Semantic Language as a Mechanism Explaining the Association between ADHD Symptoms and Reading and Mathematics Underachievement
Open accessAbstract
ADHD is associated with academic underachievement, but it remains unclear what mechanism accounts for this association. Semantic language is an underexplored mechanism that provides a developmental explanation for this association. The present study will examine whether semantic language deficits explain the association between ADHD and reading and mathematics underachievement, taking into account alternative explanations for associations, including verbal working memory (WM) impairments, as well as specificity of effects to inattentive and hyperactive-impulsive ADHD symptom domains. Participants in this cross-sectional study were 546 children (54 % male) ages six to twelve (M = 9.77, SD = 1.49). ADHD symptoms were measured via maternal and teacher report during structured interviews and on standardized rating forms. Children completed standardized semantic language, verbal WM, and academic testing. Semantic language fully mediated the ADHD-reading achievement association and partially mediated the ADHD-mathematics achievement association. Verbal WM also partially mediated the ADHD-mathematics association but did not mediate the ADHD-reading achievement association. Results generalized across inattentive and hyperactive-impulsive ADHD symptom domains. Semantic language explained the association between ADHD and reading underachievement and partially explained the association between ADHD and mathematics underachievement. Together, language impairment and WM fully explained the association between ADHD and reading underachievement, in line with developmental models suggesting that language and WM conjointly influence the development of attention and subsequent academic achievement. This work has implication for the development of tailored interventions for academic underachievement in children with ADHD.
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- Findingown data
Children with ADHD did not have significantly lower reading achievement than non-ADHD comparison children.
“Contrary to study hypotheses, children with ADHD did not have significantly lower reading achievement compared to non-ADHD comparison children, t(471)=1.16, p=.246.”
Quote in the paperSubstantial claim - Findingown data
Lower semantic language scores were associated with poorer mathematics achievement.
“lower semantic language scores were significantly associated with poorer mathematics achievement.”
Quote in the paperSubstantial claim - Findingown data
Poor semantic language was associated with lower academic achievement.
“Poor semantic language was associated with lower academic achievement and worse WM (all p<.01).”
Quote in the paperSubstantial claim - Findingown data
Children with ADHD had lower estimated full scale IQ than non-ADHD comparison children.
“significantly lower estimated FSIQ, t(469)=2.81, p=.005, d=.26, than non-ADHD comparison children.”
Quote in the paperNot a substantial claim - Findingown data
Children with ADHD had lower semantic language scores than non-ADHD comparison children.
“children with ADHD had significantly lower semantic language, t(471)=2.74, p=.006, d=.25”
Quote in the paperSubstantial claim
- Findingown data
More inattentive, hyperactive-impulsive, and total ADHD symptoms were associated with lower semantic language ability.
“increased inattentive, hyperactive-impulsive, and total number of ADHD symptoms were associated with lower semantic language ability, worse verbal WM, and poorer reading and mathematics achievement (all p<.001; Table 2).”
Quote in the paperSubstantial claim - Findingown data
Children with ADHD had lower mathematics achievement than non-ADHD comparison children.
“significantly lower mathematics achievement, t(471)=3.43, p<.001, d=.32”
Quote in the paperSubstantial claim - Findingown data
Children with ADHD had poorer verbal working memory than non-ADHD comparison children.
“significantly poorer verbal WM, t(353)=3.73, p<.001, d=.35”
Quote in the paperSubstantial claim - Findingown data
More ADHD symptoms were associated with lower reading achievement.
“More ADHD symptoms were associated with lower reading achievement and lower semantic language.”
- Also stated in: § Do verbal WM deficits independently mediate the ADHD-underachievement association? · plain
“More ADHD symptoms were significantly associated with poorer verbal WM, estimate=−.22, p=.002, and lower reading achievement, estimate=−.37, p=.028”
Quote in the paperSubstantial claim - Also stated in: § Do verbal WM deficits independently mediate the ADHD-underachievement association? · plain
- Findingown data
Poor semantic language was associated with worse working memory.
“Poor semantic language was associated with lower academic achievement and worse WM (all p<.01).”
Quote in the paperSubstantial claim - Findingown data
More ADHD symptoms were associated with poorer reading achievement.
“increased inattentive, hyperactive-impulsive, and total number of ADHD symptoms were associated with lower semantic language ability, worse verbal WM, and poorer reading and mathematics achievement (all p<.001; Table 2).”
Quote in the paperSubstantial claim - Findingown data
More ADHD symptoms were associated with lower semantic language.
“More ADHD symptoms were associated with lower reading achievement and lower semantic language.”
Quote in the paperSubstantial claim - Findingown data
Lower semantic language ability was associated with lower reading achievement.
“Lower semantic language ability was associated with lower reading achievement.”
Quote in the paperSubstantial claim - Findingown data
Semantic language mediated the association between ADHD symptoms and reading underachievement.
“Once semantic language was entered into the model, the association between ADHD symptoms and reading underachievement became non-significant, suggesting that semantic language mediated the association between ADHD symptoms and reading underachievement, Δr2= .20, p<.001; indirect effects: z= −.01, p=.02.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
More ADHD symptoms were associated with worse verbal working memory.
“increased inattentive, hyperactive-impulsive, and total number of ADHD symptoms were associated with lower semantic language ability, worse verbal WM, and poorer reading and mathematics achievement (all p<.001; Table 2).”
Quote in the paperSubstantial claim - Findingown data
More ADHD symptoms were associated with poorer mathematics achievement.
“increased inattentive, hyperactive-impulsive, and total number of ADHD symptoms were associated with lower semantic language ability, worse verbal WM, and poorer reading and mathematics achievement (all p<.001; Table 2).”
- Also stated in: § Does semantic language mediate the association between ADHD symptoms and underachievement? · plain
“more ADHD symptoms were significantly associated with poorer mathematics achievement (Figure 2)”
Quote in the paperSubstantial claim - Also stated in: § Does semantic language mediate the association between ADHD symptoms and underachievement? · plain
- Findingown data
Semantic language partially mediated the association between ADHD symptoms and mathematics underachievement.
“semantic language significantly partially mediated the association between ADHD symptoms and mathematics underachievement, Δr2= .58, p<.001; indirect effects: z=−.027, p<.001.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
The indirect effect of semantic language on reading achievement was stronger than the indirect effect of verbal working memory.
“The indirect effects of semantic language, estimate=−.35, 95% CI=−.57 to −.13, appeared to be somewhat stronger than the indirect effects of verbal WM, estimate=−.09, 95% CI=−.18 to −.03. Differences in indirect effects of semantic language and verbal WM were significant, z=−4.02, p<.001.”
Quote in the paperSubstantial claim - Findingown data
When nonverbal IQ was controlled, semantic language only partially mediated the ADHD-reading achievement link rather than fully mediating it.
“With nonverbal IQ entered as a covariate, semantic language partially mediated, instead of fully mediating, the association between ADHD and reading achievement, indirect effects z=−.03, p=.005.”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC is highly correlated with IQ and academic achievement.
- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
Children with ADHD also showed lower mathematics achievement than children without ADHD.
“Children with ADHD also exhibited lower levels of mathematics achievement, compared to children without ADHD.”
Quote in the paperSubstantial claim - Findingown data
Verbal working memory partially accounted for the link between ADHD symptoms and mathematics underachievement.
“Results of the current study suggested that verbal WM partially explained the relationship between ADHD symptoms and mathematics underachievement, in line with current research that suggests that verbal WM is a better predictor of mathematics achievement than reading achievement (Wilson & Swanson, 2001).”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
More ADHD symptoms were associated with lower mathematics achievement.
“More ADHD symptoms were significantly associated with poorer verbal WM, estimate=−.22, p=.002, and lower reading achievement, estimate=−.37, p=.028, and mathematics achievement, estimate=−.28, p<.001.”
Quote in the paperSubstantial claim - Findingown data
Verbal working memory had a weaker effect than semantic language in both achievement domains.
“However, in both models, poor verbal WM did not appear to exert as strong of an effect as semantic language on either achievement domain”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
Semantic language fully accounted for the ADHD-mathematics achievement link even after nonverbal IQ deficits were taken into account.
“poor semantic language seemed to fully account for the ADHD-mathematics achievement association and partially account for the association with reading achievement even over and above deficits in nonverbal IQ.”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC is highly correlated with IQ and academic achievement.
- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
Lower semantic language fully mediated the association between reading achievement and both inattention and hyperactivity-impulsivity.
“Lower semantic language scores fully mediated the association between reading achievement and both inattention and hyperactivity-impulsivity”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
Poorer verbal working memory was associated with lower reading achievement.
“Poorer verbal WM was also significantly associated with lower reading and mathematics achievement, estimate=.60, p=.028 for reading; estimate=.45, p<.001 for mathematics.”
Quote in the paperSubstantial claim - Findingown data
Verbal working memory did not appear to account for the link between ADHD symptoms and reading achievement.
“In line with this idea, verbal WM did not appear to explain the relationship between ADHD symptoms and reading achievement.”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
Among younger children (ages 6-9), verbal working memory alone fully mediated the link between ADHD symptoms and reading achievement.
“For the younger participants, verbal WM fully mediated the association between ADHD symptoms and reading achievement, estimate=−.12, p=.087”
- Also stated in: § DISCUSSION · plain
“poor verbal WM fully mediated the association between ADHD symptoms and reading achievement in younger children”
Quote in the paperNot a substantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Also stated in: § DISCUSSION · plain
- Findingown data
The ADHD-mathematics achievement models produced the same results after nonverbal IQ was controlled.
“Results remained the same for the ADHD-mathematics achievement models.”
Quote in the paperNot a substantial claim- Rests on an assumption: The Vocabulary subtest from the WISC is highly correlated with IQ and academic achievement.
- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
Poorer verbal working memory was associated with lower mathematics achievement.
“Poorer verbal WM was also significantly associated with lower reading and mathematics achievement, estimate=.60, p=.028 for reading; estimate=.45, p<.001 for mathematics.”
Quote in the paperSubstantial claim - Findingown data
Semantic language and verbal working memory together fully mediated the association between ADHD symptoms and reading underachievement.
“With both semantic language and verbal WM in the model, the association between ADHD symptoms and reading underachievement became non-significant, suggesting that semantic language and verbal WM together fully mediated this association.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
Semantic language and verbal working memory together partially mediated the association between ADHD symptoms and mathematics underachievement.
“bootstrap results for indirect effects were significant, estimate=−.28, 95% CI=−47 to −.11, suggesting partial mediation of the ADHD-mathematics achievement association by semantic language and verbal WM.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
The indirect effect of semantic language on mathematics achievement was stronger than the indirect effect of verbal working memory.
“Again, the indirect effects of semantic language, estimate=−.23, 95% CI=−40 to −.07, appeared to be somewhat stronger than the indirect effects of verbal WM, estimate=−05, 95% CI=−.12 to −.02. Differences in indirect effects of semantic language and verbal WM were significant, z=−2.69, p=.007.”
Quote in the paperSubstantial claim - Findingown data
In the same models, the combined indirect effects of semantic language and verbal working memory significantly partially accounted for the link between both ADHD symptom dimensions and mathematics performance.
“The association between inattention and hyperactivity-impulsivity and mathematics achievement was significantly partially mediated by the combined effects of semantic language and verbal WM, estimate=−.19, p=.032, indirect effects: z=−.36 for inattention; estimate=−.26, p=.007, indirect effects: z=−.57 for hyperactivity-impulsivity, suggesting no differential effects based on ADHD symptom domain.”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
In the multiple-mediator analysis, the combined indirect effects of semantic language and verbal working memory accounted for the entire link between both ADHD symptom dimensions and reading performance.
“Using multiple mediator models, effects of semantic language and verbal WM fully mediated the association between inattentive and hyperactive-impulsive symptoms and reading achievement, estimate=−23, p=.162, indirect effects: z=−.57 for inattention; estimate=−.17, p=.346; indirect effects: z=−.91 for hyperactivity-impulsivity.”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
Verbal working memory did not mediate the association between either ADHD symptom domain and reading underachievement.
“Verbal WM did not appear to mediate the association between either ADHD symptom domain and reading underachievement, estimate=−.13, p=.031, indirect effects: z=−047, p=.138 for inattention; estimate=−.22, p=.003, indirect effects: z=−049, p=.156 for hyperactivity-impulsivity”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
Verbal working memory did not significantly partially mediate the association between ADHD symptoms and reading underachievement.
“However, verbal WM did not significantly partially mediate the association between ADHD symptoms and reading underachievement Δr2= .40, p<.001; indirect effects: z=−.023, p=.141.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
Lower semantic language only partially mediated the association between mathematics achievement and both ADHD symptom domains.
“but only partially mediated the association between mathematics achievement and both ADHD symptom domains.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
Semantic language and verbal working memory problems were significantly related to both ADHD symptom domains.
“results of the current study suggested that problems in semantic language and verbal working memory were significantly associated with both ADHD symptom domains.”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
More ADHD symptoms were associated with poorer verbal working memory.
“More ADHD symptoms were significantly associated with poorer verbal WM, estimate=−.22, p=.002”
Quote in the paperSubstantial claim - Findingcitation
Children with ADHD showed poorer semantic language skills than children without ADHD.
“Consistent with prior research (Kim & Kaiser, 2000) children with ADHD exhibited worse semantic language skills than children without ADHD.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Kim & Kaiser, 2000 source
Not checked in the free run.
- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Findingown data
Verbal working memory partially mediated the association between mathematics and both ADHD symptom domains.
“Verbal WM also partially mediated the association between mathematics and both ADHD symptom domains, estimate=−.13, indirect effects: z=−.027, p<.01 for inattention; estimate=−.21, indirect effects: z=−.023, p<.001 for hyperactivity-impulsivity.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Findingown data
Verbal working memory independently partially mediated the association between ADHD symptoms and mathematics underachievement.
“Verbal WM independently partially mediated the association between ADHD symptoms and mathematics underachievement, Δr2= .23, p<.001; indirect effects: z=−.015, p<.001.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Premisecitation
Verbal working memory deficits relate to both ADHD and underachievement.
“Verbal WM deficits appear to be related to both ADHD and underachievement (Martinussen & Tannock, 2006; Passolunghi & Siegel, 2004; Swanson & Sachse-Lee, 2001a; 2001b), possibly explaining comorbidity.”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
Children with ADHD with more inattentive symptoms are more likely to have academic problems than those with more hyperactive-impulsive symptoms.
“prior work suggests that children with ADHD who exhibit higher levels of inattentive symptoms are more likely to exhibit academic problems, compared to children with higher levels of hyperactivity-impulsivity (Barriga, Doran, Newal, Morrison, Barbetti, & Robbins, 2002; Breslau et al., 2010; Lahey & Willcutt, 2002; Marshall, Hynd, Handwerk & Hall, 1997).”
Quote in the paperSubstantial claim0 of 3 sources checked - Premisecitation
ADHD is linked to lower academic achievement.
“ADHD is associated with academic underachievement, but it remains unclear what mechanism accounts for this association.”
- Also stated in: § Abstract · plain
“ADHD is impairing, being associated with executive function deficits, language impairment, problems in interpersonal relationships, and academic underachievement (Loe & Feldman, 2007).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Loe & Feldman, 2007 source
Not checked in the free run.
- Also stated in: § Abstract · plain
- Premisecitation
Low IQ is associated with both ADHD and underachievement.
“low IQ has been associated with both ADHD and underachievement (Mayes et al., 2000; Neisser et al., 1996).”
Quote in the paperNot a substantial claim0 of 2 sources checked - Study design and conductown data
Children with ADHD were more likely to be male than non-ADHD comparison children.
“children with ADHD were more likely to be male than non-ADHD comparison children, X2(1)=29.16, p<.001.”
Quote in the paperSubstantial claim - Premisenone given
Longitudinal studies have established that ADHD in early childhood predicts later reading and mathematics underachievement.
“Though longitudinal associations between ADHD in early childhood and later reading and mathematics underachievement have been established”
Quote in the paperNot a substantial claim - Premisecitation
Children with ADHD show a developmental lag in verbal working memory, developing it more slowly than typically developing children.
“research has indicated that children with ADHD display a “developmental lag” in verbal WM, such that children with ADHD develop verbal WM skills slower than typically developing children (Denckla, 1996; Sowerby, Seal, & Tripp, 2011).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Verbal working memory predicts later mathematics and reading comprehension.
“verbal WM abilities predict later mathematical ability and reading comprehension (Bull, Espy & Wiebe, 2008; Cain, Oakhill, & Bryant, 2004; Wilson & Swanson, 2001).”
Quote in the paperNot a substantial claim0 of 3 sources checked - Premisecitation
Early semantic language delays or problems increase risk for later academic underachievement in reading comprehension and mathematics.
“Research has also suggested that children with early semantic language delays or problems are at risk for later academic underachievement, such that children with poor semantic language skills are less likely to succeed in reading comprehension and mathematics (Aiken, 1971; Ouellette, 2006; Young et al., 2002).”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationown data
For younger children, verbal working memory may play a more important role in reading achievement.
“suggesting that, at younger ages, verbal WM may be more crucial for reading achievement.”
Quote in the paperNot a substantial claim - Premisecitation
Verbal working memory predicts mathematics achievement better than it predicts reading achievement.
“in line with current research that suggests that verbal WM is a better predictor of mathematics achievement than reading achievement (Wilson & Swanson, 2001).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wilson & Swanson, 2001 source
Not checked in the free run.
- Interpretationown data
The mediation effects of semantic language and verbal working memory did not vary between the inattentive and hyperactive-impulsive symptom domains.
“suggesting no differential effects based on ADHD symptom domain.”
- Also stated in: § DISCUSSION · plain
“Further, the effects of semantic language and verbal WM on the association between ADHD and underachievement generalized across ADHD symptom domains.”
- Also stated in: § DISCUSSION · plain
“Contrary to study hypotheses, the mediating effects of both semantic language and verbal WM were not specific to ADHD symptom domains.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · plain
- Study design and conductreasoning
Because the study was cross-sectional, it cannot support conclusions about the longitudinal course of the language, ADHD, and achievement associations.
“Further, the current study is cross-sectional so no conclusions can be drawn regarding the longitudinal progression or trajectory of the associations between language, ADHD, and academic achievement.”
Quote in the paperNot a substantial claim - Premisecitation
Slower verbal working memory development in children with ADHD may matter for reading achievement development.
“in line with previous research suggesting that slower development of verbal WM in children with ADHD may be important for the development of reading achievement (Denckla, 1996; Sowerby et al., 2011).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
Language deficits predict teacher-rated inattention.
“in line with research suggesting that language deficits are a predictor of teacher-rated inattention (Jonsdottir, Bouma, Sergeant, & Scherder, 2006)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Jonsdottir, Bouma, Sergeant, & Scherder, 2006 source
Not checked in the free run.
- Interpretationown data
There were no differential effects based on ADHD symptom domain compared to total ADHD symptom count.
“suggesting no differential effects based on ADHD symptom domain compared to the total ADHD symptom count.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
- Interpretationown data
Semantic language skills act as a primary mediator of the link between ADHD and underachievement in both reading and mathematics.
“As hypothesized, semantic language skills appeared to be a primary mechanism, or mediator, of the association between ADHD and reading and mathematics underachievement.”
- Also stated in: § DISCUSSION · hedged
“Based on results of the present study, there was support for the idea that poor semantic language skills in school-age children can help explain the association of ADHD with academic underachievement.”
Quote in the paperSubstantial claim - Also stated in: § DISCUSSION · hedged
- Premisecitation
Language development occurs earlier than ADHD and reading development.
“Due to the fact that language comes on-line earlier than ADHD and reading (Kieling et al., 2010; Kuhl & Rivera-Gaxiola, 2008)”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationreasoning
Semantic language and verbal working memory problems may raise the risk of academic underachievement in children with ADHD irrespective of symptom profile.
“Thus, problems with semantic language and verbal WM may increase risk for academic underachievement in children with ADHD regardless of their symptom profile.”
Quote in the paperSubstantial claim - Interpretationown data
Verbal working memory is another promising mediator of the link between ADHD and academic underachievement.
“Further, verbal WM emerged as another promising mechanism of ADHD-underachievement associations.”
Quote in the paperSubstantial claim
- May combine two claims. 16
- Classified as probably not a substantial claim. 16
May combine two claims.
Findingown dataSemantic language and verbal working memory deficits together fully accounted for the ADHD-reading link but only partially accounted for the ADHD-mathematics link.
“Interestingly, poor semantic language skills and verbal WM deficits together fully explained the ADHD-reading achievement association, but only partially explained the association between ADHD and mathematics achievement”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
May combine two claims.
Findingown dataInattentive and hyperactive-impulsive ADHD symptoms were associated with both reading and mathematics achievement.
“inattentive and hyperactive-impulsive ADHD symptoms were significantly associated with both reading (Figure 1) and mathematics achievement (Figure 2; all p<.05).”
Quote in the paperSubstantial claimMay combine two claims.
Findingown dataSemantic language and verbal working memory together accounted for the ADHD-reading achievement link and partially accounted for the ADHD-mathematics achievement link.
“Together, semantic language and verbal WM explained the association between ADHD symptoms and reading achievement and partially explained the association between ADHD symptoms and mathematics achievement.”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
May combine two claims.
Findingown dataSemantic language accounted for the ADHD-reading underachievement link and partially accounted for the ADHD-mathematics underachievement link.
“Study results indicated that semantic language explained the association between ADHD and reading underachievement and partially explained the association between ADHD and mathematics underachievement.”
- Also stated in: § DISCUSSION · plain
“Importantly, semantic language explained the association of ADHD symptoms with reading and mathematics underachievement”
Quote in the paperSubstantial claim- Rests on an assumption: The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
- Also stated in: § DISCUSSION · plain
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataA clinical diagnostic team reassessed diagnostic status using the same algorithm, with agreement rates above .89.
“A clinical diagnostic team consisting of board certified and licensed clinical child psychologists reassessed diagnostic status, using the same “or” algorithm with acceptable agreement rates (all kappas > .89).”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductcitationThe WISC-IV Vocabulary subtest has high internal consistency, test-retest reliability, and content and construct validity for this age group.
“The vocabulary subtest exhibits high internal consistency and high test-retest reliability (Wechsler, 2003) as well as high content and construct validity for this age group (Sattler, 2008).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Wechsler, 2003
Not checked in the free run.
- cites Sattler, 2008
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationAbout 30% of children with ADHD have working memory deficits.
“Approximately 30% of children diagnosed with ADHD exhibit deficits in WM (Wahlstedt, Thorell, & Bohlin, 2009)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wahlstedt, Thorell, & Bohlin, 2009 source
Not checked in the free run.
May combine two claims.
PremisecitationADHD and severe academic underachievement share etiological factors, including genetic influences and executive function deficits.
“ADHD and extreme academic underachievement share etiological factors, including common genetic influences (Willcutt et al., 2001; 2007) and shared executive function deficits”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Willcutt et al., 2001; 2007
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- cites Banaschewski et al, 2005 source
Not checked in the free run.
May combine two claims.
Study design and conductcitationThe abbreviated three-subtest WISC-IV is reliable and valid for estimating full scale IQ in this age range.
“Estimated full scale IQ was assessed using an abbreviated three subtest version (i.e., Block Design, Information, and Vocabulary) of the WISC-IV that is both reliable and valid for this age range (Wechsler, 2003; Sattler, 2008).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Wechsler, 2003
Not checked in the free run.
- cites Sattler, 2008
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductcitationSibling non-independence was handled using Mplus clustering.
“The presence of siblings and the resulting non-independence of data points were addressed using the clustering feature of Mplus (Muthén & Muthén, 1998–2008).”
Quote in the paperNot a substantial claimMay combine two claims.
Study design and conductown dataThe ADHD and control groups did not differ in age or ethnicity.
“the ADHD and control groups did not differ on age,t(471)=.51, p=.609(Table 1) or ethnicity, X2(4)=3.11, p=.540.”
Quote in the paperNot a substantial claimClassified as probably not a substantial claim.
PremisecitationGeneral language ability is theorized to shape attention, which is critical for academic performance.
“developmental theory suggests that general language ability plays a role in shaping attention which is then critical for academic performance (Gartstein, Crawford, & Robertson, 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gartstein, Crawford, & Robertson, 2008 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationVerbal working memory deficits are a well-validated mechanism for the ADHD-academic underachievement association.
“Another possible and well-validated mechanism explaining the association between ADHD and academic underachievement is verbal working memory (WM) deficits (Gropper & Tannock, 2009; Thorell, 2007).”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningParents were asked to have children stop psychostimulant medication for 24 to 48 hours before the laboratory visit to improve cognitive measurement accuracy.
“Parents of children taking psycho-stimulant medication were asked to consult with a physician about discontinuing medication for 24 to 48 hours prior to the laboratory visit to ensure a more accurate measure of cognitive performance.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationLanguage impairment is common in children with ADHD and academic underachievement, with co-occurrence around 45%.
“Language Impairment (LI) is highly prevalent in children with ADHD and academic underachievement, co-occurring at a rate of approximately 45% (Beitchman, Wilson, Brownlie, Watlters, & Lancee, 1996; Cohen et al., 2000; Tirosh & Cohen, 1998; Tomblin, Zhang, Buckwalter, & Catts, 2000).”
Quote in the paperSubstantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationWorking memory effects in ADHD appear most specific to inattentive symptoms.
“effects seem most specific to the inattentive ADHD symptom domain (Wahlstedt et al., 2009; Thorell, 2007).”
Quote in the paperNot a substantial claim0 of 2 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductnone givenA certified trainer reviewed 5% of recorded diagnostic interviews to check fidelity.
“Fidelity to interview procedure was checked by having the interview recorded with 5% reviewed by a certified trainer.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataMissingness and nonnormality were handled with robust full information maximum likelihood estimation in Mplus.
“This missingness and nonnormality of data was addressed using robust full information maximum likelihood estimation (FIML; i.e., direct fitting) in Mplus”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationADHD and underachievement are each associated with poor language skills.
“Purvis and Tannock (1997; 2000) found that ADHD and underachievement are both associated with poor language skills.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Purvis and Tannock (1997; 2000)
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
Classified as probably not a substantial claim.
Study design and conductreasoningSex was included as a covariate in all correlation and regression analyses.
“sex was covaried in all subsequent correlation and regression analyses.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
Study design and conductown dataMissing data affected less than 8% of the sample for all measures except verbal working memory, which was available for 65% by design.
“Missingness was minimal in the current study, affecting less than 8% of the sample for all measures except verbal WM. The WM measure was available for 65% of the sample by design (n=355; i.e., data was collected during the second visit after additional families had been screened out).”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationChildren with early semantic language problems are at risk for attention problems and worse school performance.
“children with initial semantic language problems are at risk for developing attention problems and have worse school performance (Gartstein et al., 2008; Young et al., 2002).”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
Study design and conductcitationThe WIAT-II Reading Comprehension subtest reflects school reading achievement and is not overly dependent on language ability.
“The major benefit of the WIAT-II reading comprehension subtest over other measures of reading comprehension is that this specific subtest maps onto reading achievement in school and is not overly dependent on language ability (Lichtenberger & Smith, 2005; Wechsler, 2001).”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Lichtenberger & Smith, 2005
Not checked in the free run.
- cites Wechsler, 2001
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationInattentive ADHD symptoms are usually more strongly linked to academic underachievement than hyperactive-impulsive symptoms.
“Although prior research has established that inattentive ADHD symptoms typically are more highly associated with academic underachievement than hyperactive-impulsive ADHD symptoms (Breslau et al., 2010)”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Breslau et al., 2010 source
Not checked in the free run.
May combine two claims.
Interpretationown dataSemantic language and verbal working memory together, with semantic language primary and working memory secondary, independently and nearly completely accounted for the ADHD-achievement link.
“Together, semantic language primarily and WM secondarily independently and almost fully explained the association between ADHD symptoms and academic achievement.”
Quote in the paperSubstantial claimMay combine two claims.
Interpretationown dataSemantic language together with verbal working memory is critical for reading achievement, while each independently partially accounts for the ADHD-mathematics link.
“suggesting that poor semantic language skills in conjunction with poor verbal WM are critical for reading achievement, whereas semantic language skills and poor verbal WM independently partially explain the association between ADHD symptoms and mathematics achievement.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductreasoningThe present study did not investigate maternal education or family socioeconomic status, which are important contextual factors for achievement.
“demographic variables such as maternal education and family socioeconomic status are important contextual factors that influence achievement and were not investigated in the present study.”
Quote in the paperNot a substantial claim- Rests on an assumption: Maternal education and family socioeconomic status influence achievement.
Probably not a substantial claim: may not pass S3 (load-bearing).
Study design and conductown dataAdding ethnicity as a covariate did not materially alter any of the study's results.
“All results were checked with ethnicity as a covariate with no significant changes in findings.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S2 (checkable).
InterpretationreasoningSemantic language is an important mechanism that should be considered in future ADHD-achievement research.
“suggesting that semantic language is an important mechanism that needs consideration in future work on ADHD symptoms and achievement.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationLanguage and verbal working memory have bidirectional effects on attention development, with later effects on academic achievement.
“which is in line with developmental theory suggesting that language and verbal WM exert bidirectional influences on the development of attention with later-emerging effects on academic achievement (Gartstein et al., 2008).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gartstein et al., 2008 source
Not checked in the free run.
Classified as probably not a substantial claim.
InterpretationreasoningLanguage and working memory conjointly influence the development of attention and subsequent academic achievement.
“in line with developmental models suggesting that language and WM conjointly influence the development of attention and subsequent academic achievement.”
Quote in the paperSubstantial claim- Rests on an assumption: The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
- Rests on an assumption: The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
The paper relies on this without support.
The cross-sectional data reflect the temporal ordering required for mediation, with ADHD symptoms preceding semantic language and working memory, which precede achievement.
“Participants in this cross-sectional study were 546 children (54% male) ages six to twelve (M=9.77, SD=1.49).”
“a series of multiple linear regressions using ADHD symptom counts were conducted using Mplus (Muthén & Muthén, 1998–2008) in order to assess Baron and Kenny’s (1986) mediation criteria”
The paper relies on this without support.
The associations among ADHD symptoms, semantic language, verbal working memory, and achievement are not due to unmeasured confounding.
“Partial correlations controlling for sex were conducted to examine descriptive associations between reading and mathematics achievement, semantic language, verbal WM, and ADHD symptoms.”
The paper relies on this without support.
Maternal education and family socioeconomic status influence achievement.
“demographic variables such as maternal education and family socioeconomic status are important contextual factors that influence achievement and were not investigated in the present study.”
The paper relies on this without support.
The Vocabulary subtest from the WISC is highly correlated with IQ and academic achievement.
“Further, language in general and the measure of language used in the current study in particular (i.e., the Vocabulary subtest from the WISC), is highly correlated with IQ and academic achievement.”
The paper relies on this without support.
The Vocabulary subtest from the WISC-IV is sensitive to semantic language in school-age children.
“the Vocabulary section of the WISC-IV was utilized because it is sensitive to semantic language in school-age children”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Working memory deficits consistently emerge as the only cognitive mechanism mediating the ADHD/reading problem association, alone or with semantic language skills.
“with working memory deficits consistently emerging as the only cognitive mechanism to mediate the ADHD/reading problem association, alone (Friedman et al., 2017; Miller et al., 2013) or in combination with semantic language skills (Gremillion & Martel, 2012).”
From Do Working Memory Deficits Underlie Reading Problems in Attention-Deficit/Hyperactivity Disorder (ADHD)? (2019) · cites this paper as Gremillion & Martel, 2012
Statistics that don’t add up
Each reported p-value recomputed from its test statistic and degrees of freedom.
Inconsistent p-value across alpha = .05: z=−.015, p < .001
MajorThe paper reports p < .001 here; recomputing from the test statistic and its degrees of freedom gives p = .988 (two-tailed). The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p < .001 · recomputed p = .988
“z=−.015, p<.001”
Inconsistent p-value across alpha = .05: z=−.027, p < .01
MajorThe paper reports p < .01 here; recomputing from the test statistic and its degrees of freedom gives p = .978 (two-tailed). The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p < .01 · recomputed p = .978
“z=−.027, p<.01”
Inconsistent p-value across alpha = .05: z=−.023, p < .001
MajorThe paper reports p < .001 here; recomputing from the test statistic and its degrees of freedom gives p = .982 (two-tailed). The two fall on opposite sides of alpha = .05. The check cannot tell whether the statistic or the p-value is the misprint.
Reported p < .001 · recomputed p = .982
“z=−.023, p<.001”
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Doesn’t add upz = -0.015reported p < .001 · recomputed p = .988The two fall on opposite sides of .05
“z=−.015, p < .001”
- Doesn’t add upz = -0.027reported p < .01 · recomputed p = .978The two fall on opposite sides of .05
“z=−.027, p < .01”
- Doesn’t add upz = -0.023reported p < .001 · recomputed p = .982The two fall on opposite sides of .05
“z=−.023, p < .001”
- Not confirmedz = -0.01reported p = .02 · recomputed p = .992
“z= −.01, p = .02”
- Not confirmedz = -0.027reported p < .001 · recomputed p = .978
“z=−.027, p < .001”
- Not confirmedz = -0.023reported p = .141 · recomputed p = .982
“z=−.023, p = .141”
- Not confirmedz = -47reported p = .138 · recomputed p < .001
“z=−047, p = .138”
- Not confirmedz = -49reported p = .156 · recomputed p < .001
“z=−049, p = .156”
- Not confirmedz = -0.03reported p = .005 · recomputed p = .976
“z=−.03, p = .005”
- Consistentt(471) = 0.51reported p = .609 · recomputed p = .610
“t(471)=.51, p = .609”
- Consistentχ²(4) = 3.11reported p = .54 · recomputed p = .540
“X2(4)=3.11, p = .540”
- Consistentχ²(1) = 29.16reported p < .001 · recomputed p < .001
“X2(1)=29.16, p < .001”
- Consistentt(471) = 2.74reported p = .006 · recomputed p = .006
“t(471)=2.74, p = .006”
- Consistentt(471) = 3.43reported p < .001 · recomputed p < .001
“t(471)=3.43, p < .001”
- Consistentt(353) = 3.73reported p < .001 · recomputed p < .001
“t(353)=3.73, p < .001”
- Consistentt(469) = 2.81reported p = .005 · recomputed p = .005
“t(469)=2.81, p = .005”
- Consistentt(471) = 1.16reported p = .246 · recomputed p = .247
“t(471)=1.16, p = .246”
- Consistentz = -4.02reported p < .001 · recomputed p < .001
“z=−4.02, p < .001”
- Consistentz = -2.69reported p = .007 · recomputed p = .007
“z=−2.69, p = .007”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Discussion reverses the reported mathematics mediation result
MajorThe discussion says semantic language fully accounted for the ADHD-mathematics association, whereas the results report partial mediation.
“Further, poor semantic language seemed to fully account for the ADHD-mathematics achievement association and partially account for the association with reading achievement even over and above deficits in nonverbal IQ.”
“As indicated by follow-up Sobel tests, semantic language significantly partially mediated the association between ADHD symptoms and mathematics underachievement, Δr2= .58, p<.001; indirect effects: z=−.027, p<.001.”
The reported family count cannot accommodate 154 sibling pairs
MinorIf 539 families participated and 154 had two children, the study would include at least 693 children, not 546.
Reported 546 · recomputed 693
“Children came from 539 families; 154 families had two children in the study.”
Participant age summaries differ between the abstract and methods
MinorThe abstract and methods describe the same 546 children but give different mean ages and standard deviations.
“Participants in this cross-sectional study were 546 children (54% male) ages six to twelve (M=9.77, SD=1.49).”
“Participants were 546 children between the ages of six and twelve (M=9.69, SD=1.44).”
Cites
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.51.6.1173 · Cited by 91,542 · see citing works
Baron, R. M., & Kenny, D. A. (1986) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.51.6.1173 · Cited by 91,532 · see citing works
SPSS and SAS procedures for estimating indirect effects in simple mediation models
Preacher, K. J., & Hayes, A. F. (2004) · Behavior Research Methods, Instruments, & Computers · doi:10.3758/bf03206553 · Cited by 17,383 · see citing works
Executive functions and developmental psychopathology.
Pennington, B. F., & Ozonoff, S. (1996) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.1996.tb01380.x · Cited by 3,150 · see citing works
Computerized training of working memory in children with ADHD – a randomized, controlled trial
Klingberg, T., Fernell, E., Olesen, P. J., Johnson, M., Gustafsson, P., Dahlström, K., Gillberg, C. G., Forssberg, H., & Westerberg, H. (2005) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200502000-00010 · Cited by 1,949 · cited 2× · see citing works
“Regardless, these findings suggest that children with ADHD may benefit from both early language interventions, as well as exercises that enhance WM (Klingberg et al., 2005; Rueda, Rothbart, McCandliss, Saccomanno, & Posner, 2005).”
Holmbeck, G. N. (2002) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/27.1.87 · Cited by 1,819 · see citing works
Bull, R., Espy, K. A., & Wiebe, S. A. (2008) · Developmental Neuropsychology · doi:10.1080/87565640801982312 · Cited by 1,544 · cited 2× · see citing works
“Thus, it is entirely possible that both semantic language and verbal WM problems are synergistically related to academic underachievement and ADHD, providing a mechanistic explanation of this association (Bull et al. 2008; Geary 2004; Jakobson and Kikas 2007; Van Daal et al. 2007).”
Cain, K., Oakhill, J., & Bryant, P. (2004) · Journal of Educational Psychology · doi:10.1037/0022-0663.96.1.31 · Cited by 1,496 · see citing works
Mathematics and Learning Disabilities
Geary, D. (2004) · Journal of Learning Disabilities · doi:10.1177/00222194040370010201 · Cited by 1,294 · see citing works
Training, maturation, and genetic influences on the development of executive attention
Rueda, M. R., Rothbart, M. K., McCandliss, B. D., Saccomanno, L., & Posner, M. I. (2005) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0506897102 · Cited by 1,110 · see citing works
What's meaning got to do with it: The role of vocabulary in word reading and reading comprehension.
Ouellette, G. P. (2006) · Journal of Educational Psychology · doi:10.1037/0022-0663.98.3.554 · Cited by 1,027 · see citing works
Gathercole, S. E., & Baddeley, A. D. (1989) · Journal of Memory and Language · doi:10.1016/0749-596x(89)90044-2 · Cited by 1,018 · see citing works
LEVY, F., HAY, D. A., McSTEPHEN, M., WOOD, C., & WALDMAN, I. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199706000-00009 · Cited by 956 · see citing works
Academic and Educational Outcomes of Children With ADHD
Loe, I. M., & Feldman, H. M. (2007) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsl054 · Cited by 951 · see citing works
DSM-IV field trials for attention deficit hyperactivity disorder in children and adolescents
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.11.1673 · Cited by 935 · see citing works
Biederman, J., Mick, E., Faraone, S. V., Braaten, E., Doyle, A., Spencer, T., Wilens, T. E., Frazier, E., & Johnson, M. A. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.1.36 · Cited by 863 · see citing works
Frazier, T. W., Youngstrom, E. A., Glutting, J. J., & Watkins, M. W. (2007) · Journal of Learning Disabilities · doi:10.1177/00222194070400010401 · Cited by 700 · see citing works
Willcutt, E. G., Pennington, B. F., Olson, R. K., Chhabildas, N., & Hulslander, J. (2005) · Developmental Neuropsychology · doi:10.1207/s15326942dn2701_3 · Cited by 612 · see citing works
Marchman, V. A., & Fernald, A. E. (2008) · Developmental Science · doi:10.1111/j.1467-7687.2008.00671.x · Cited by 603 · see citing works
Instability of the DSM-IV Subtypes of ADHD From Preschool Through Elementary School
Lahey, B. B., Pelham, W. E., Loney, J., Lee, S. S., & Willcutt, E. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.8.896 · Cited by 528 · see citing works
What Is the Prevalence of Adult ADHD? Results of a Population Screen of 966 Adults
Faraone, S. V., & Biederman, J. (2005) · Journal of Attention Disorders · doi:10.1177/1087054705281478 · Cited by 503 · see citing works
Learning Disabilities and ADHD: Overlapping Spectrum Disorders
Mayes, S. D., Calhoun, S. L., & Crowell, E. W. (2000) · Journal of Learning Disabilities · doi:10.1177/002221940003300502 · Cited by 457 · see citing works
Willcutt, E. G., Pennington, B. F., Boada, R., Ogline, J. S., Tunick, R. A., Chhabildas, N. A., & Olson, R. K. (2001) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.110.1.157 · Cited by 451 · see citing works
Willcutt, E. G., Pennington, B. F., Boada, R., Ogline, J. S., Tunick, R. A., Chhabildas, N. A., & Olson, R. K. (2001) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.110.1.157 · Cited by 451 · see citing works
Swanson, H. L., & Sachse-Lee, C. (2001) · Journal of Experimental Child Psychology · doi:10.1006/jecp.2000.2587 · Cited by 443 · see citing works
Ouellette, G. P., & Beers, A. (2009) · Reading and Writing · doi:10.1007/s11145-008-9159-1 · Cited by 428 · see citing works
Neuropsychological profiles of adolescents with ADHD: effects of reading difficulties and gender
Rucklidge, J. J., & Tannock, R. (2002) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00227 · Cited by 426 · see citing works
Working memory and access to numerical information in children with disability in mathematics
Passolunghi, M. C., & Siegel, L. S. (2004) · Journal of Experimental Child Psychology · doi:10.1016/j.jecp.2004.04.002 · Cited by 389 · cited 1× · see citing works
“Verbal WM deficits appear to be related to both ADHD and underachievement (Martinussen and Tannock 2006; Passolunghi and Siegel 2004; Swanson and Sachse-Lee 2001a, b), possibly explaining comorbidity.”
Young, A. R., Beitchman, J. H., Johnson, C., Douglas, L., Atkinson, L., Escobar, M., & Wilson, B. (2002) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00052 · Cited by 362 · see citing works
Willcutt, E. G., Betjemann, R. S., McGrath, L. M., Chhabildas, N. A., Olson, R. K., DeFries, J. C., & Pennington, B. F. (2010) · Cortex · doi:10.1016/j.cortex.2010.06.009 · Cited by 354 · cited 1× · see citing works
“…research indicating that ADHD and extreme academic underachievement share etiological factors, including common genetic influences (Willcutt et al. 2001, 2007) and shared executive function deficits (Banaschewski et al 2005; Seidman et al. 2001; Willcutt et al. 2005; Willcutt et al. 2001, 2010).”
Tomblin, J. B., Zhang, X., Buckwalter, P. R., et al. (2000) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00632 · Cited by 348 · see citing works
McCartney, K., Burchinal, M., & Bub, K. L. (2006) · Monographs of the Society for Research in Child Development · doi:10.1111/j.1540-5834.2006.07103001.x · Cited by 292 · see citing works
Purvis, K. L., & Tannock, R. (1997) · Journal of Abnormal Child Psychology · doi:10.1023/a:1025731529006 · Cited by 277 · see citing works
Neural Substrates of Language Acquisition
Kuhl, P., & Rivera-Gaxiola, M. (2008) · Annual Review of Neuroscience · doi:10.1146/annurev.neuro.30.051606.094321 · Cited by 275 · see citing works
Cohen, N. J., Vallance, D. D., Barwick, M., Im, N., Menna, R., Horodezky, N. B., & Isaacson, L. (2000) · Journal of Child Psychology and Psychiatry · doi:10.1111/1469-7610.00619 · Cited by 272 · see citing works
Martinussen, R., & Tannock, R. (2006) · Journal of Clinical and Experimental Neuropsychology · doi:10.1080/13803390500205700 · Cited by 270 · cited 1× · see citing works
“Verbal WM deficits appear to be related to both ADHD and underachievement (Martinussen and Tannock 2006; Passolunghi and Siegel 2004; Swanson and Sachse-Lee 2001a, b), possibly explaining comorbidity.”
Working memory and comprehension in children with specific language impairment: what we know so far
Montgomery, J. W. (2003) · Journal of Communication Disorders · doi:10.1016/s0021-9924(03)00021-2 · Cited by 262 · see citing works
SHERMAN, D. K., IACONO, W. G., & McGUE, M. K. (1997) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199706000-00010 · Cited by 250 · see citing works
Heterogeneity in ADHD: Neuropsychological Pathways, Comorbidity and Symptom Domains
Wåhlstedt, C., Thorell, L. B., & Bohlin, G. (2009) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-008-9286-9 · Cited by 237 · see citing works
Thorell, L. B. (2007) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2007.01777.x · Cited by 230 · see citing works
Are Mathematics Disabilities Due to a Domain-General or a Domain-Specific Working Memory Deficit?
Wilson, K. M., & Swanson, H. L. (2001) · Journal of Learning Disabilities · doi:10.1177/002221940103400304 · Cited by 224 · see citing works
Long-Term Consistency in Speech/Language Profiles: I. Developmental and Academic Outcomes
BEITCHMAN, J. H., WILSON, B., BROWNLIE, E. B., WALTERS, H., & LANCEE, W. (1996) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199606000-00021 · Cited by 219 · see citing works
Phonological Processing, Not Inhibitory Control, Differentiates ADHD and Reading Disability
Purvis, K., & Tannock, R. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200004000-00018 · Cited by 218 · see citing works
Seidman, L. J., Biederman, J., Monuteaux, M. C., Doyle, A. E., & Faraone, S. V. (2001) · Neuropsychology · doi:10.1037//0894-4105.15.4.544 · Cited by 191 · see citing works
Barriga, A. Q., Doran, J. W., Newell, S. B., Morrison, E. M., Barbetti, V., & Dean Robbins, B. (2002) · Journal of Emotional and Behavioral Disorders · doi:10.1177/10634266020100040501 · Cited by 191 · see citing works
Seidman, L. J., Biederman, J., Monuteaux, M. C., Doyle, A. E., & Faraone, S. V. (2001) · Neuropsychology · doi:10.1037/0894-4105.15.4.544 · Cited by 190 · see citing works
The Age at Onset of Attention Deficit Hyperactivity Disorder
Kieling, C., Kieling, R. R., Rohde, L. A., Frick, P. J., Moffitt, T., Nigg, J. T., Tannock, R., & Castellanos, F. X. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2009.09060796 · Cited by 185 · see citing works
Language Deficit With Attention-Deficit Disorder: A Prevalent Comorbidity
Tirosh, E., & Cohen, A. (1998) · Journal of Child Neurology · doi:10.1177/088307389801301005 · Cited by 165 · see citing works
DENCKLA, M. B. (1996) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-199604000-00011 · Cited by 153 · cited 3× · see citing works
“Further, research has indicated that children with ADHD display a “developmental lag” in verbal WM, such that children with ADHD develop verbal WM skills slower than typically developing children (Denckla 1996; Sowerby et al. 2011).”
Towards an understanding of unique and shared pathways in the psychopathophysiology of ADHD
Banaschewski, T., Hollis, C., Oosterlaan, J., Roeyers, H., Rubia, K., Willcutt, E., & Taylor, E. (2005) · Developmental Science · doi:10.1111/j.1467-7687.2005.00400.x · Cited by 152 · see citing works
A Pilot Study of Working Memory and Academic Achievement in College Students With ADHD
Gropper, R. J., & Tannock, R. (2009) · Journal of Attention Disorders · doi:10.1177/1087054708320390 · Cited by 148 · see citing works
Language Characteristics of Children with ADHD
Kim, O. H., & Kaiser, A. P. (2000) · Communication Disorders Quarterly · doi:10.1177/152574010002100304 · Cited by 146 · see citing works
The Latent Structure of Attention-Deficit/Hyperactivity Disorder: A Taxometric Analysis
Haslam, N., Williams, B., Prior, M., Haslam, R., Graetz, B., & Sawyer, M. (2006) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2006.01863.x · Cited by 145 · see citing works
Korkman, M., & Pesonen, A.-E. (1994) · Journal of Learning Disabilities · doi:10.1177/002221949402700605 · Cited by 137 · see citing works
Academic Underachievement in ADHD Subtypes
Marshall, R. M., Hynd, G. W., Handwerk, M. L., & Hall, J. (1997) · Journal of Learning Disabilities · doi:10.1177/002221949703000607 · Cited by 134 · see citing works
Gender ratios for reading difficulties
Hawke, J. L., Olson, R. K., Willcutt, E. G., Wadsworth, S. J., & DeFries, J. C. (2009) · Dyslexia · doi:10.1002/dys.389 · Cited by 134 · see citing works
Behaviour problems in children with language impairment
van Daal, J., Verhoeven, L. T. W., & van Balkom, H. (2007) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2007.01790.x · Cited by 133 · see citing works
Working memory and inattentive behaviour in a community sample of children
Lui, M., & Tannock, R. (2007) · Behavioral and Brain Functions · doi:10.1186/1744-9081-3-12 · Cited by 109 · cited 1× · see citing works
“Based on developmental theory, semantic language and verbal WM appear to exhibit a bidirectional relationship with one another (Lui and Tannock 2007) such that verbal WM appears critical to the development of semantic language, and semantic language also facilitates the further development of…”
A Subgroup Analysis of Working Memory in Children with Reading Disabilities
Swanson, H. L., & Sachse-Lee, C. (2001) · Journal of Learning Disabilities · doi:10.1177/002221940103400305 · Cited by 105 · see citing works
Ward, S. (1999) · International Journal of Language & Communication Disorders · doi:10.1080/136828299247405 · Cited by 90 · see citing works
Verbal Factors and Mathematics Learning: A Review of Research
Aiken, L. R. (1971) · Journal for Research in Mathematics Education · doi:10.2307/748485 · Cited by 81 · see citing works
Willcutt, E. G., Betjemann, R. S., Wadsworth, S. J., Samuelsson, S., Corley, R. P., DeFries, J. C., Byrne, B., Pennington, B. F., & Olson, R. K. (2006) · Reading and Writing · doi:10.1007/s11145-006-9020-3 · Cited by 79 · see citing works
JONSDOTTIR, S., BOUMA, A., SERGEANT, J., & SCHERDER, E. (2006) · Archives of Clinical Neuropsychology · doi:10.1016/j.acn.2006.05.003 · Cited by 78 · cited 1× · see citing works
“…et al. 2010; Kuhl and RiveraGaxiola 2008) and in line with research suggesting that language deficits are a predictor of teacher-rated inattention (Jonsdottir et al. 2006), assessment of semantic language in young children might allow for earlier identification of children at high risk for…”
Gartstein, M. A., Crawford, J., & Robertson, C. D. (2008) · Child Psychiatry and Human Development · doi:10.1007/s10578-007-0067-4 · Cited by 72 · see citing works
Sowerby, P., Seal, S., & Tripp, G. (2011) · Journal of Attention Disorders · doi:10.1177/1087054710370674 · Cited by 59 · see citing works
Jakobson, A., & Kikas, E. (2007) · Journal of Learning Disabilities · doi:10.1177/00222194070400030101 · Cited by 57 · see citing works
White, R. F., Campbell, R., Echeverria, D., Knox, S. S., & Janulewicz, P. A. (2008) · Journal of Epidemiology & Community Health · doi:10.1136/jech.2007.071530 · Cited by 56 · see citing works
Breslau, N., Breslau, J., Peterson, E., Miller, E., Lucia, V. C., Bohnert, K., & Nigg, J. (2010) · Psychological Medicine · doi:10.1017/s0033291709005960 · Cited by 52 · see citing works
Why are Hyperactivity and Academic Achievement Related?
Saudino, K. J., & Plomin, R. J. (2007) · Child Development · doi:10.1111/j.1467-8624.2007.01044.x · Cited by 42 · see citing works
Basic behavioral science research for mental health: Perception, attention, learning, and memory.
National Advisory Mental Health Council (1996) · American Psychologist · doi:10.1037/0003-066x.51.2.133 · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 9
- DuPaul, G. J., Power, T. J., Anastopolous, A. D., & Reid, R. (1998). ADHD Rating Scale—IV: Checklists, norms, and clinical interpretation. New York: Guilford.
- Lahey, B. B., & Willcutt, E. (2002). Validity of the diagnosis and dimensions of attention deficit hyperactivity disorder. In P. S. Jenson & J. R. Cooper (Eds.), Attention deficit hyperactivity disorder: State of the science (pp. 1–23). New York: Civic Research Institute.
- Lichtenberger, E. O., & Smith, D. R. (2005). Essentials of WIAT-II and KTEA-II assessment. Hoboken: Wiley.
- McCartney, K., Burchinal, M.R., & Bub, K.L. (2006). Best practices in quantitative methods for developmentalists. In W.F. Overton & M. Berry (Eds.), Monographs of the Society for Research in Child Development, 285.
- Nigg, J. T. (2006). What causes ADHD? Understanding what goes wrong and why. New York: Guilford.
- Puig-Antic, J., & Ryan, N. (1986). Kiddie schedule for affective disorders and schizophrenia. Pittsburgh: Western Psychiatric Institute.
- Sattler, J. M. (2008). Assessment of children: Cognitive Foundations (5th ed.). La Mesa: Jerome M. Sattler, Publisher, Inc.
- Semel, E., Wiig, E. H., & Seccord, W. A. (2003). Clinical evaluation of language fundamentals (4th ed.). San Antonio: The Psychological Corporation.
- Wiig, E. H. (2008). Language disabilities. In A. Prifitera, D. H. Saklofske, & L. G. Weiss (Eds.), WISC-IV clinical assessment and intervention (2nd ed., pp. 173–193). Oxford: Elsevier.
Cited by
Sorted by citations
A meta-analysis on verbal working memory in children and adolescents with ADHD
Ramos, A. A., Hamdan, A. C., & Machado, L. (2020) · The Clinical Neuropsychologist · doi:10.1080/13854046.2019.1604998 · Cited by 125 · see citing works
Kofler, M. J., Spiegel, J. A., Soto, E. F., Irwin, L. N., Wells, E. L., & Austin, K. E. (2019) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-018-0447-1 · Cited by 57 · see citing works
Soria, I. N., Cortés, J. F., Cerván, R. L., & Mier, R. J. R. D. (2017) · Universal Journal of Psychology · doi:10.13189/ujp.2017.050403 · Cited by 6 · see citing works
- Authors
- Gremillion, M. L., & Martel, M. M.
- Affiliations
- LSU New Orleans (US)
- Corresponding author
- Gremillion, Monica L.
- ORCID
- Martel, Michelle M.
- Venue
- Journal of Abnormal Child Psychology
- Published
- 2012-06-02
- Volume
- 40
- Issue
- 8
- Pages
- 1339-1349
- ISSN
- 0091-0627 (ISSN-L)
- 1573-2835
- PMC
- PMC4278425
- OpenAlex
- W2128673596
- Cited by
- 47
- References
- 70
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 6 · 2015: 2 · 2014: 4
- FWCI
- 1.37
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Research on Child and Adolescent Psychopathology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health (R01 MH-59105, R01MH070004, R01MH059105)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
- Social Sciences › Psychology › Developmental and Educational Psychology › Reading and Literacy Development
- Keywords
- attention deficit hyperactivity disorder, semantic language, academic underachievement, verbal working memory, mediation, inattentive symptoms, hyperactive-impulsive symptoms, language impairment, children, attention development
- MeSH terms
- Attention Deficit Disorder with Hyperactivity, Child, Cross-Sectional Studies, Dyslexia, Educational Status, Female, Humans, Language Development, Language Disorders, Male, Mathematics, Semantics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-05.
Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-05.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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