Language Problems vs ADHD: How Faculties Consider
He always says, “Huh? I don’t know, I forgot. “
She doesn’t seem to understand the lessons.
They cannot repeat what they are told.
She reads well, but her reading comprehension is poor.
When parents hear these comments from school, they may wonder, what’s going on? Does my child’s problems arise from ADHD? Or do you have difficulty understanding language? Could it be both? Or something completely different? And who can help us find out?
As a speech pathologist (SLP) at a public school, I often examine language disorders that can look very similar to ADHD and other diseases. Accurate special education evaluation requires a strong understanding of these similar conditions and the particular challenges faced by the student, which requires extensive information gathering and analysis. Here is a quick rundown of these conditions and the general process I follow when evaluating students.
Language Disorders vs. ADHD: Overview
A language disorder often manifests as deficits that can include (but are not limited to):
- vocabulary
- grammar
- narrative skills
- Read and write
- Expression (to speak)
- Reception (understanding)
- social communication
A language disorder can create challenges in a wide variety of school subjects. It can seem like a difficulty answering open-ended questions in social studies, interpreting story problems in math, understanding the teacher’s teaching in science, following multi-level instructions in sports, and learning a foreign language.
[Take This Self-Test: Language Processing Disorders in Children]
ADHD can affect similar areas. But unlike a child with only one language disorder, a child with ADHD can stand out in these common difficulties when they are particularly interested in a subject. Of course, the usual behavioral traits of ADHD must also be considered: inattentiveness, hyperactivity, and impulsiveness.
In addition, children with ADHD often have difficulty with social skills, such as making and maintaining friendships or controlling the impulses that can lead to mischief and conflict. And let’s not forget all of the managerial challenges that come with ADHD, such as initiating and completing tasks, organizing materials, and planning and time management.
How are language disorders and other conditions assessed in school?
For a formal school assessment, the Building Screening Committee (BSC) or team will collect information about your child and move on from there. And parents? You are the star member of the team.
As a member of the special education team, I start by talking to the family to get a thorough developmental history of the child. I look at things like the following:
- Does the child meet the language milestones on time?
- Is the family bilingual?
- Is there a history of language delay in the family?
- Does the child have health problems or a history of trauma?
- When was the last time you had your hearing and eyesight checked?
[Read: What Language Processing Disorders Look Like in Children]
The parenting interview is crucial to uncover clues that could lead the school team to involve or implement various specialists. For example, anxiety and mood disorders or negative childhood experiences can cause similar symptoms and must be excluded from the assessment. An aspiring bilingual child also has characteristics that make them appear delayed when simply in the normal process of second language acquisition.
Second, I look at education data. What are the student’s past and current grades, test reports, test scores, and attendance history? I also ask teachers to fill out checklists to see if the student is meeting academic expectations. Are there any areas where they are excellent? And where are they fighting?
Thirdly and finally, the special education team reviews the information gathered by the BSC and decides on the next steps. Perhaps they will decide to move on to the SLP test to assess a communication disorder. Or it can recommend a test by a school psychologist for ADHD (ADHD can come under a different umbrella claim, such as other health impairments).
Alternatively, the team may have fully dug up another special school rating; it may conclude that there are multiple suspected disorders and each of them may be tested for at the same time; it can suggest quick screening instead of extensive testing; or it can refer the family to healthcare professionals for more information before proceeding.
Assessment of language disorders and other conditions: It takes a village
I’ve learned sometimes the hard way not to jump to conclusions. I’ve had students who we originally suspected had one of the most common levels of eligibility – communication disorder, ADHD, autism spectrum disorder, and specific learning disability – but it turned out to be an undiagnosed hearing or visual impairment, a post- Had concussion syndrome, absence seizures, selective mutism, insomnia or lead poisoning as the primary underlying disease.
The takeaway message is that we need to slow down and adopt a measured, team-based approach in determining special education eligibility. The things that are said about your child (for example, “He’s not following the instructions”) are important, but they don’t automatically tell us what’s going on. Raise your concerns with the school and your pediatrician, and ask for help pinpointing the underlying problems.
It takes a village to raise a child … and a really solid team to make village life accessible, meaningful, worth living and fertile for the child.
* These are my own observations and experiences from over 18 years as an SLP in special needs teams in the public school environment. These views may not reflect the opinions or practices of other colleagues, organizations or institutions.
Language Disorders and ADHD: The Next Steps
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