ADHD and AAC

ADHD with many positive and negative attributes

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.

https://aaccommunity.net/caac_slp/curriculum-resources/

 

References

Dongen‐Boomsma, M., Vollebregt, M., Buitelaar, J., & Slaats‐Willemse, D. (2014, March 15). Working memory training in young children with adhd: A randomized placebo‐controlled trial. Retrieved April 09, 2021, from https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.12218?casa_token=5O_21bha4CsAAAAA%3AciiLWovRyJ2_MGwo_bW8f2p8uMy2uW2x4t8sGMXa5wUrjn4nFxDWV5GY-MjIRzbtuTRgEP5Cwy2bsnVL

Jang, J., Matson, J., Williams, L., Tureck, K., Goldin, R., & Cervantes, P. (2013, May 22). Rates of comorbid symptoms in children with asd, adhd, and comorbid asd and adhd. Retrieved April 09, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S0891422213001832?via%3Dihub

Malfa, G., Lassi, S., Bertelli, M., Pallanti, S., & Albertini, G. (2007, April 09). Detecting attention-deficit/hyperactivity disorder (ADHD) in adults with intellectual DISABILITY: The use OF CONNERS’ Adult ADHD rating SCALES (CAARS). Retrieved April 09, 2021, from https://www.sciencedirect.com/science/article/pii/S0891422207000200?casa_token=3HqAOgN8q2MAAAAA%3AoHOsgaiPLSHMW8n4VMfLQzjHpQz-0pVW5ExOQ0d52a9L7s4ncctd2sPmitGUSaDu8N5pR614ZJk

Martinussen, R., & Major, A. (n.d.). Working memory weaknesses in students With ADHD: Implications for instruction. Retrieved April 09, 2021, from https://www.tandfonline.com/doi/full/10.1080/00405841.2011.534943?casa_token=xQd-G0g7qLMAAAAA%3AMGzurWcNIARb8eee-nivXCTKRZZXTYjkzS6lowY_L7NUPSpxpLElRetCda0bjiYML-_hkcscBzlLMA

Spencer, T. (n.d.). ADHD and Comorbidity in Childhood. Retrieved 2006, from https://www.psychiatrist.com/wp-content/uploads/2021/02/10464_adhd-comorbidity-childhood.pdf

Shrestha, M., Lautenschleger, J., & Soares, N. (2020, February). Non-pharmacologic management of attention-deficit/hyperactivity disorder in children and adolescents: A review. Retrieved April 09, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7082245/

Sivan Ekstein, B. (n.d.). Down syndrome AND attention-deficit/hyperactivity Disorder (ADHD) – Sivan ekstein, Benjamin Glick, Michal Weill, Barrie Kay, Itai Berger, 2011. Retrieved

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Kathryn Helland

Kathryn is a certified speech-language pathologist and works with children and adults with complex communication needs. She has been with the TechOWL team since 2015 and is currently working on her doctorate. She would like to examine how to best support AAC users in higher education.

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