Children with Attention Deficit/Hyperactivity Disorder and Reading Disability: A Review of the Efficacy of Medication Treatments

Abstract

Reading is a multifaceted skillset that has the potential to profoundly impact a child’s academic performance and achievement. Mastery of reading skills is often an area of difficulty for children during their academic journey, particularly for children with Attention Deficit/Hyperactivity Disorder (ADHD), Specific Learning Disorder with Impairment in Reading (SLD-R), or children with a comorbid diagnosis of both ADHD and SLD-R. ADHD is characterized by executive functioning and impulse control deficits, as well as inattention and impulsivity. Among the academic struggles experienced by children with ADHD are challenges with word reading, decoding, or reading comprehension. Similarly, children with SLD-R frequently encounter difficulties in the development of appropriate reading skills. SLD-R incorporates dysfunctions in basic visual and auditory processes that result in difficulties with decoding and spelling words. There have been limited empirical studies investigating the efficacy of interventions to improve the reading ability of children with both ADHD and SLD-R. Research studies that have focused on reading interventions for children from this population have predominantly included the use of medication treatments with stimulants (e.g., methylphenidate) and non-stimulants (e.g., atomoxetine). This review paper will present and integrate findings from empirical studies on successful medication treatments for children with comorbid ADHD and SLD-R. Furthermore, this paper will extend findings from empirically successful medication treatments to provide directions for future research.

Comorbidity of reading disabilities and ADHD: Structural and functional brain characteristics

“…The three independent disorders model would imply that treating children with interventions developed for the single disorders may be suboptimal, which could explain why COM children do not benefit from single‐disorder therapies as much as their peers who suffer from RD or ADHD alone (Bental & Tirosh, ; Pritchard, Nigro, Jacobson, & Mahone, ; Rabiner, Malone, & Conduct Problems Prevention Research Group, ; Sexton et al, ). For a comprehensive review about clinical interventions for COM, see Gray and Climie ().…”

Recognizing Psychiatric Comorbidity With Reading Disorders

“…The great majority of these studies examined RD with comorbid ADHD. Results from these studies are summarized in recent reviews ( 56 , 116 ). In summary, these studies have investigated the use of atomoxetine (ATX), methylphenidate (MPH), and nutritional supplements such as polyunsaturated fatty acids ( 117 ) on outcomes of reading, ADHD symptoms, and executive functions in ADHD + RD groups.…”

“…In summary, these studies have investigated the use of atomoxetine (ATX), methylphenidate (MPH), and nutritional supplements such as polyunsaturated fatty acids ( 117 ) on outcomes of reading, ADHD symptoms, and executive functions in ADHD + RD groups. Reviews reporting on treatment studies found that outcome effect sizes range from small to medium [as low as 0.13 for ATX and as high as 0.60 for MPH ( 56 )], although effects on ADHD symptoms are larger and more consistent than for executive function or reading ( 56 , 116 ). Future work in this area should investigate the impact of these and other medications on RD with other commonly co-occurring conditions, as well as examine the neurophysiological mechanisms of these treatments in comorbid groups.…”

Using ADHD Medications to Treat Coexisting ADHD and Reading Disorders: A Systematic Review

“…However, all of the long‐term studies in uncomplicated ADHD samples are limited by their lack of control for some important potential confounding variables. Unlike MPH, there has been little prior study of either short‐term or long‐term atomoxetine effects on standardized academic achievement test outcomes in uncomplicated ADHD samples, so it is not possible to provide further contextualization of the findings in ADHD + RD samples.…”