Extended time improves reading comprehension test scores for adolescents with ADHD


Objective: To test the hypotheses that reading comprehension difficulties of adolescent students with ADHD: 1) are related not so much to weak verbal abilities or weak basic reading skills, as to impairments of working memory and processing speed characteristic of ADHD; and 2) that extended time on a test of reading comprehension would yield significantly higher reading comprehension scores than would standard time. Method: Charts of 145 adolescents 13-18 years diagnosed with DSM-IV ADHD and no specific reading disorder after a comprehensive clinical and psycho-educational evaluation, were reviewed to extract 1) word reading and word attack subtest scores from the Woodcock-Johnson Achievement Test or the Wechsler Individual Achievement Test; 2) Index scores from WISC-IV or WAIS-III IQ tests; 3) scores from the Nelson-Denny Reading Test. Results: Mean index scores for verbal comprehension abilities not including reading were in the high average range, but working memory and processing speed index scores were significantly weaker. Under standard time limits 53% were unable to complete the reading comprehension test and only 42.8% were able to score within 1 SD of their IQ verbal comprehension index (VCI). When allowed extended time, 77.9% were able to score within 1 SD of their VCI. T-test comparisons between standard time and extended time were significant at < 0.001. Conclusions: Allowing extended time for adolescents with ADHD to complete tests involving reading may help to compensate for their impairments of working memory and processing speed, allowing them to score closer to their actual verbal abilities.

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Brown, T. , Reichel, P. and Quinlan, D. (2011) Extended time improves reading comprehension test scores for adolescents with ADHD. Open Journal of Psychiatry, 1, 79-87. doi: 10.4236/ojpsych.2011.13012.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Pennington, B.F. (1991) Diagnosing learning disorders: A neurological framework. Guilford Press, New York.
[2] Brown, T.E. (2005) Attention deficit disorder: The unfocused mind in children and adults. Yale University Press, New Haven.
[3] Brown, T.E. (2009) Developmental complexities of attentional disorders. In T.E. Brown (Ed.), ADHD Comorbidities: Handbook for ADHD complications in children and adults. American Psychiatric Publishing, Inc., Washington, D.C., 3-22.
[4] Anmarkrud, O. and Braten, I. (2009) Motivation for reading comprehension. Learning and Individual Differences, 19, 252-256. doi:10.1016/j.lindif.2008.09.002
[5] Willcutt, E.G., Pennington, B.F., et al. (2005) Neuropsychological analyses of comorbidity between reading disability and attention deficit hyperactivity disorder: In search of the common deficit. Developmental Neuropsychology, 27, 35-78. doi:10.1207/s15326942dn2701_3
[6] Shanahan, M.A., Pennington, B.F., et al. (2006) Processing speed deficits in attention deficit/hyperactivity disorder and reading disability. Journal of Abnormal Child Psychology, 34, 585-602. doi:10.1007/s10802-006-9037-8 2
[7] Laasonen, M., Leppamaki, S., et al. (2009) Adult dyslexia and attention deficit disorder in Finland-project DyAdd. Journal of Learning Disabilities, 42, 511-527. doi:10.1177/0022219409345013
[8] McGrath, L.M., Pennington, B.F., et al. (2011) A multiple deficit model of reading disability and attention-deficit-hyperactivity disorder: Searching for shared cognitive deficits. Journal of Child Psychology and Psychiatry, 52, 547-557 doi:10.1111/j.1469-7610.2010.02346.x
[9] Arnell, K.M., Joanisse, M.F., et al. (2009) Decomposing the relation between rapid automatized naming (RAN) and reading ability. Canadian Journal of Experimental Psychology, 63, 173-184. doi:10.1037/a0015721
[10] Swanson, H.L., Zheng, X., et al. (2009) Working memory, short-term memory, and reading disabilities. Journal of Learning Disabilities, 42, 260-287. doi:10.1177/0022219409331958
[11] Sesma, H.W., Mahone, E.M., et al. (2009) The contribution of executive skills to reading comprehension. Child Neuropsychology, 15, 232-246. doi:10.1080/09297040802220029
[12] Locascio, G., Mahone, M., Eason, S. and Cutting, L. (2010) Executive dysfunction among children with reading comprehension deficits. Journal of Learning Disabilities, 43, 441-454. doi:10.1177/0022219409355476
[13] Samuelsson, S., Lundberg, I., et al. (2004) ADHD and reading disability in male adults: Is there a connection? Journal of Learning Disabilities, 37, 155-168. doi:10.1177/00222194040370020601
[14] Jacobson, L.A., Matthew, R., et al. (2011) Working memory influences processing speed and reading fluency in ADHD. Child Neuropsychology, 17, 209-224. doi:10.1080/09297049.2010.532204
[15] Bental, B. and Tirosh, E. (2007) The relationship between attention, executive functions and reading domain abilities in attention deficit hyperactivity disorder: A comparative study. Journal of Child Psychology and Psychiatry, 48, 455-463. doi:10.1111/j.1469-7610.2006.01710.x
[16] Leong, C.K., Tse, S.K., et al. (2008) Text comprehension in Chinese children: Relative contribution of verbal working memory, pseudoword reading, rapid automatized naming, and onset-rime phonological segmentation. Journal of Educational Psychology, 1, 135-149. doi:10.1037/0022-0663.100.1.135
[17] Willcut, E., Pennington, B., Boada, R., Ogline, J., Tunick, R. and Chhabildas, N. (2001) A comparison of the cognitive deficits in reading disability and attention-deficit/ hyperactivity disorder. Journal of Abnormal Psychology, 110, 157-172. doi:10.1037//0021-843X.110.1.157
[18] Cain, C. and Oakhill, J. (2007) Reading comprehension difficulties: Correlates, causes and consequences. In children’s comprehension problems in oral and written language. Guilford Press, New York, 41-75.
[19] Shaywitz, S.E. and Shaywitz, B.A. (2008) Paying Attention to Reading: The neurobiology of reading and dyslexia. Development and Psychopathology, 20, 1329-1349. doi:10.1017/S0954579408000631
[20] Walczyk, J.J., Wei, M., et al. (2007) Development of the interplay between automatic processes and cognitive resources in reading. Journal of Educational Psychology, 99, 867-887. doi:10.1037/0022-0663.99.4.867
[21] Mayes, S.D. and Calhoun, S.L. (2007) Wechsler intelligence scale for children-third and -fourth edition predictors of academic achievement in children with attention-deficit/hyperactivity disorder. School Psychology Quarterly, 22, 234-249. doi:10.1037/1045-3830.22.2.234
[22] Brown, T.E. (1996) Brown attention deficit disorder scales for adolescents and adults. TX. The Psychological Corporation, San Antonio.
[23] Brown, T.E. (2001) Brown Attention Deficit Disorder Scales for Children and Adolescents. The Psychological Corporation, San Antonio.
[24] Wechsler, D. (2003) Wechsler intelligence scale for children-fourth edition. TX. The Psychological Corporation, San Antonio.
[25] Wechsler, D. (1997) Wechsler adult intelligence scale-third edition administration and scoring manual. The Psychological Corporation, San Antonio.
[26] Wechsler, D. (2002) Wechsler individual achievement test-second edition. TX. Psychological Corporation, San Antonio.
[27] Woodcock, R.W., McGrew, K.S., et al. (2001) Woodcock-johnson-third edition tests of achievement. IL. Riverside Publishing, Itasca.
[28] Mayes, S.D., Calhoun, S.L., et al. (2009) ADHD subtypes and co-occurring anxiety, depression, and oppositional defiant disorder: Differences in gordon diagnostic system and wechsler working memory and processing speed index scores. Journal of Attention Disorders, 12, 540-549. doi:10.1177/1087054708320402
[29] Brown, J.I., Fishco, V.V. and Hanna, G. (1993) Nelson-denny reading test. Riverside Publishing Co., Chicago.
[30] Ofiesh, N., Mather, N. and Russell, A. (2005) Using speeded cognitive, reading, and academic measures to determine the need for extended test time among university students with learning disabilities. Journal of Psychoeducational Assessment, 23, 35-52. doi:10.1177/073428290502300103
[31] Lovett, B.J. (2010) Extended time testing accommodations for students with disabilities: Answers to five fundamental questions. Review of Educational Research, 80, 611-638. doi:10.3102/0034654310364063
[32] Sireci, S.G., Scarpati, S.E. and Li, S. (2005) Test accommodations for students with disabilities: An analysis of the interaction hypothesis. Review of Educational Research, 75, 457-490. doi:10.3102/00346543075004457
[33] Coleman, C., Lindstrom, J., Nelson, J., Lindstrom, W. and Gregg, K. (2010) Passageless comprehension on the nelson-denny reading test: Well above chance for university students. Journal of Learning Disabilities, 43, 244-249. doi:10.1177/0022219409345017

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