Occurrence and pattern of impaired reading and written language in children with attention deficit disorders

The purpose of this study was to investigate the occurrence and severity of reading, spelling, and written language impairment in children clinically referred for Attention Deficit Hyperactivity Disorder (ADHD). Specific questions involved 1) whether ADD subgroups with and without hyperactivity differ in reading, spelling, and written language achievement, 2) whether age and gender interact with ADD sub-group class to affect reading/written language achievement, and 3) whether prevalence of impaired reading/written language in these subgroups is consistent with previous reports in heterogeneous samples. Subjects were 115 ADD children aged 6-12 who were subclassified as ADD + H(72 percent) and ADD - H(28 percent) by objective teacher ratings. Dependent measures included tests of single word recognition and vocabulary, word attack, contextual comprehension, written spelling, written sentence construction, and writing fluency, in addition to a structured behavioral observation, during which aspects of inattention and motor activity were coded. A large fraction of this sample met public school LD criteria (54 percent), and achievement on most measures was globally poorer than the respective test normative groups. The ADD + H subgroup showed significantly poorer word attack skills, while the subgroups did not significantly differ from each other on other reading/written language measures. However, 17 percent of the total ADD sample were ≥ 1.5 SD below the mean in total reading achievement, and 29 percent were ≥ 1.5 SD below the mean on measures of written spelling/language. Gender X age interactions, indicating poorer performance in the middle age group of females, were likely related to lower IQ.