Contrasting Deficits in the Function of the Phonological Loop Between Children With Attention Deficit Hyperactivity Disorder and Reading Disability

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) and reading disability (RD) often co-occur. Impairments in the phonological loop of working memory are central to RD, but it is unclear whether this is linked to ADHD, especially in Chinese reading. Two experiments were conducted with Chinese children aged 7 to 12 (Experiment 1, n = 65; Experiment 2, n = 60). Immediate and delayed recognition paradigms were used to assess phonological encoding and rehearsal. Both the RD-only and comorbid (ADHD + RD) groups performed worse than the control and ADHD-only groups in response time and accuracy. Notably, the comorbid group performed similarly to the RD-only group, indicating that phonological loop deficits in comorbid children are likely due to RD, not ADHD. This highlights phonological loop function as the key to distinguishing between ADHD and RD.

Keywords

Attention deficit hyperactivity disorder reading disability phonological loop phonological encoding phonological rehearsal

Get full access to this article

View all access options for this article.

References

American Psychiatric Association, DSM-5 Task Force . (2013). Diagnostic and statistical manual of mental disorders: DSM-5™ (5th ed.). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596

Aravena

Snellings

Tijms

van der Molen

M. W.

(2013). A lab-controlled simulation of a letter–speech sound binding deficit in dyslexia. Journal of Experimental Child Psychology, 115(4), 691–707. https://doi.org/10.1016/j.jecp.2013.03.009

Åsberg Johnels

Kopp

Gillberg

(2014). Spelling difficulties in school-aged girls with attention-deficit/hyperactivity disorder: Behavioral, psycholinguistic, cognitive, and graphomotor correlates. Journal of Learning Disabilities, 47(5), 424–434. https://doi.org/10.1177/0022219412467058

Baddeley

(2000). The episodic buffer: A new component of working memory? Trends in Cognitive Sciences, 4(11), 417–423. https://doi.org/10.1016/S1364-6613(00)01538-2

Baddeley

(2010). Working memory. Current Biology, 20(4), R136–R140. https://doi.org/10.1016/j.cub.2009.12.014

Baddeley

A. D.

(1990). Human memory: Theory and practice. Allyn & Bacon.

Barkley

R. A.

(1997). Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD. Psychological Bulletin, 121(1), 65–94. https://doi.org/10.1037/0033-2909.121.1.65

Beneventi

Tønnessen

F. E.

Ersland

Hugdahl

(2010). Working memory deficit in dyslexia: Behavioral and FMRI evidence. International Journal of Neuroscience, 120(1), 51–59. https://doi.org/10.3109/00207450903275129

Bental

Tirosh

(2007). The relationship between attention, executive functions and reading domain abilities in attention deficit hyperactivity disorder and reading disorder: A comparative study. The Journal of Child Psychology and Psychiatry and Allied Disciplines, 48(5), 455–463. https://doi.org/10.1111/j.1469-7610.2006.01710.x

10.

Bolden

Rapport

M. D.

Raiker

J. S.

Sarver

D. E.

Kofler

M. J.

(2012). Understanding phonological memory deficits in boys with attention- deficit/hyperactivity disorder (ADHD): Dissociation of short-term storage and articulatory rehearsal processes. Journal of Abnormal Child Psychology, 40(6), 999–1011. https://doi.org/10.1007/s10802-012-9619-6

11.

Bowers

P. G.

Steffy

Tate

(1988). Comparison of the effects of IQ control methods on memory and naming speed predictors of reading disability. Reading Research Quarterly, 23(3), 304–319. https://doi.org/10.2307/748044

12.

Champ

R. E.

Adamou

Tolchard

(2023). Seeking connection, autonomy, and emotional feedback: A self-determination theory of self-regulation in attention-deficit hyperactivity disorder. Psychological Review, 130(3), 569–603. https://doi.org/10.1037/rev0000398

13.

Chan

D. W.

C. S.

Tsang

Lee

Chung

K. K.

(2007). Prevalence, gender ratio and gender differences in reading-related cognitive abilities among Chinese children with dyslexia in Hong Kong. Educational Studies, 33(2), 249–265. https://doi.org/10.1080/03055690601068535

14.

Chen

Peng

(2001). The time course of graphic, phonological and semantic information processing in Chinese character recognition:I. Acta Psychology Sinica, 33(1), 1–6. https://journal.psych.ac.cn/xlxb/CN/Y2001/V33/I1/1

15.

Chen

Wang

Peng

(2003). The time course of graphic, phonological and semantic information processing in Chinese character recognition:II. Acta Psychology Sinica, 35(5), 576–581. https://journal.psych.ac.cn/acps/EN/Y2003/V35/I05/576

16.

Cockcroft

(2011). Working memory functioning in children with attention-deficit/hyperactivity disorder (ADHD): A comparison between subtypes and normal controls. Journal of Child and Adolescent Mental Health, 23(2), 107–118. https://doi.org/10.2989/17280583.2011.634545

17.

Cowan

(2001). The magical number 4 in short-term memory: A reconsideration of mental storage capacity. Behavioral and Brain Sciences, 24(1), 87–185. https://doi.org/10.1017/S0140525X01003922

18.

de Jong

C. G. W.

Van De Voorde

Roeyers

Raymaekers

Oosterlaan

Sergeant

J. A.

(2009). How distinctive are ADHD and RD? Results of a double dissociation study. Journal of Abnormal Child Psychology, 37(7), 1007–1017. https://doi.org/10.1007/s10802-009-9328-y

19.

Faraone

S. V.

Biederman

Mick

(2006). The age-dependent decline of attention deficit hyperactivity disorder: A meta-analysis of follow-up studies. Psychological Medicine, 36(2), 159–165. https://doi.org/10.1017/S003329170500471X

20.

Fernández-Andrés

M. I.

Tejero

Vélez-Calvo

(2021). Visual attention, orthographic word recognition, and executive functioning in children with ADHD, dyslexia, or ADHD + dyslexia. Journal of Attention Disorders, 25(7), 942–953. https://doi.org/10.1177/1087054719864637

21.

Germanò

Gagliano

Curatolo

(2010). Comorbidity of ADHD and dyslexia. Developmental Neuropsychology, 35(5), 475–493. https://doi.org/10.1080/87565641.2010.494748

22.

Karatekin

(2004). A test of the integrity of the components of Baddeley's model of working memory in attention-deficit/hyperactivity disorder (ADHD). Journal of Child Psychology and Psychiatry, 45(5), 912–926. https://doi.org/10.1111/j.1469-7610.2004.t01-1-00285.x

23.

Karatekin

Asarnow

R. F.

(1998). Working memory in childhood-onset schizophrenia and attention-deficit/hyperactivity disorder. Psychiatry Research, 80(2), 165–176. https://doi.org/10.1016/S0165-1781(98)00061-4

24.

Kofler

M. J.

Spiegel

J. A.

Soto

E. F.

Irwin

L. N.

Wells

E. L.

Austin

K. E.

(2018). Do working memory deficits underlie reading problems in Attention-Deficit/Hyperactivity Disorder (ADHD)? Journal of Abnormal Child Psychology, 47(3), 433–446. https://doi.org/10.1007/s10802-018-0447-1

25.

Landerl

Ramus

Moll

Lyytinen

Leppänen

P. H. T.

Lohvansuu

O'Donovan

Williams

Bartling

Bruder

Kunze

Neuhoff

Tóth

Honbolygó

Csépe

Bogliotti

Iannuzzi

Chaix

Démonet

J.-F.

Schulte-Körne

(2013). Predictors of developmental dyslexia in European orthographies with varying complexity. Journal of Child Psychology and Psychiatry, 54(6), 686–694. https://doi.org/10.1111/jcpp.12029

26.

Wang

Dong

Liu

Jia

(2022). Screening of ADHD symptoms in primary school students and investigation of parental awareness of ADHD and its influencing factors: A cross-sectional study. Frontiers in Psychology, 13, 1070848. https://doi.org/10.3389/fpsyg.2022.1070848

27.

Liu

Yan

Tong

(2018). The prevalence of attention deficit/hyperactivity disorder among Chinese children and adolescents. Scientific Reports, 8(1), 1169. https://doi.org/10.1038/s41598-018-29488-2

28.

Liu

Ding

Wang

(2017). Involvement of working memory in mental multiplication in Chinese elementary students. The Journal of Educational Research, 110(4), 380–390. https://doi.org/10.1080/00220671.2015.1103689

29.

Lúcio

P. S.

Salum

Swardfager

Mari

J. d. J.

Pan

P. M.

Bressan

R. A.

Gadelha

Rohde

L. A.

Cogo-Moreira

(2017). Testing measurement invariance across groups of children with and without attention-deficit/hyperactivity disorder: Applications for word recognition and spelling tasks. Frontiers in Psychology, 8, 1891. https://doi.org/10.3389/fpsyg.2017.01891

30.

Lyon

G. R.

Shaywitz

S. E.

Shaywitz

B. A.

(2003). A definition of dyslexia. Annals of Dyslexia, 53, 1–14. https://doi.org/10.1007/s11881-003-0001-9

31.

Marzocchi

G. M.

Oosterlaan

Zuddas

Cavolina

Geurts

Redigolo

Vio

Sergeant

J. A.

(2008). Contrasting deficits on executive functions between ADHD and reading disabled children. Journal of Child Psychology and Psychiatry, 49(5), 543–552. https://doi.org/10.1111/j.1469-7610.2007.01859.x

32.

Mascheretti

Trezzi

Giorda

Boivin

Plourde

Vitaro

Brendgen

Dionne

Marino

(2017). Complex effects of dyslexia risk factors account for ADHD traits: Evidence from two independent samples. Journal of Child Psychology and Psychiatry, 58(1), 75–82. https://doi.org/10.1111/jcpp.12612

33.

Merrill

B. M.

Morrow

A. S.

Altszuler

A. R.

Macphee

F. L.

Gnagy

E. M.

Greiner

A. R.

Coles

E. K.

Raiker

J. S.

Coxe

Pelham

W. E.

(2017). Improving homework performance among children with ADHD: A randomized clinical trial. Journal of Consulting and Clinical Psychology, 85(2), 111–122. https://doi.org/10.1037/ccp0000144

34.

Moura

Pereira

Alfaiate

Fernandes

Nogueira

Moreno

Simões

M. R.

(2017). Neurocognitive functioning in children with developmental dyslexia and attention-deficit/hyperactivity disorder: Multiple deficits and diagnostic accuracy. Journal of Clinical and Experimental Neuropsychology, 39(3), 296–312. https://doi.org/10.1080/13803395.2016.1225007

35.

Moura

Simões

M. R.

Pereira

(2015). Executive functioning in children with developmental dyslexia. The Clinical Neuropsychologist, 28(Suppl 1), S20–S41. https://doi.org/10.1080/13854046.2014.964326

36.

Nigg

J. T.

(2001). Is ADHD a disinhibitory disorder? Psychological Bulletin, 127(5), 571–598. https://doi.org/10.1037/0033-2909.127.5.571

37.

Nishiyama

Ukita

(2013). Articulatory rehearsal is more than refreshing memory traces. Experimental Psychology, 60(2), 131–139. https://doi.org/10.1027/1618-3169/a000179

38.

Pennington

B. F.

(2002). The development of psychopathology: Nature and nurture. Guilford Press.

39.

Pennington

B. F.

Groisser

Welsh

M. C.

(1993). Contrasting cognitive deficits in attention deficit hyperactivity disorder versus reading disability. Developmental Psychology, 29(3), 511–523. https://doi.org/10.1037/0012-1649.29.3.511

40.

Peterson

R. L.

Pennington

B. F.

(2015). Developmental dyslexia. Annual Review of Clinical Psychology, 11, 283–307. https://doi.org/10.1146/annurev-clinpsy-032814-112842

41.

Purvis

K. L.

Tannock

(2000). Phonological processing, not inhibitory control, differentiates ADHD and reading disability. Journal of the American Academy of Child & Adolescent Psychiatry, 39(4), 485–494. https://doi.org/10.1097/00004583-200004000-00018

42.

Reiter

Tucha

Lange

K. W.

(2005). Executive functions in children with dyslexia. Dyslexia, 11(2), 116–131. https://doi.org/10.1002/dys.289

43.

Saeki

Baddeley

A. D.

Hitch

Saito

(2013). Breaking a habit: A further role of the phonological loop in action control. Memory & Cognition, 41(7), 1065–1078. https://doi.org/10.3758/s13421-013-0320-y

44.

Sayal

Prasad

Daley

Ford

Coghill

(2018). ADHD in children and young people: Prevalence, care pathways, and service provision. The Lancet Psychiatry, 5(2), 175–186. https://doi.org/10.1016/S2215-0366(17)30167-0

45.

D. L.

(1994). Deficient phonological processing in disabled readers implicates processing deficits beyond the phonological module. In van den Bos

K. P.

Siegel

L. S.

Bakker

D. J.

D. L.

(Eds.), Current directions in dyslexia research (pp. 149–167). Swets & Zeitlinger Publishers.

46.

Sibley

M. H.

Pelham

W. E.

Jr. Molina

B. S. G.

Gnagy

E. M.

Waschbusch

D. A.

Garefino

A. C.

Kuriyan

A. B.

Babinski

D. E.

Karch

K. M.

(2012). Diagnosing ADHD in adolescence. Journal of Consulting and Clinical Psychology, 80(1), 139–150. https://doi.org/10.1037/a0026577

47.

Skodzik

Holling

Pedersen

(2016). Long-Term memory performance in adult ADHD. Journal of Attention Disorders, 21(4), 267–283. https://doi.org/10.1177/1087054713510561

48.

Stubenrauch

Freund

Alecu de Flers

Scharke

Braun

Jacobs

A. M.

Konrad

(2014). Nonword reading and Stroop interference: What differentiates attention-deficit/hyperactivity disorder and reading disability? Journal of Clinical and Experimental Neuropsychology, 36(3), 244–260. https://doi.org/10.1080/13803395.2013.878690

49.

Huang

Luo

Zhang

(2001). Norms of the Conners parent symptom questionnaire in Chinese urban children. Chinese Journal of Clinical Psychology, 9(4), 241–243.

50.

Sun

Zou

Zhang

Shao

Zhong

Miao

Song

(2013). Prevalence and associated risk factors of dyslexic children in a middle-sized city of China: A cross-sectional study. PLoS One, 8(2), e56688. https://doi.org/10.1371/journal.pone.0056688

51.

Tabiee

Azhdarloo

(2023). Comparing executive functions in children with attention deficit hyperactivity disorder with or without reading disability: A resting-state EEG study. Brain and Behavior, 13(4), e2951. https://doi.org/10.1002/brb3.2951

52.

Thapar

Cooper

(2016). Attention deficit hyperactivity disorder. The Lancet, 387(10024), 1240–1250. https://doi.org/10.1016/S0140-6736(15)00238-X

53.

Thapar

Cooper

Rutter

(2017). Neurodevelopmental disorders. The Lancet Psychiatry, 4(4), 339–346. https://doi.org/10.1016/S22150366(16)30376-5

54.

Vellutino

F. R.

Fletcher

J. M.

Snowling

M. J.

Scanlon

D. M.

(2004). Specific reading disability (dyslexia): What have we learned in the past four decades? Journal of Child Psychology and Psychiatry, 45(1), 2–40. https://doi.org/10.1046/j.0021-9630.2003.00305.x

55.

Verbruggen

Logan

G. D.

(2008). Response inhibition in the stop-signal paradigm. Trends in Cognitive Sciences, 12(11), 418–424. https://doi.org/10.1016/j.tics.2008.07.005

56.

Wagner

R. K.

Torgesen

J. K.

Rashotte

C. A.

(1994). Development of reading-related phonological processing abilities: New evidence of bidirectional causality from a latent variable longitudinal study. Developmental Psychology, 30(1), 73–87. https://doi.org/10.1037/0012-1649.30.1.73

57.

Wang

Tao

(1993). Chinese character recognition assessment Scale for primary school children. Shanghai Publishing House.

58.

Warmington

Hulme

(2012). Phoneme awareness, visual-verbal paired-associate learning, and rapid automatized naming as predictors of individual differences in reading ability. Scientific Studies of Reading, 16(1), 45–62. https://doi.org/10.1080/10888438.2010.534832

59.

Willcutt

E. G.

Doyle

A. E.

Nigg

J. T.

Faraone

S. V.

Pennington

B. F.

(2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57(11), 1336–1346. https://doi.org/10.1016/j.biopsych.2005.02.006

60.

Willcutt

E. G.

Pennington

B. F.

Boada

Ogline

J. S.

Tunick

R. A.

Chhabildas

N. A.

Olson

R. K.

(2001). A comparison of the cognitive deficits in reading disability and attention-deficit/hyperactivity disorder. Journal of Abnormal Psychology, 110(1), 157–172. https://doi.org/10.1037/0021-843X.110.1.157

61.

Willcutt

E. G.

Pennington

B. F.

DeFries

J. C.

(2000). Twin study of the etiology of comorbidity between reading disability and attention-deficit/hyperactivity disorder. American Journal of Medical Genetics, 96(3), 293–301. https://doi.org/10.1002/1096-8628(20000612)96:3<293::aid-ajmg12>3.0.co;2-c

62.

Willcutt

E. G.

Sonuga-Barke

E. J. S.

Nigg

J. T.

Sergeant

J. A.

(2008). Recent developments in neuropsychological models of childhood psychiatric disorders. In Banaschewski

Rohde

L. A.

(Eds.), (Vol. 24, pp. 195–226). Advances in Biological Psychiatry. https://doi.org/10.1159/000118526.Recent developments in neuropsychological models of childhood psychiatric disorders.

63.

Yan

Perkins

Cao

(2021). A hierarchical deficit model of reading disability: Evidence from dynamic causal modelling analysis. Neuropsychologia, 154(3), 107777. https://doi.org/10.1016/j.neuropsychologia.2021.107777

64.

Zhang

Wang

(1985). Raven’s IQ reasoning standardized test. Beijing Normal University Publishing House.

65.

Zhang

Liu

Kang

(2008). Influence of ADHD on reading dyslexia: The evidence from decoding and language comprehension disability. Chinese Journal of Special Education, 3, 53–58.

66.

Zheng

Liu

(2015). Chinese guidelines for the prevention and treatment of attention deficit hyperactivity disorder (2nd ed.). China Medical Electronic Audiovisual Press.