Extended time improves reading comprehension test scores for adolescents with ADHD

Abstract

Objective: To test the hypotheses that reading com-prehension difficulties of adolescent students with ADHD: 1) are related not so much to weak verbal abilities or weak basic reading skills, as to impair-ments of working memory and processing speed characteristic of ADHD; and 2) that extended time on a test of reading comprehension would yield signifi-cantly higher reading comprehension scores than would standard time. Method: Charts of 145 adoles-cents 13-18 years diagnosed with DSM-IV ADHD and no specific reading disorder after a comprehensive clinical and psycho-educational evaluation, were re-viewed to extract 1) word reading and word attack subtest scores from the Woodcock-Johnson Achieve-ment 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 aver-age 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 compre-hension 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 ex-tended time were significant at <0.001. Conclusions: Allowing extended time for adolescents with ADHD to complete tests involving reading may help to com-pensate for their impairments of working memory and processing speed, allowing them to score closer to their actual verbal abilities.