The effect of picture support on narrative retells in Swedish adolescents with ADHD

ADHD is characterized by executive functioning (EF) deficits, which in turn may affect language, and therefore EF demands in language assessment tasks are important to consider. This study aims to inform clinical practice by 1) comparing and describing narrative retells in Swedish adolescents with and without ADHD, and 2) investigating the effects of picture support on narration in the two groups. Fifteen adolescents with ADHD and 31 with typical development (TD) participated. Two carefully matched narratives for retelling, one with and one without picture support were administered, transcribed, and analyzed regarding content and linguistic complexity (macro- and microlevel measures). The results showed that the ADHD group included less content than the TD group in both tasks, measured in fewer story grammar units and details. Both groups included more story grammar units in the task without picture support. The TD group had shorter retells with higher syntactic complexity in the task with picture support compared to the task without picture support. Compared to TD peers, retells without picture support from the ADHD group were significantly shorter and had a higher proportion of grammatical errors. These results show different strengths and weaknesses in the two groups and indicate that the narrative task without picture support, which places higher demands on EF, captured a linguistic vulnerability in the ADHD group. In conclusion, the choice of narrative task is important to consider in clinical practice to enable accurate descriptions of linguistic strengths and weaknesses in individuals with ADHD, and aid in differential diagnosis.