Executive Functions and Morphosyntax: Distinguishing DLD From ADHD in French-Speaking Children

Abstract

Attention deficit hyperactivity disorder (ADHD) is commonly associated with deficits in executive functions executive functions (EF), but children with this disorder frequently demonstrate co-occurring morphosyntactic impairment when assessed using standardized tests. On the other hand, children with developmental language disorder (DLD), a population defined by impaired linguistic functioning, are often diagnosed with comorbid EF deficits. We investigated EF and morphosyntax in 60 Frenchspeaking children aged six to 12: 20 with typical development (TD), 20 with ADHD, and 20 with DLD. To obtain an EF profile for the different cognitive groups, we used standardized tests to assess lower-order EF skills, (i) selective attention and (ii) shortterm memory capacity, and higher-order EF skills, (i) working memory capacity and (ii) attention shifting. To test morphosyntax, we used (i) a standardized omnibus test that elicited a variety of complex structures and (ii) a more fine-grained probe test that assessed the production of third person object clitic pronouns, a clinical marker of DLD in French. Children with ADHD and DLD were associated with different EF and morphosyntactic profiles: children in the ADHD group demonstrated higher-order EF weakness and difficulty on the omnibus morphosyntax task, whereas children with DLD showed both lower-and higher-order limitations and struggled with both morphosyntax tasks. Our findings indicate that deficits in morphosyntax are not characteristic of ADHD but that the performance of children with ADHD can mimic morphosyntactic impairment when all-encompassing omnibus tests evaluating various and unpredictable structures are used. If morphosyntax is tested using reliable markers of atypical language development and external cognitive-load factors are optimally reduced, there are significant discrepancies in the observed ADHD-DLD outcomes. Clinical implications that include perspectives for the differential diagnosis of ADHD and DLD are discussed.

A Preliminary Examination of the Impact of Working Memory Training on Syntax and Processing Speed in Children with ASD

“…Future studies should also evaluate these transfer effects in children with DLD. Similar effects would be expected, consistent with studies linking attentional resources to the processing of complex syntax in children with DLD (Montgomery et al, 2009 ; Stanford & Delage, 2020 ). Moreover, it would be informative to contrast effects of pure training of the attentional component (such as the TALI, Kirk et al, 2016 ) with effects in the current study, and to compare effects of both on syntax; this would reveal whether linguistic gains following intensive WM training can be attributed to WM improvements or to better functioning of the attentional system.…”

“…Executive functions are linked to syntactic capacities, in typically-developing children (e.g., Finney et al, 2014 ; Ibbotson & Kearvell-White, 2015 ; Viterbori et al, 2012 ; White et al, 2017 ), in children who present either syntactic difficulties, such as children with DLD (Ellis Weismer & Thordardottir, 2002 ; Im-Bolter et al, 2006 ; Montgomery, 2008 ; Montgomery et al, 2009 ), and in executive dysfunction such as ADHD (Stanford & Delage, 2020 ).…”

The contribution of visual and linguistic cues to the production of passives in ADHD and DLD: evidence from thematic priming

“…Analysis of individual results also highlighted that poor performance on the standardized syntax assessment that was part of our pre-test evaluation was not always associated with difficulty producing the passive in the priming task. For children with ADHD, this is in line with recent work done by Stanford and Delage (2020) showing that this population is more likely to perform poorly on omnibus syntax tests that contain a variety of syntactic structures than on probe syntax tests that focus on one specific construction. In the case of children with DLD, the fact that more than half of these participants were able to reach ceiling or near ceiling levels of accuracy for passive production following the final linguistic cue offers strong support for the added value of including Dynamic Assessment paradigms (Hasson et al, 2013;Hasson & Joffe, 2007), which focus on the extent to which an individual's language performance is modifiable, when evaluating children's syntactic abilities, a method that has become increasingly popular among speech-language practitioners.…”

“…Using more finegrained measures to assess seven-to-eight-year-old children with ADHD on (i) the repetition of active and passive sentences containing ten to 14 syllables and (ii) the production of past tense morphology, which are both clinical markers of DLD in English, Redmond et al (2011) showed that children with ADHD performed comparably to typically developing (TD) children on the two syntax tasks and that both ADHD and TD performance was significantly better than that of children with DLD. Similar results were found in schoolaged French-speaking children: children with ADHD could be distinguished from children with DLD when tested on the production of third person object pronouns, a reliable clinical marker of DLD in French (Stanford & Delage, 2020). In the same study, children with ADHD showed performance approaching that of children with DLD when tested on a variety of structures using a standardized evaluation that is commonly employed to identify DLD in French-speaking children, pointing to a clear asymmetry between ADHD performance on omnibus syntactic evaluations and those that are more targeted.…”

Diagnostic de troubles du langage chez l’enfant réfugié : Challenges actuels

“…Il apparaît que les mesures de bien-être émotionnel ne corrèlent pas avec les mesures de langage. En revanche, la mémoire de travail verbale et les capacités d'inhibition corrèlent avec les résultats obtenus aux différentes tâches Litmus, répliquant de précédentes observations sur les liens existants entre fonctions exécutives et langage (Delage & Frauenfelder, 2020 ;Stanford & Delage, 2020 ;Stanford, 2020 ;Viterbori et al, 2012).…”