Psychological Services

Reading Problems and ADD (Attention Deficit Disorder)

A reading comprehension problem is probably the most common symptom of ADD, (Attention Deficit Disorder) the true genetic disorder seen clinically in providing assessment for over twenty years. Unfortunately, when decoding skills are poor or reading comprehension problematic, the focus will be on the reading problem as opposed to the presence of an attention disorder. Children and adults are mistakenly labeled dyslexic, a term used by neuropsychologists to label aphasic (language) disorders. While there are those cases that improve when language is directly targeted, the majority continue to evidence reading and reading comprehension problems. They may read slowly with the energy spent upon decoding and a result of not knowing what they just read. In other words, reading fluency is not sufficient to provide a visual picture and to “comprehend” what one is reading. This is the reason that diagnosed ADD (Attention Deficit Disorder) individuals will report that they have to read things several times. While possibly a result of distractibility the more likely causal factor is reading fluency.

Generally, after receiving some type of intervention and tutorial help, things improve sufficiently for the child to perform commensurate with their grade although not sufficiently to make reading fun and a positive learning experience. Bright children with ADD (Attention Deficit Disorder) tend to use their high-level ability to compensate and begin to memorize words forming a library of content words and practicing content reading. This is when they may arrive at the end of a sentence and realize they had just read the word “hire” and “hare” which no longer makes sense. Often the ADD reader in this scenario is familiar with enough words to use logical reasoning to guess and assume the remainder of the sentence. Generally this process works reasonably well, however if comprehension questions increase in detail the system naturally falls short.

Children who are more compulsive, the achievers, proceed to develop a large vocabulary based upon memory and sight recognition. As noted above this approach may fail them when they tend to read the word incorrectly, substituting a similar word. Those children that cannot attain success by memorization often declare that they no longer like to read, maintaining that they never liked to read and keeping this stance to protect against criticism of their increasingly under-developed reading skills. Spelling follows a similar pattern unless memorized. Point being that spelling and reading are related to the spatial deficits accompanying the ADD (Attention Deficit Disorder) diagnosis negating the learning of phonetics and the ability to see that a word is spelled incorrectly unless memorized. Compensation is the key here as opposed to the development of the skills necessary to perform the tasks.

Evaluation has confirmed through time the presence of visuospatial deficits and the accompanying problem of decoding and reading comprehension. Exclusions to this norm are those individual who truly devote themselves to improving their reading skills arduously working on the understanding and use of phonetics as the blueprint of language. We have found tremendous reading gains, specifically improvement in the ability to decode (word attack skills) following the intervention of our cognitive training program.

From our experience, reading problems associated with ADD (Attention Deficit Disorder) are qualitatively different from the reading difficulties seen clinically when there is brain impairment. Listening to an ADD child or adult read, we typically see symptoms of substituting words or parts of words. The neglect of small words such as: and, so, but, not, of, for, is another common phenomenon. It is always an amazing experience when the ADD individual finishes reading a passage that was so different from the printed page yet somehow they manage to correctly respond to many of the comprehension questions.

The more detailed questions or the questions that require a complete understanding of the story or the information do become problematic. Thus it is the laboriousness of reading and the lack of fluency that is primarily the problem when in the presence of a genetic ADD (Attention Deficit Disorder) disorder. More often the problem is the lack of sufficient reading fluency to “read” a passage with ease to the degree that reading produces the simultaneous process of visualizing the picture that the written word has created.

Consequently ADD children typically do not like to read. If they say they like to read it is only certain types of reading materials (such as a sports magazine or fiction books) or they do not read very often. Children who compensate by memorizing their words and do not read much have a problem with reading due to lack of practice. Children who compensate by memorizing and do read a lot enlarge their vocabulary, although they may still pronounce words wrong having not heard the word and connected it with the spelling (such as corps as corpse). The culprit is seen as a visuospatial or spatial problem, the result of years of compensating for attention symptoms by building upon logical reasoning skills and overdeveloping those brain areas.

Take Home Points:

  • Genetic ADD (Attention Deficit Disorder) results in greater difficulty reading and acquiring adequate phonetic decoding skills with the overall result of reading being a laborious experience that produces more pain than pleasure.
  • When a brain injury accompanies a genetic ADD (Attention Deficit Disorder), the problem becomes more severe and reading difficulties are the result of additional symptoms of problematic memory and impaired frontal processes.
  • When there is a brain injury from birth or at a very young age, the injury may result in damage to the language tracts and the difficulty developing language, creating the true dyslexia or various forms of aphasia.