Abby Barnes, M.S., CCC-SLP
Research has shown that many kids who are diagnosed with ADHD also have speech and language problems. We don’t know for sure that ADHD causes communication issues. However, there is a strong correlation between decreased attention skills and being diagnosed with a communication disorder.
Does speech therapy work for ADHD? Let’s discuss the types of speech and language disorders that may be present in people with ADHD and how speech therapy for ADHD works.
What are the main symptoms of ADHD?
ADHD is a neurodevelopmental condition that affects 11% of children ages 4 to 17. Not all people with ADHD will have a speech delay or disorder. However, many people with ADHD experience symptoms such as the following:
Difficulty focusing on a specific task
Forgetfulness or problems with memory
Acting without thinking
Impatience or trouble waiting their turn
Struggling with impulse control
High amount of energy or activity
Interrupting or speaking at inappropriate times
Trouble following instructions
Fidgeting or squirming in their seat
It’s easy to see how difficulty in any of these areas could affect communication development or performance. For example, when a child is having trouble focusing and sitting still at school, it can be hard for them to work with other students or interact smoothly with their teacher.
It’s important to note that ADHD also comes with strengths. People with ADHD report that qualities like these can help them at school, at work, or socially: hyperfocus, resilience, creativity, high energy, and spontaneity and adventurousness.
Speech and language issues that may coexist with ADHD
Let’s look more specifically at some of the communication disorders that may be present for a person with ADHD.
Expressive language disorder
With an expressive language disorder, a person has difficulty communicating their thoughts and ideas in a clear, organized way. For example, they may have trouble answering questions, structuring their sentences clearly, or participating in a back-and-forth conversation.
The person may also make grammatical mistakes when speaking. There may be errors in their speech that just don’t sound quite right. They could even have trouble recalling details about something that happened, or have trouble finding the right words to express what they need to say.
Receptive language disorder
People with ADHD may also have challenges with receptive language. This refers to the ability to understand the words and sentences spoken to them. They may have trouble following verbal directions, recalling the details or main ideas of a story or conversation, or fully understanding questions that people ask them.
Social communication problems
There’s also quite a bit of research showing that children with ADHD are more prone to issues with pragmatic language. Pragmatic language skills, also known as social communication skills, refer to a person’s ability to follow the “social rules” of a conversation.
For example, a child with ADHD might often interrupt their conversation partner or give answers before a question is finished. They might misunderstand nonverbal cues or avoid eye contact. They also may change topics frequently or jump to another idea in conversation that just doesn’t seem to flow.
Stuttering
Experts believe that there is a link between stuttering and ADHD. Of children who stutter, research suggests that about 4% to 26% of them also have ADHD.
People who stutter may have repetitions in their speech, like, “I n-n-n-n-need to go.” This is typically what people think of when they think about stuttering. But there are other types of disfluencies. The person may have prolongations of sounds, such as, “Wwwwwwhere are you going?” They could also have something called a "block" when they speak. A block is when the person is unable to move their mouth and no sound comes out. So in the middle of a sentence, it may sound like a pause, and their mouth may appear to be frozen: “The test…………was hard.”
How can speech therapy help children with ADHD?
Speech therapy for ADHD can make a significant difference for people with speech delays or disorders. If ADHD's impact on a child is not addressed and supported, it may affect their ability to succeed at school, build relationships, and develop confidence.
So how does speech therapy work for ADHD? While a speech therapist can’t treat ADHD directly, they can treat the language issues that arise due to the attention deficits. For direct support with the ADHD diagnosis, such as medication or behavioral therapy, it’s best to speak with your pediatrician.
If ADHD's impact on a child is not addressed, it may affect their ability to succeed at school, build relationships, and develop confidence.
Speech therapy for ADHD begins with an evaluation. The speech therapist will assess the areas of language development that may be posing challenges. Perhaps the issues are with expressive language, receptive language, or both. Each child and their needs are different.
The speech therapist may also perform a formal assessment of social language, along with observing how the child interacts with others. For example, if a child is talking quickly, interrupting often, or isn’t able to stay on topic, these may be signs that ADHD is impacting their social communication skills.
During conversation, the speech therapist may assess speech fluency to determine if stuttering is present. If needed, the speech therapist can perform a formal stuttering assessment.
After the testing is complete, and the speech therapist has spent time getting to know the child and talking with their family, the therapist will develop a treatment plan with goals specific to the child and their needs.
Each session of speech therapy for ADHD will focus on working toward these goals. This is typically done through play. Speech therapists are creative at “hiding” the work that kids need to do in speech therapy. Here’s an example: When working on a concept like sentence structure, they may play games that naturally involve talking, like “I Spy” or “Guess Who?” Or, when working on auditory comprehension tasks, the therapist may read a favorite book of the child’s and then ask them questions about the story.
Speech therapy doesn’t have to be intimidating or challenging. The key is for it to be fun! This will keep the child engaged and learning during their sessions.
The speech therapist will continuously measure how accurately the child is performing toward their goals. They will also keep track of how much help they have to give the child. Over time, the speech therapist will back off on the support they provide in order to increase the child’s independence.
Your speech therapist should keep you updated on your child’s overall progress and provide ways they can practice at home. Let’s say your child is working on following 3-step directions. The speech therapist can explain what types of cues, or hints, are working best for your child and how you can use them. Maybe your child benefits from hearing the set of directions two times, as well as using a visual schedule. The speech therapist can walk you through how to use these techniques at home.
If your child has ADHD and you’re concerned about their speech and language development, don’t hesitate to reach out to a speech therapist. The earlier you can give them support, the better!
