ADHD With and Without Comorbid Specific Learning Disorder: Comparisons of WISC-R Profiles, Cognitive Disengagement...

Attention-deficit/hyperactivity disorder (ADHD) and specific learning disorder (SLD) are neurodevelopmental conditions, and cognitive disengagement syndrome (CDS) is a related symptom construct that frequently co-occurs in clinical settings, complicating differential diagnosis and intervention planning. The present study aimed to compare cognitive profiles, CDS symptoms and clinical/academic functioning among children and adolescents diagnosed with ADHD and/or SLD.

This cross-sectional study included 96 children and adolescents aged 6-16 years who were evaluated at a tertiary child and adolescent psychiatry outpatient clinic. Participants were classified into three groups: ADHD-only (n = 45), SLD-only (n = 15) and comorbid ADHD+SLD (n = 36). Cognitive functioning was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R). Clinical and functional characteristics were evaluated using the Barkley Child Attention Scale, Turgay's ADHD Rating Scale, the Specific Learning Disorder Evaluation Scale and the Strengths and Difficulties Questionnaire.

No statistically significant differences were found among groups in WISC-R Full Scale, Verbal, or Performance scores, nor in subtest mean scores (p > 0.05). Similarly, CDS symptom levels and CDS positivity rates did not differ significantly between groups. In contrast, the ADHD + SLD group exhibited significantly higher levels of inattention, oppositional defiant symptoms, peer problems and total difficulties compared with the other groups (p < 0.05). Regarding academic functioning, the comorbid group demonstrated the most pronounced impairments in reading-writing skills, organization, sequencing and study habits.

Although cognitive profiles were comparable, children diagnosed with comorbid ADHD+SLD exhibited more pronounced impairments in learning-related domains and psychosocial functioning. In clinical practice, priority should be given to comprehensive functional assessments, and comorbid cases should be managed using an integrated approach encompassing academic, behavioural and social interventions.