Functional Listening Difficulties in Children With ADHD: Associations With Language Abilities

Listening difficulties are commonly reported in children with attention-deficit/hyperactivity disorder (ADHD) and are often interpreted as manifestations of inattention. However, it remains unclear whether functional listening difficulties are related to broader language abilities or whether they differ across ADHD subtypes. The present study examined the association between functional listening difficulties and language abilities in children with ADHD and explored whether these relationships vary between predominantly inattentive and combined subtypes.

This cross-sectional observational study included 125 children diagnosed with ADHD, categorized into predominantly inattentive (n = 32) and combined (n = 93) ADHD subtypes. Functional listening was assessed using the Children's Home Inventory for Listening Difficulties (C.H.I.L.D.), with higher scores indicating better functional listening, and language abilities were assessed using the Turkish version of the Test of Early Language Development (TELD-3:T). Between-group differences were examined using Mann-Whitney U tests. The primary analysis was a hierarchical linear regression examining the adjusted association between total C.H.I.L.D. score and language performance, controlling for age, gender, and ADHD subtype. A C.H.I.L.D.-by-ADHD-subtype interaction was examined in a secondary analysis.

There was no statistical evidence of a difference between ADHD subtypes in C.H.I.L.D. or language scores (all p > 0.05). In the adjusted regression, higher total C.H.I.L.D. scores were associated with better language performance (B = 6.66, β = 0.594, p < 0.001, 95% CI [4.996, 8.315]). Exploratory correlations between total C.H.I.L.D. and language scores were positive in the predominantly inattentive type (r = 0.72), combined type (r = 0.56), and total sample (r = 0.61; all p < 0.001). The C.H.I.L.D.-by-ADHD-subtype interaction was not significant (B = 0.63, β = 0.031, p = 0.72, 95% CI [-2.919, 4.177]).

Better functional listening was associated with stronger language performance in children with ADHD. There was no statistical evidence that this association differed between ADHD subtypes. These findings highlight the relevance of considering both functional listening and language performance in the clinical assessment of children with ADHD.