Conventional methods of differentiating reading disability (RD) caused by deficits in decoding skills or comprehension from poor reading performance caused by inconsistent attention associated with attention-deficit/hyperactivity disorder (ADHD) have produced equivocal results. This study presents a model of differential diagnosis of attentional problems and RD that differs from these conventional approaches. The new diagnostic procedure uses intraindividual differences seen in the performance of at-risk learners on tasks related to reading that vary in their sensitivity to the sustained attention required for successful performance. The hypothesis is that children with inconsistent attention would perform more poorly on tests that require sustained attention, such as listening comprehension, than on tests that are more tolerant of inattention, such as reading comprehension. Such differences would not be seen in the test scores of children who have only RD, because their performance is determined more by the difficulty level of the reading tests than by the degree of sensitivity of the task to attention. The validity of this new model was evaluated by determining the capability of the differences seen in the scores of tests that differ in their sensitivity to sustained attention to predict the degree of inconsistency in sustained attention as measured by a continuous performance test. The data obtained from 39 children who are at risk for RD suggest that this is a viable model.
Get full access to this article
View all access options for this article.
References
1.
Aaron, P.G. (1991). Can reading disabilities be diagnosed without using intelligence tests?Journal of Learning Disabilities , 24, 178—186.
2.
Aaron, P.G. (1997). The impending demise of the discrepancy formula . Review of Educational Research, 67(4), 461—502.
3.
Aaron, P.G., & Joshi, R.M. (1992). Reading problems: Consultation and remediation . New York: Guilford Press.
4.
Aaron, P.G., Joshi, R.M., & Williams, K. (1999). Not all reading disabilities are alike. Journal of Learning Disabilities, 32, 120—137.
5.
Accardo, P.J. (2001). ADHD: The neurodevelopmentalist's perspective . In B. T. Rogers, T. R. Montgomery, T. M. Lock, & P. J. Accardo (Eds.), Attention deficit hyperactivity disorder (pp. 33—50). Baltimore: York Press.
6.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
7.
Aylward, G.P., Verhulst, S.U., & Bell, S. (1990). Individual and combined effects of attention deficits and learning disabilities on computerized ADHD assessment. Journal of Psychoeducational Assessment, 8, 497—508.
8.
Barkley, R.A. (1991). The ecological validity of laboratory and analogue assessment methods of ADHD symptoms. Journal of Abnormal Child Psychology, 19, 149—178.
9.
Barkley, R.A. (1996). Linkages between attention and executive functions. In G. R. Lyon & N. A. Krasnegor (Eds.), Attention, memory, and executive function (pp. 307— 348). Baltimore: Brookes.
10.
Barkley, R.A. (1997). ADHD and the nature of self-control. New York: Guilford Press.
11.
Biederman, J., Newcorn, J., & Sprich, S. (1992). Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. American Journal of Psychiatry,148, 564— 577.
12.
Bonafina, M.A., Newcorn, J.H., McKay, K.E., Koda, V.H., & Halperin, J.M. (2000). ADHD and reading disabilities: A cluster analytic approach for distinguishing subgroups. Journal of Learning Disabilities, 33, 297—315.
13.
Breggin, R.P. (1998). Talking back to Ritalin. Monroe, ME: Common Courage Press.
14.
Catts, H.W., & Kamhi, A.G. (1999). Language and reading disabilities. Needham Heights, MA: Allyn & Bacon.
15.
Conners, C.K. (2000). Conners' continuous performance test II. North Tonawanda, NY: Multi-Health Systems.
16.
Diller, L.H. (1998). Running on Ritalin. New York : Bantam Books.
17.
Douglas, V. (1972). Stop, look and listen. Canadian Journal of Behavioral Science, 4, 259—282.
18.
DuPaul, G.T., & Stoner, G. (1994). ADHD in the schools: Assessment and intervention strategies. New York: Guilford Press .
19.
Felton, R.H., Wood, F.B., Brown, I.B., Campbell, S.K., & Harter, S.L. (1987). Separate verbal memory and naming deficits in attention deficit disorder and reading disability. Brain & Language, 31, 171—184.
20.
Felton, R.H., & Wood, F.B. (1989). Cognitive deficits in reading disability and attention deficit disorder. Journal of Learning Disabilities, 22, 3—22.
21.
Fergusson, D.M., & Horwood, L.J. (1992). Attention deficit and reading achievement. Journal of Child Psychology and Psychiatry, 33, 375—385.
22.
Garrod, S., & Sanford, T. (1977). Interpreting anaphoric relations: The integration of semantic information while reading. Journal of Verbal Learning and Verbal Behavior, 16, 77—90.
23.
Garrod, S., & Sanford, T. (1990). Referential processes in reading: Focusing on roles and individuals. In D. A. Balota , G. B. Flores d'Arcais, & K. Rayner (Eds.), Comprehension processes in reading (pp. 465—485). Hillsdale, NJ: Erlbaum.
24.
Gilger, J.W., Pennington, B.F., & DeFries, J.C. (1992). A twin study of the etiology of comorbidity: Attention-deficit hyperactivity disorder and dyslexia. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 343—348.
25.
Gough, P., & Tunmer, W. (1986). Decoding, reading, and reading disability. Remedial and Special Education, 7, 6—10.
26.
Hall, S.J., Halperin, J.M., Schwartz, S.T., & Newcorn, J.H. (1997). Behavioral and executive functions in children with attention-deficit hyperactivity disorder and reading disability. Journal of Attention Disorders, 1, 235—247.
27.
Halperin, J.M. (1996). Conceptualizing, describing, and measuring components of attention. A summary. In G. R. Lyon & N. A. Krasnegor (Eds.), Attention, memory, and executive function (pp. 119—136). Baltimore : Brookes.
28.
Halperin, J.M., Gittelman, R., Klein, D., & Rudel, R.G. (1984). Reading-disabled hyperactive children: A distinct subgroup of attention deficit disorder with hyperlexia?Journal of Abnormal Child Psychology, 12, 1—14.
29.
Halperin, J., Sharma, V., Greenblatt, E., & Schwartz, S. (1991). Assessment of the continuous performance test: Reliability and validity in a non-referred sample. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 603—608.
30.
Haviland, S.E., & Clark, H.H. (1974). What's new? Acquiring new information as a process in comprehension. Journal of Verbal Learning and Verbal Behavior , 13, 512—521.
31.
Javorsky, J. (1996). An examination of youth with attention-deficit/hyperactivity disorder and language learning disabilities: A clinical study. Journal of Learning Disabilities, 29, 247—258.
32.
Karlsen, B., & Gardner, E. (1995). Stanford Diagnostic Reading Test (4th ed.). San Antonio, TX: Harcourt.
33.
Keogh, B.A. (1971). Hyperactivity and learning disorders: Review and speculations. Exceptional Children, 38, 101—109.
34.
Interagency Committee on Learning Disabilities. ( 1987). Learning disabilities: A report to the U.S. Congress . Washington, DC: U.S. Government Printing Office.
35.
Lovejoy, M.C., & Rasmussen, N.H. (1990). The validity of vigilance tasks in differential diagnosis of children referred for attention and learning problems. Journal of Abnormal Child Psychology, 18, 671—681.
36.
Mayes, S., & Bixler, E. (1993). Reliability of global impressions for assessing methylphenidate effects in children with attention-deficit hyperactivity disorder . Perceptual and Motor Skills, 77, 1215—1218.
McGee, R., & Share, D.I. (1988). Attention deficit disorder—hyperactivity and academic failure: Which comes first and what should be treated?Journal of the American Academy of Child and Adolescent Psychiatry, 27, 318—325.
39.
McGee, R., Williams, S., Moffitt, T., & Anderson, J. (1989). A comparison of 13-year-old boys with attention deficit and/ or reading disorder on neuropsychological measures. Journal of Abnormal Child Psychology, 17, 37—53.
40.
Mercugliano, M. (1999). What is attention deficit/hyperactivity disorder? In M. Mercugliano, T. J. Power, & N. J. Blum (Eds.). The clinician's practical guide to attention-deficit/hyperactivity disorder (pp. 1—15). Baltimore: Brookes .
41.
Mercugliano, M., Power, T., & Blum, N. (1999). The clinician's practical guide to attention-deficit/hyperactivity disorder. Baltimore: Brookes.
42.
Pennington, B.F., Groisser, D., & Welsh, M.C. (1993). Contrasting cognitive deficits in attention deficit hyperactivity disorder vs. reading disability. Developmental Psychology, 29, 511—523.
43.
Pisecco, S., Baker, D.B., Silva, P.A., & Brooke, M. (2001). Boys with reading disabilities and/or ADHD: Distinctions in early childhood. Journal of Learning Disabilities, 34, 98—106.
44.
Pliszka, S.R., Carlson, C.L., & Swanson, J.M. (1999). ADHD with comorbid disorders. New York: Guilford Press.
45.
Purvis, K.L., & Tannock, R. (2000). Phonological processing, not inhibitory control, differentiates ADHD and reading disability. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 485— 493.
46.
Reason, R. (1999). ADHD: A psychological response to an evolving concept (Report of a working party of the British Psychological Society). Journal of Learning Disabilities, 32, 85—91.
47.
Reid, R., & Maag, W. (1994). How many fidgets in a pretty much: A critique of behavior rating scales for identifying students with ADHD. Journal of School Psychology, 32, 424—428.
48.
Schulte, A.C., Conners, K.C., & Osborne, S.S. (1999). Linkages between attention deficit disorders and reading disability. In D. D. Drake (Ed.), Reading and attention disorders: Neurobiological correlates (pp. 161— 184). Baltimore: York Press.
49.
Semrud-Clikeman, M., Biederman, J., Sprich-Buckminster, S., Lehman, K., Faraone, S., & Norman, D. (1992). Comorbidity between ADHD and learning disability: A review and report in a clinically referred sample. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 439—448.
50.
Shapiro, B.K. (2001). The use and abuse of behavior checklists. In B. T. Rogers, T. R. Montgomery, T. M. Lock., & P. J. Accardo (Eds.), Attention deficit hyperactivity disorder (pp. 73—86). Baltimore : York Press.
51.
Shaywitz, S.E., Fletcher, J.M., & Shaywitz, B.A. (1994). Issues in the definition and classification of attention deficit disorder. Topics in Language Disorders, 14, 1—25.
52.
Snow, C. E., Burns, S. M., & Griffin, P. (Eds.). (1998). Preventing reading difficulties in young children . Washington, DC: National Academy Press.
53.
Stein, D.B. (1999). Ritalin is not the answer. San Francisco: Jossey Bass.
54.
Swanson, H.L., Mink, J., & Bocian, M. (1999). Cognitive processing deficits in poor readers with symptoms of reading disabilities and ADHD: More alike than different?Journal of Educational Psychology, 91, 321—333.
55.
Tannock, R., & Schachar, R. (1996). Executive dysfunction as an underlying mechanism of behavior and language problems in attention deficit hyperactivity disorder . In J. H. Beitchman, N. J. Cohen, M. M. Konstantareas , & R. Tannock (Eds.), Language, learning, and behavior disorders: Developmental, biological, and clinical perspectives (pp. 102—132). Cambridge, UK: Cambridge University Press.
56.
Voeller, K.S. (1999). Neurological factors underlying the comorbidity of attentional dysfunction and dyslexia. In D. D. Drake (Ed.), Reading and attention disorders: Neurobiological correlates (pp. 185— 211). Baltimore: York Press.
57.
Willcutt, E.G., & Pennington, B.F. (2000). Comorbidity of reading disability and attention-deficit/hyperactivity disorder: Differences by gender and subtype. Journal of Learning Disabilities, 33, 179—191.
58.
Wolraich, M., & Hannah, N. (1996). Comparison of diagnostic criteria for attention-deficit hyperactivity disorder in a county-wide sample. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 319—324.
59.
Wood, F.B., & Felton, R.H. (1994). Separate linguistic and attentional factors in the development of reading. Topics in Language Disorders, 14(4), 42—57.
