ADHD
and speech and language problems
Why
underlying speech and language disorders in conditions from ADHD and autism
to dyslexia and DSI need to be addressed
Even though speech and language disorders are the number one disability
in children, and on the rise for some reason, genetic
or environmental or both, and even though the importance of early
detection and treatment to children exhibiting early speech and language
delays has been well researched and documented, there is little awareness about
its impact on learning and behavior. The silence both from and about
"late talker" children is not golden. Awareness can help
bring more children a voice, which is why The
Late Talker book is so important.
According
to the analysis of the US Department of Education
2001 statistics by Dr. Mark Geier, while
there has been a 4 fold increase in the numbers of children with autism,
there has been a 30 fold increase in the numbers of children with speech
and language disorders in the past ten years. As alarming as that
sounds, we suspect the numbers of children with an undetected underlying
speech and language disorder could in fact could be higher. It is
hard to know the exact numbers of how many children have speech and language
impairments for two main reasons:
1. Speech and language disorders are frequently attributed as part of another
diagnosis.
2. Speech and language disorders are often undiagnosed.
The problem in not recognizing if a child has a specific speech and language
disorder either alone, or co-existing with another diagnosis, is that
the child may or may not receive the appropriate therapies to address
the communication impairment to give the child the best prognosis.
Most appreciate that there are specific appropriate therapies for autism,
dyslexia, sensory integration dysfunction, central auditory processing
disorder, and ADHD, and that they can vary. Yet most don't address
the fact that there are also specific appropriate therapies for speech
and language disorders as well, which are also unique. In the case
of severe speech disorders such as apraxia, it is critical to do these
specific therapies frequently and intensively.
If
disorders of speech and language go undiagnosed and/or untreated, or they
continue to be attributed to another diagnosis, we are not addressing
the full problem and not providing children with undetected underlying
speech and language disorders the best chance at being a successful communicator
in the future.
As neurodevelopmental pediatrician Dr.
Agin states, " We know that many children who have neurologic
problems do not have just one problem, but multiple overlapping signs
and symptoms. A child can have a speech and language impairment,
sensory issues, ADHD, PDD...."
So keeping that in mind, why then is the importance of addressing specific
speech and language disorders with appropriate therapies ignored or downplayed
in so many conditions?
Through
CHERAB's outreach many report that in addition to the speech and language
disorder their child has also been diagnosed as having another condition,
or two, or three... Some children do have more than one condition,
and some have been misdiagnosed. When you read some of the symptoms
of other diagnoses it's no wonder. Perhaps we need
to stop listing speech and language as part of another diagnosis and address
it for what it is -a disorder that is on the rise to epidemic proportions.
Here are examples of how speech and language disorders are attributed
to other conditions. All have specific therapies, however I'll
only touch on them for example. As you read the following -think
of your "late talker child" and how closely he falls into the
following descriptions of:
Autism
"Autism
is a term that refers to a collection of neurologically-based developmental
disorders in which individuals have impairments in social
interaction and communication skills" ... "People
with autism can make progress if they receive appropriate, individual
intervention. Pre-school children who receive intensive, individualized,
behavioral interventions show good progress. In addition, limited pharmacological
interventions are available to treat symptoms associated with autism."
http://www.cdc.gov/nip/vacsafe/concerns/autism/autism-facts.htm
...could
they also suggest speech and occupational therapy? At least speech
therapy? Was something left out here or is it me?
CAPD
"Children
with CAPD may demonstrate difficulties in speech, language,
and/or learning"
http://www.ldonline.org/ld_indepth/process_deficit/capd_perc.html
Dyslexia
The
British
Dyslexia Association describes a sign of dyslexia as "Later
than expected speech development " and states "There
is a large body of research linking speech and language difficulties in
early childhood to later literacy problems." And according
to the Society
for Neuroscience "Many scientists have identified brain regions
related to dyslexia with high-tech imaging techniques that photograph
the brain in action. The tools have helped them link the disability
to speech sound processing, vision and language brain systems"
Therapy? According to Dr.
Harold Levinson, a world-renowned psychiatrist and neurologist "some
dyslexics will have severe reading, spelling and speech
difficulties while others will have major problems with only
math, memory and concentration. Yet all suffer from an inner-ear-determined
dysfunction"
...What
is and is speech therapy good for "inner-ear-determined dysfunction" for dyslexics who exhibit speech problems?
Sensory
Integration Dysfunction
In
the book The Out of Sync Child (which I love!) the author Carol Kranowitz "gives excellent examples of typical
indicators that can signal a parent (or grandparent or caregiver)
that a sensory integration dysfunction may be present. A few of the examples
of typical symptoms in children include oversensitivity to touch, movement,
sights, or sounds; an activity level that is unusually high or unusually
low; coordination problems; delays in speech,
language, motor skills"
And
the list goes on...
Since
I don't have time or room to go into every disorder, impairment, disability
and condition that also credits "speech delay or difficulty" as part of the diagnosis, let's just study what we found above.
Motor
planning problems, speech delays and difficulties, the signs of the various
conditions above, are signs of a speech or language disorder as well as
discussed in "The
Late Talker" What about ADHD someone may ask. (OK so one
of you did which is why I built this new page) "Are there links
between ADHD and speech problems?"
Since
I list ADHD in my top
ten reasons to celebrate the new book, 'The Late Talker', let's
concentrate on ADHD.
Did
you know in some samples those with a diagnosis of ADHD have "undiagnosed" speech and language disorders as high as 40% and 50% of the time?
As
a mom, I have personal experience ( twice
) with late talkers. One of my late talker boys also has ADHD.
Due
to a traumatic birth, my oldest son
Dakota was in therapy overseen by a neurologist from three weeks
old. Dakota also was a late talker, (which we all considered the
least of his problems in comparison to his eating and breathing problems)
Dakota has been diagnosed by neurologists and developmental pediatricians
as having either ADHD, ADD, or CAPD (central auditory processing disorder)
numerous times as well (and ADHD "suspected" and pointed
out to me by each of his teachers from preschool to second grade... as
well as most baby sitters, strangers in the supermarket, and one neurologist
who left the exam room for a second to get a pen and came back to find
Dakota knocked his entire wall shelf down that I was trying to put back
up!)
Even
though Dakota has been diagnosed with ADD, due to educational and therapeutic
strategies, and without any medication, Dakota is a brilliant gifted third
grade student who receives straight A's academically. Dakota
is mainstreamed, and classified for his ADHD, and he receives pull out
speech therapy two times a week through the school district. Dakota,
like Tanner, has benefited from the right formula of Omega 3 and Omega
6 oils. (You can read about that here) Dakota is a true success story and a testament to early intervention.
Quite a few doctors have called Dakota the "miracle child" at this point.
Perhaps it was part miracle, part therapy, part early intervention, and
part brain stimulation. Either way, with or without ADD, Dakota is "normal"
now, actually better than normal, and for that we couldn't be happier,
no matter how it happened.
ADHD and Communication Disorders
Here
are some snips from articles about the relationships between ADHD and
speech and language development. Please click on the links to view
the entire article.
"...Communication
disorders describe developmental speech and/or language disorders. These
children have elevated rates of ADHD. It is also clear that children referred
for psychiatric problems and given a diagnosis of ADHD have undiagnosed
speech and language disorders in a number of cases, as high as 40% and
50% in some samples. The nature of this relationship is not well understood.
It may be that the speech and language disorders lead to attentional problems
in some particular way or that they are both due to some common underlying
factor, such as some type of central nervous system (CNS)
dysfunction.
The long-term outcome of children with speech and language disorders is
fairly good for the disorders themselves. However, these children are
highly likely to develop learning disorders as a residual outcome of their
speech and language disorders. Thus, the presence of
communication disorders is likely to lead in ADHD children, as it does
in non-ADHD children, to the development of academic performance problems
due to specific learning disabilities in the language- related areas.
This probability must be taken into account in the
design of treatment plans to alter long-term negative outcome..."
Impulsivity,
Inattention and Language
Sam Goldstein,
Ph.D.
"Toddlers
and preschoolers at risk to receive a diagnosis of ADHD are often impulsive
and inattentive. These children also demonstrate a higher incidence of
problems with language development. In some studies as many as 50% to
70% of young children with hyperactive and impulsive behavior were experiencing
problems in understanding and expressing ideas through language. These
children also demonstrated a high rate of learning disability when they
entered school. It is unclear whether their temperament contributes to
delayed language or delayed language contributes to their difficulty temperamentally.
Before they learn to speak and begin to attach verbal labels to things,
infants must touch, feel and taste as a means of gaining information about
the world. Once they learn to use language effectively, words replace
touch. Impulsive toddlers, however, often have difficulty making this
transition. Typically they continue to need to touch and feel things,
possibly as a means of gaining sensory input from the world. This problem
may lead to difficulty
understanding personal space in older children with ADHD.
In long-term studies, Dr. Walter Mischel and colleagues found a most interesting
relationship between a young child's ability to use language skills while
waiting for rewards and later success as a teenager or young adult....
ADHD:
Speech and Language
American
Speech Hearing Association
"Inattention,
hyperactivity, and impulsivity have their effects on speech and language...some
children with ADHD also have learning disabilities that affect their speech
and language. Evaluation of each child's individual speech and language
pattern is critical to developing an appropriate treatment plan..."
ADHD
And Communication Skills
Eileen
Bailey Director of ADDHelpline
"There
are a number of ADD symptoms that can become barriers to effective communication (see
a list here) ...The ADD brain, always active, yet lacking in certain
chemicals can not always retrieve the accurate data it needs. The right
descriptive word may be filed somewhere in their brain, but not readily
accessible. We have all "known" something that we can't remember and say
that it is "on the tip of our tongue." Somewhere in our brain we have
the knowledge, but at the moment we do not have the ability to locate
it.
So
it is with an ADD brain. With thoughts constantly moving quickly around
and distractions taking attention away, it can be hard to locate the piece
of information within the vast storage of the brain. Therefore, the correct
words or phrases do not come. The ADD person becomes frustrated because
the know what they want to convey, they can feel what they want to convey,
and sometimes they think they have conveyed that very thought. But somewhere,
it has been misconstrued, or not understood. Those that do not understand
ADD may feel lost in the conversation, get annoyed or just look at you
with amusement or non-comprehension.
Whatever
happens, the communication can break down and cause frustration on both
ends..."
The Cherab Foundation is a world-wide nonprofit organization working to improve the communication skills and education of all children with speech and language delays and disorders. Our area of emphasis is verbal and oral apraxia, severe neurologically-based speech and language disorders that hinder children's ability to speak.
The Cherab Foundation is committed to assisting with the development of new therapeutic approaches, preventions and cures to neurologically-based speech disorders. We bring together parents and medical, research, and educational professionals. Please join us and help to give our children a smile and a voice.
Cherab Foundation
Communication Help, Education, Research, Apraxia Base
P.O. Box 8524 PSL, Florida 34952-8524
Phone: 772-335-5135
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Last Update: June 18, 2006
