Comorbidity of language disorder with attention -deficit /hyperactivity disorder in a sample of early elementary children: A preliminary investigation

Two samples of children identified by school and community professionals as having either language disorder or ADHD were assessed for receptive and expressive language levels and were rated by parents and teachers for the presence of inattention and hyperactive/impulsive behaviors. Academic, behavioral, and demographic characteristics of the two samples of system-identified pupils were described. Language functioning significantly differentiated language disorder from ADHD pupils.;The system-identified children were assessed on measures of broad language and inattention/hyperactivity behaviors. Using research criteria, the children were reclassified into one of three research groups: "pure" language disorder, "pure" ADHD, or "comorbid," those children manifesting both language impairment and inattention or hyperactivity. Twenty of 59 children (33.6%) were classified as comorbid, which yielded a significant chi-square.;Academic and behavioral profiles of the three research-identified groups were presented. The incidence of overlap is discussed in light of studies in the clinical literature that have described a prevalence rate of 18% to 30% of children with language disorder also having ADD, and 34% to 90% of children with ADHD also meeting criteria for language impairment. These rates of comorbidity far exceed chance expectations, and suggest there may be a relationship between the two conditions. The overlap has implications for professionals who evaluate and treat children with either language disorder or ADHD.;As predicted, system-identified samples did not differ on important demographic characteristics including socioeconomic status, ethnicity, mother's education, and nonverbal IQ. Therefore, differences found between the groups are most likely attributable to characteristics of their diagnostic classification, rather than to external variables.;Findings supported a small but significant (33.9%) overlap between language disorder and ADHD groups, indicating the presence of comorbid conditions for about one in three children in this sample. Three research-identified clusters, pure language disorder, pure ADHD, and comorbid language and ADHD were described and contrasted on language, academic, inattentive, hyperactive, internalizing, externalizing, total problems, and social skills.;All students were rated by teachers as having below grade level academic competence. Reading scores were lowest for the children with pure language impairment and comorbid language disorder. Only children identified by the school system as having academic needs were receiving special education assistance. Children with ADHD received medication as the primary intervention; nearly 3 of 4 pupils with ADHD received no special help in school for their attentional deficits or hyperactive behaviors.;School systems were well designed to address speech, language, and academic needs of students. What was apparent from this investigation was that the domain of inattention/hyperactivity was not assessed by the school systems. Teacher and parent ratings of ADHD and comorbid children's inattention and total behavioral problems suggest that these are areas for assessment and intervention.;As predicted, more than a third of the pupils with identified language impairment were also rated by parents or teachers as having significant problems with inattention or hyperactivity. Greater than 1 in 5 of the pupils with ADHD were found to be at risk for developmental language disorder. Incidences of both disorders are higher than would be predicted by chance overlap. This study therefore supports research with clinical populations that documented significant comorbidity between these two conditions.;The research concludes that children with significant comorbidity exist among school samples. At the present time, the needs of these dual diagnosed children are not well assessed and addressed through non-academic interventions in the public schools.