Reading Comprehension in Children with ADHD

Unfortunately, many children diagnosed with ADHD go on to have important difficulties in their academic development. For example, prior research has shown that children with ADHD are more likely to have learning disabilities than other children, and are also more likely to be retained in a grade at some point during their schooling.
One especially important area that has not been carefully studied is the effect that ADHD may have on children’s reading comprehension. Because reading comprehension requires sustained mental effort and attention, it seems reasonable to expect that ADHD would have an adverse effect on this skill. An interesting study published in the Journal of Attention Disorders (Vol. 3, 1996, pages 173-185) provides an interesting and instructive initial look at this important question.
In this study, the reading comprehension abilities of 21 children in grades 4-6 with and without ADHD were compared. What is noteworthy about the children in this study is that the authors first made sure that the two groups were matched on their basic sight-reading skills. In other words, the children with ADHD were selected so that their ability to read individual words did not differ from the non-ADHD children. This enabled the authors to determine whether children with ADHD have deficits in reading comprehension even when their more basic reading abilities (e.g. their ability to read and sound out individual words) are intact.
For the reading comprehension assessment, children were asked to read several passages of approximately 440 words in length from a 5th grade science text. After reading each passage, children were asked to rate on a 5-point scale how well they understood what they had just read. They were then asked to give the passage a good title and to identify the specific number of main ideas in the text and their accuracy in identifying the topic and main ideas present in each passage was evaluated.
As predicted, children with ADHD were less accurate than children in the control group in correctly identifying the different topics and main ideas in each passage. Children without ADHD were able to correctly identify about 50% more of the important topics and were twice as likely to correctly identify the main idea of the passage. Thus, even though children with ADHD were able to read the passages as well (recall that they were carefully matched to insure that their basic sight reading skills were equivalent) they were still less able to correctly comprehend the important aspects of what they had read. (It is interesting to note that some of the children in the ADHD group were on medication at the time of testing. These children did better on the comprehension tasks than the non-medicated children and did not differ in their comprehension results from the children without ADHD).
What are the implications of these results? First, the authors suggest that children with ADHD may have special reading instructional needs. Even when children with ADHD are able to sight read passages as well as other children - as the children in this study were selected to be able to do - many are still less able to construct meaning from the passages they have read. Thus, they will be at a disadvantage when asked to read for new learning. In other words, comprehending material read from a long chapter may be quite difficult for the student with ADHD. (This may ring a bell for you. I have had many children I work with who report that it is very difficult for them to read chapters in social studies or science books and then have to answer questions about what they have read.)
Remember, this is not necessarily true for all children with ADHD, but it is apparently an issue for many.
Special instruction in understanding and comprehending written material may thus be very important for the student with ADHD, even if he or she is a very good oral reader.(Recall, however, that the results of this study also suggest that medication may significantly improve reading comprehension in a child with ADHD, although this was based on a very small sample size. Therefore, any firm conclusions about the effects of medication on reading comprehension cannot be made from these results alone.)
In regards to assessment, it may be quite important to use longer passages when evaluating the reading comprehension abilities of children with ADHD. The use of longer passages, as was done in this study, increases the demands for sustained attention and effort while processing the material. The most widely used tests to evaluate reading comprehension for students being assessed for possible learning difficulties, however, typically use much shorter passages. As a result, how a child with ADHD does on these reading achievement tests may overestimate how they will actually perform when required to read chapter books for school assignments. Because a child’s score on these tests is one factor used to determine his or her eligibility for specialized reading instruction, some children with ADHD who actually require extra instruction in reading will not be selected to receive it.


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