There is little research on AAC and ADHD. Folks with ADHD as a primary condition do not typically need augmentative and alternative communication, so this is understandable. However, ADHD frequently co-occurs with other conditions that can negatively impact the ability to speak. These include language disorders, autism, Cerebral Palsy, Down Syndrome, and intellectual disability (ID). One study found that more than 19% of adults diagnosed with ID may also have ADHD. Research in Norway found that 41% of children with cerebral palsy, also qualified for an ADHD diagnosis! They found that psychiatric diagnoses and communication disorders were strongly correlated. Their sample size was limited, but the findings were highly significant. ADHD also occurs in people with Down Syndrome as much as 43.9% of the time.
ADHD may not be the reason why someone needs AAC, but it can have a strong impact on their learning styles and how we approach teaching AAC. So why has so little attention been paid to ADHD and AAC? This is perhaps due to the fact that we already use a number of evidence-based strategies that support folks with attention deficits!
Let’s take a look at the overlap.
|Strategies/Needs Seen in ADHD||Strategies/Needs Seen in AAC Learning|
|Use of visuals to support task completion||Use of visuals to support task completion|
|Visual schedules to support organization||Visual Schedules to support comprehension and organization|
|Need for Visual Novelty||Use of Dynamic Display Devices|
|Focus best on high-interest activities||Use of motivating activities to model AAC|
Keep learning fun. Focus, when possible, on topics of interest to the person. Don’t expect someone to sit quietly for extended periods of time. Allow opportunities for movement. Build in breaks and let preferred choices be the topic of conversation.
A lot of AAC implementation is language therapy, but we don’t want it to feel like drill work. When possible, follow the student’s lead. Use these interests to reinforce academic topics. Measure Legos, read a book about Pokémon, write an essay about trains. Make a video about a Pokémon on a train playing with Legos! And keep in mind that a student might not appear to be paying full attention but will still be learning. That fidget or stim that might look like a distraction, might just be that person’s way of trying to manage their body and their attention. Use movement and balance to stimulate areas of the brain that are key for attention and organization. Perhaps try yoga breaks.
We can learn to look beyond the medical model that sees ADHD simply as a deficit. It can be creative, imaginative, energetic, and laser-focused on topics of interest. Incorporate those interests into a new device as personal core vocabulary. Take what sparks joy and use it to build a relationship with the learner.
For more information on the tools that can be used to build these topics into therapy, go to our article on AAC Curriculum Resources.
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