Narrative comprehension and production abilities of children with attention-deficit/hyperactivity disorder.

摘要

The present study sought to investigate the effects that executive processing difficulties may have on the narrative comprehension and production of children with ADHD. Another goal was to determine if children with ADHD have a verbal working memory (WM) problem and to explore the relationship between verbal WM and narrative comprehension and production.; Children with ADHD (n = 22) and typical controls (n = 19), 8–14 years with average language abilities, heard a typically ordered narrative (Normal condition) and a scrambled narrative (Scrambled condition). Participants also completed a verbal short-term memory (STM) test and a verbal WM test. In the Scrambled story condition, the ADHD group was poorer in comprehending inferences. With respect to production in the Scrambled condition, their narrative retells included fewer of the most central ideas and spontaneous inferences, more confabulations and poorer organization/summary statements. Children with ADHD did not differ from controls on a measure of verbal STM, but they scored lower in verbal WM.; Within the entire sample there were more significant associations between comprehension and production in the Scrambled condition than the Normal condition. Verbal WM was not significantly related to any of the comprehension or production variables. Regression analyses indicated that both Age and basic Language ability scores significantly predicted the comprehension of facts and inferences in the Normal condition only. ADHD ratings and verbal WM made no additional contribution. Story Comprehension (total score for comprehension of the actual stories) made a significant contribution to predicting the production of idea units in the Normal condition while Age, Story Comprehension and ADHD ratings all contributed to production in the Scrambled condition. Verbal WM was not found to be a significant contributor to the prediction of production. These results suggest that children with ADHD who do not have language difficulties, may nevertheless have problems in narrative comprehension and production due to increased temporal/sequential executive processing demands rather than verbal WM deficits. The results are discussed and interpreted in the context of Barkley's Unified Theory of ADHD (Barkley, 1994, 1997a, 1997b) with respect to theoretical, clinical and educational implications.