Children with ADHD frequently present learning difficulties, either due to the inherent characteristics of ADHD itself (inattention, poor impulse control, lack of organization and motivation); or as a direct consequence of certain learning disorders that may specifically affect the areas of reading, spelling, written expression, mathematics or language.
In fact, it is estimated that the incidence of these disorders in the ADHD population ranges between 35-50% of cases. This means that about half of the students with ADHD will also present some of these problems, so it is of fundamental importance that education and health professionals can detect them early, since the risk of dropping out of school and the emotional impact in these cases is usually high.
How does ADHD itself affect learning?
Let us imagine for a moment that we were unable to “filter” all the information and stimuli that come to us from around us and that, in addition, we had serious difficulties in maintaining our focus and setting priorities, planning and organizing our time well, or learning from experience and anticipating the consequences of our actions. This is precisely what happens to people with ADHD; the trees do not let them see the forest.
Their chaotic, volatile and restless minds do not allow them to focus on tasks and see their goals clearly enough to go for them, so they easily lose the motivation needed to stay on track and achieve their goals.
And when they get the information, they get lost in irrelevant details and do not grasp or retain the main idea (because they are unable to select the important things they should pay attention to). Or in exams they misallocate time and go off on tangents without answering what they are really being asked. They make silly mistakes, because they do not pay attention to details and hand in papers in a hurry without having reviewed them beforehand. And because they are unable to keep their attention on an assignment that is of no interest to them, it is difficult for them to learn, integrate and store the concepts worked on in class. This lack of “quality control”, added to the “inability to sustain effort” and “inadequate selection of relevant information”, causes children with ADHD to perform below their potential in their studies.
What is the much talked about executive control in ADHD?
Stopping to think and reflecting on the consequences of our actions is a human function that we can carry out thanks to the executive control function that resides in the frontal lobes of our brain.
Stopping to think” before acting allows us to “retain” certain information in our brain in order to reflect, study the possibilities and compare them with our past experiences; in order to plan a “future action”. In other words, we are able to make conjectures about what will happen next because we have thought about our past actions and built with them a future assumption. In this way, the human being is able to use his “sense of the past” to construct a sense of the future”. And this is possible thanks to the frontal lobe and its connections with the rest of the brain, thus becoming the orchestra conductor in charge of making our learning and behavior work in harmony.
Children with ADHD have significant difficulties in this area, they find it difficult to retain information in their mind in order to reflect on it (this is called working memory). And they have difficulties in establishing an order of priorities, in planning, in rectifying in time when something is not going well, in anticipating what will happen next and in learning from experience. This brings with it a series of consequences, not only academic but also behavioral and emotional, since they do not always “tune in socially” with their peers, and begin to judge their own worth based on the reactions of those around them, entering into a spiral of helplessness, sense of failure and low self-esteem.
What are the main specific learning disorders that may accompany ADHD?
Among the specific learning disorders that can be associated with ADHD, dyslexia (or literacy learning disorder) is the most common. However, others may also be present, such as dyscalculia (or math learning disorder), developmental language disorders (DLT), or nonverbal learning disorder (NLSD), among others.
What happens to learning when a child has dyslexia and ADHD?
Dyslexia is a disorder in which boys and girls with a normal level of intelligence, motivation and schooling, find it difficult to learn to read fluently like other children their age.
The first step in learning to read is to be able to decode words into their component elements. First the letters of the alphabet are learned and then the association between the sound and each of the letters that compose it (grapheme-phoneme correspondence).
In this way, the child learns to break words into their individual sounds, to combine two sounds (one consonant and one vowel, or two consonant sounds together), and to recognize that certain spellings can sound different depending on which others they are combined with (such as the compound letters ch, ll and rr). And this ability to grasp that words are made up of smaller units or phonemes is called “phonological awareness”, and it is essential that it becomes automatic and entrenched in the initial stage of learning to read.
However, reading fluency is achieved thanks to the fact that our brain learns to identify the word by its global graphic representation, when a word is read several times (without the need for detailed letter-by-letter analysis). This is the so-called “lexical route” and to reach it (at around 8 years of age), it is essential to have developed and correctly automated the “phonological route”.
This is the reason why the dyslexic child reads in a costly, slow, choppy way, with pauses, errors and rectifications that alter his reading speed and mechanics. Because they have difficulties either in carrying out the phonemic fragmentation of words (dividing words into the sounds that compose them), or in recognizing their graphic representation.
However, when ADHD is added to dyslexia, the child’s poor working memory means that by the end of the paragraph he has forgotten the meaning of the first words he read (he does not retain the information and therefore it is difficult for him to understand what he reads); and his poor self-monitoring may also lead him not to check whether or not a word fits in a given sentence. Now imagine for a second if we add to these ADHD difficulties those of dyslexia already discussed. What will happen is that the child will have to invest so much time, effort and energy in the tasks of decoding, deciphering, identifying individual words and understanding the text that he/she will not be able to keep up the level of effort and will eventually lose interest.
What happens when the child has dyscalculia and ADHD?
While mental calculation problems are fairly universal in children with ADHD, many of them may also have specific difficulties in the area of mathematics. This is known as dyscalculia.
Children with this type of problem have significant difficulties in classifying relative sizes, understanding the concept of number and the process underlying mathematical operations. In other words, they are children who have marked difficulties in performing calculation procedures and in creating strategies to solve mathematical problems.
Now, in order to master mathematics it is an indispensable condition to know how to organize oneself and to have a good working memory. That is, the child will have to be able to retain the information necessary to solve the problem, maintain the focus of attention throughout the process, detect and correct errors to finally successfully solve the exercise presented. Therefore, when ADHD is added to dyscalculia, in addition to all these difficulties, there will be the difficulties of understanding the relative size of figures, learning the multiplication tables, remembering sequences of digits, understanding the meaning of mathematical signs, mastering fractions and understanding the concepts of advanced mathematics. With all this, it’s no wonder that math is a tough nut to crack for these kids.
What happens when the child has oral language problems in addition to ADHD?
Many children with ADHD have a particular way of expressing themselves. Their speech may lack a clear line of argument and they tend to beat around the bush, making it difficult for them to give an overall picture. They answer without having heard the question, interrupt, do not know how to interpret social cues correctly, intrude into other people’s conversations and are very disorganized with their thoughts and ideas.
However, sometimes in addition to the difficulties mentioned above, children with ADHD may have a specific language development disorder (SLD), also known as “dysphasia”. This is a series of alterations in language development, which persist over time and prevent the child from acquiring normal language, and whose cause lies in a malfunction of the brain areas involved in linguistic functions.
Their expression may be very limited and not very fluent, with a marked impairment of the articulation of sounds and speech that is not very intelligible. These are children who understand language, know what they want to say and try to say it, but their speech is poorly understood. They may have a lower level of vocabulary than their healthy peers, with poor grammatical structuring and inappropriate use of language.
How can children with ADHD who also have a specific school learning disorder be helped?
As a general rule, the first step in helping a person to overcome a difficulty is to be very clear about where the problem lies, create a strategy and act accordingly.
The therapeutic approach will depend to a large extent on the type of learning disorder the child has. But broadly speaking, it should include a series of methodological curricular adaptations, specific reeducation work, and if necessary, psychological intervention that allows for an adequate management of the inadequate behaviors typical of ADHD, low self-esteem and secondary emotional problems that may coexist.
The information of the child and his environment (parents and teachers) about the disorder is of fundamental importance, since it will allow them to understand that his difficulties are not the result of a lack of effort, motivation or intelligence, thus reducing the feeling of guilt of the child and his family.
And finally, the pharmacological approach to ADHD itself becomes indispensable in many cases, since, although the environment can influence its course, it is still a medical problem whose cause lies in a dysfunction of brain chemistry. And on many occasions, if medication is not introduced, the rest of the measures may not be sufficient. Because “to teach a child something, you must first be able to reach him”.
In summary, about half of the children with ADHD present some specific learning disorder, affecting areas such as reading, written or oral expression. Apart from this, practically all of them have problems in attention, executive functions and short-term memory. This is the reason why they perform below their potential and need pedagogical support to help them progress in their studies.