Relations Among ADHD Symptoms, Executive Functioning, and Reading Ability

Relations Among ADHD Symptoms, Executive Functioning, and Reading Ability

First Author: Francesca Trane -- CU Boulder
Additional authors/chairs: 
Masha R. Jones; Osman Umarji; Elham Zargar; Stephanie Day; Carol M. Connor
Keywords: ADHD, Reading comprehension, Word reading, Executive Functioning, Comorbidity
Abstract / Summary: 

Attention-Deficit/Hyperactivity Disorder (ADHD) and Reading Disability (RD) are among the most commonly diagnosed developmental disorders in the United States, with comorbidity rates ranging from 10-40%. It is important to understand how ADHD symptoms relate to specific dimensions of RD and whether these relations can be explained by shared deficits in neuropsychological functioning. Individuals with ADHD and individuals with RD both demonstrate deficits in executive functions (EF), and studies of reading ability implicate EF in reading comprehension more strongly than in word-level decoding. We hypothesized that if ADHD and RD are co-diagnosed in part due to shared EF deficits, then the reading skill most highly impacted by ADHD is perhaps reading comprehension. Within a community sample of 5th graders, we examined whether inattention symptoms were more strongly correlated with reading comprehension than with word decoding, and whether this relation was mediated by EF, using Hierarchical Linear Modeling to account for the nested structure of the data. Inattention symptoms were measured using the Strengths and Weaknesses of ADHD-symptoms and Normal-behavior (SWAN) Scale. Word decoding and reading comprehension were assessed using the Letter-Word Identification and Passage Comprehension Tests of the Woodcock Johnson III, respectively. EF was measured using the Remembering Rules and Regulation Picture Task. Results demonstrated that inattention symptoms were correlated with word decoding and reading comprehension, but more strongly associated with reading comprehension. We found that every 1-point increase on the SWAN scale (i.e., demonstrating fewer symptoms), predicted a 20-point increase in reading comprehension—a difference of almost two standard deviations. We conclude that professionals working with children with inattention problems should closely examine their students’ reading component skills, and tailor reading instruction to meet unique learning needs.