Why it matters
- ADHD and DLD are both common neurodevelopmental disorders.
- Functionally, either (or both) can get in the way of a student’s success at school.
- Language and executive functioning are deeply intertwined:
- Around 22% of children with DLD also have ADHD.
- Most children with DLD present with deficits in at least one component of executive functioning, e.g. working memory, shifting attention, and inhibiting competing thoughts, sustaining attention, goal-directed persistence, metacognition (thinking about thinking), organisation, and/or emotional regulation.
- Difficulties with language – particularly social use of language (also known as pragmatic language) and discourse level language – are often a common feature of ADHD in the classroom.
- Functional assessment and intervention approaches to support students with DLD or ADHD (and other neurodevelopmental disorders) appear to be useful across diagnostic boundaries.
Limited research to date
In 2023, Senter and colleagues published a systematic review on speech-language pathology interventions for children with executive function deficits (see full citation below). They concluded that we all have a lot more to learn about how best to support children with DLD and ADHD (and other executive functioning challenges) at school.
We hope that Senter’s study will inspire DLD and ADHD researchers around the world to keep talking to each other more and to produce high quality peer-reviewed studies. But, right this minute, teachers and speech pathologists are working with students with DLD and ADHD in schools and other settings.
We can’t simply watch and wait.
What to do: practical strategies to help children with DLD and ADHD
Fortunately – thanks to years of collective research and clinical practice supporting students with DLD or ADHD – experienced teachers, speech pathologists, psychologists, and others know of several strategies we can trial to help school students with ADHD and DLD in the classroom.
Many of the following strategies benefit all students – not just those with DLD and/or ADHD:
- Environmental modifications to decrease background noise and other distractions in the classroom and other learning spaces.
- Language instruction/therapy to help students to improve their:
- oral language and writing skills, including by explicitly teaching key vocabulary (including academic vocabulary) in context, morphology, complex syntax, the ability to understand and follow directions and to comprehend language, generally, and knowledge of academic and other text types, including narratives, recounts, expositions and persuasive writing; and
- understanding of how language is used socially, including by teachers and peers in the classroom and playground.
- Visual supports to:
- supplement learning, e.g. with videos, pictures, graphic organisers, concept maps, and organisational frameworks, and scaffolds; and
- aid executive processes, e.g., with visual activity schedules/timetables, timers, calendars, planners, diaries and checklists.
- Verbal modifications to teaching practices, e.g.:
- pre-teaching key concepts, vocabulary and background knowledge;
- repeating and stressing key information;
- reduced rate of instruction, with more time for processing;
- checking students’ comprehension;
- breaking tasks and instructions into smaller chunks, e.g. breaking complex sentences into simple and compound sentences, and multi-step-instructions into simple, specific, step-by-step instructions;
- pairing auditory cues with visuals and gestures;
- giving worked examples and models;
- reducing the use of figurative and higher level language, including figures of speech like idioms, verbal analogies and metaphors; and
- advanced notice of transitions between activities.
- Teach students memory-assisting techniques such as rehearsal and visualisation.
- Evidence-based, explicit reading and writing instruction based on the Simple View of Reading and current reading science – especially for beginning readers and students who also have reading difficulties, difficulties with spelling or writing difficulties.
- Teach students self-talk, problem-solving strategies, and practical learning strategies, such as evidence-based:
- Support parents and carers, as the experts and key advocates for their children, to help their children to make friends, play, stay healthy mentally, and to participate in their interests at school, home, and out in the community.
If you have – or are teaching, treating, or otherwise working with – a child with DLD and ADHD, we hope you find these suggestions and linked articles useful.
Principal source: Senter, R., Chow, J.C., and Willis, E.C. (2023). Speech-Language Pathology Interventions for Children with Executive Function Deficits: A Systematic Literature Review. Language, Speech, and Hearing Services in Schools, 54, 336-354.
(As always, any errors of interpretation are mine.)
Hi there, I’m David Kinnane.
Principal Speech Pathologist, Banter Speech & Language
Our talented team of certified practising speech pathologists provide unhurried, personalised and evidence-based speech pathology care to children and adults in the Inner West of Sydney and beyond, both in our clinic and via telehealth.