such as those that require defining words in various context (Bignell & Cain, 2007;Bishop, 1998;Purvis & Tannock, 1997).…”