Story comprehension in children with ADHD

Ursula Bailey and colleagues examined developmental changes in children’s comprehension of complex stories shown as television shows. They wanted to assess whether the comprehension of stories by children with attention-deficit hyperactivity disorder (ADHD) changed in the same way as the comprehension of stories by children without ADHD, and whether the comprehension of stories was affected by potentially distracting materials when the children were exposed to the story. The researchers showed 48 children with a diagnosis of ADHD (medication free for previous 24 hours) and 65 comparison peers the TV stories (13-min Rugrats episodes) when they were about 8½ years old and again when they were about 10¼ and under two conditions: while the children had toys available or when no toys were available., After the children viewed the stories, experimenters asked them to recount the story and then to answer questions about the story.

• When the toys were absent, the ADHD and comparison children did not differ in their visual attention to the television, but when the toys were present, the comparison children spent more time watching the show than the children with ADHD.
• Both groups of children recalled comparable amounts of factual information when toys were not present, but when the toys were present, comparison children recalled more factual information than did the children with ADHD.
• When the toys were not available, both groups of children recalled significant more important factual information when they were older than when they were younger; however, when the toys were present, comparison children’s scores impoved, but the recall of important factual information by children with ADHD did not improve on the second assessment.
• On measures of causal relations in the stories, comparison children’s scores were higher overall (across time) and their scores improved as they grew older, but the scores of children with ADHD did not.

The authors infer from the results of their study that treatments such as medication and behavior modification may need to be supplemented with treatments promoting children’s thinking about causal connections among events: “In this study, children with ADHD failed to show any developmental improvement even when attention was optimal (i.e., toys-absent condition) and they were asked structured questions to cue the relevant information. Children with ADHD may need educational interventions focused specifically on making connections among events and building coherent story representations… in addition to the traditional treatments that may help implement and maintain these new skills.”

Changes in visual attention and story comprehension for children (N = 132) with attention deficit hyperactivity disorder (ADHD) and comparison peers were examined. Between the ages of 7 and 9 (Phase 1) and approximately 21 months later (Phase 2), children viewed 2 televised stories: 1 in the presence of toys and 1 in their absence. Both groups of children showed developmental increases in visual attention and stable group differences over time. Deficits in comprehension among children with ADHD, however, increased over time. Whereas comparison children’s recall of factual and causal information increased over time in both viewing conditions, children with ADHD showed no developmental improvement in recall of factual information in the toys-present condition and no improvement in recall of causal relations in either viewing condition.

Bailey, R. L., Lorch, E. P., Milich, R., & Charnigo, R. (2009). Developmental changes in attention and comprehension among children with attention deficit hyperactivity disorder. Child Development, 80, 1842-1855. doi: 10.1111/j.1467-8624.2009.01371

Link to abstract.