The Task Matters Scoping Review

Reading Comprehension

Reading comprehension is a multifaceted cognitive process that involves several intricate steps including visually processing words, grasping meanings, interpreting sentences, and piecing together narratives. The culmination of these steps is a deep understanding of the text’s content. However, for individuals with Attention-Deficit/Hyperactivity Disorder (ADHD), this process can be quite challenging.

Understanding ADHD

ADHD, a common developmental disorder affecting 5% to 10% of school-age children, is typically characterized by inattention, impulsivity, and hyperactivity traits. Although reading comprehension difficulties aren’t a central feature, they have been observed in individuals with ADHD. Core traits of ADHD, such as distractibility and poor concentration, can hinder grasping essential details and linking narrative elements. However, a recent article highlights that there remains large variability across the literature regarding reading abilities in those with ADHD and suggests that these inconsistencies may be driven by the manner in which reading comprehension is assessed. 

Research Insights

In a recently published comprehensive review, Parks and colleagues aimed to unravel the intricate relationship between ADHD and reading comprehension abilities. By examining a wide array of studies, the review sheds light on the challenges individuals with ADHD face when it comes to understanding written text, paving the way for further investigations and targeted accommodations.

Key Findings

The review highlighted that individuals with ADHD encounter challenges when it comes to reading comprehension. However, this challenge isn’t uniform; it fluctuates depending on the specific tasks presented. 

Notably, research demonstrates that individuals with ADHD struggle more on tasks demanding open-ended responses or involving high cognitive demands. For instance, the cloze procedure – where participants fill in missing words within sentences – yielded mixed results. While traditional cloze tasks highlighted poorer performance among those with ADHD, modified versions yielded comparable outcomes between those with ADHD and their typically developing peers.

Similarly, in tasks where participants were asked to retell stories or identify central ideas within texts, those with ADHD consistently demonstrated lower performance compared to their typically developing peers. However, when task demands were adjusted or reduced (e.g., using recognition tasks rather than free recall tasks), participants with ADHD showed marked improvement.

Overall, performance on comprehension questions often saw enhancements when adjustments were made, such as extending the time for task completion, limiting open-ended questions, presenting tasks in written format, or even incorporating calming background music. These patterns observed across the literature underscore the pivotal influence of task modifications on the performance of individuals with ADHD.

Given these findings, Parks and colleagues suggested that reading comprehension difficulties in those with ADHD likely stem from challenges related to recall rather than initial text encoding. Working memory deficits were also highlighted as a possible explanation for these challenges. The heightened resource allocation for maintaining attention during reading may influence higher-level comprehension skills such as connecting and recalling main ideas.

Avenues for Future Research

The authors highlighted several directions for future research:

1. Impact of Medication: Exploring how stimulant medication affects reading comprehension in ADHD individuals, including assessing whether discontinuation prior to testing influences performance.
2. Testing Accommodations: Investigating the efficacy of testing accommodations, such as extended time, in enhancing reading comprehension assessments for individuals with ADHD.
3. Underlying Factors: Further investigating the roles of various cognitive processes (e.g., working memory, word decoding, language, and attention) in contributing to reading comprehension difficulties in ADHD across different age groups.

Implications for Educators and Caregivers:

Navigating the world of education for individuals with ADHD requires a nuanced understanding of their unique challenges. Educators and caregivers play a pivotal role in supporting these individuals as they strive to grasp written content effectively. Here are some factors to consider:

1. Tailored Learning Approaches: Recognizing that reading comprehension challenges in ADHD are not uniform, educators should adopt diverse teaching and testing approaches. Customizing tasks and materials to align with the cognitive strengths and weaknesses of each individual can enhance their learning experience. For instance, breaking down complex texts into smaller segments, minimizing the number of open-ended questions, or incorporating interactive discussions can promote better engagement and understanding.
2. Extended Time as a Tool: One of the most straightforward yet impactful accommodations is the provision of extended time. ADHD individuals often require additional time to process information and formulate well-constructed responses. This extension can reduce the pressure associated with time constraints and enable them to showcase their true comprehension capabilities.
3. Fostering a Supportive Environment: Creating an inclusive and understanding environment is crucial. Educators and caregivers can foster a culture of empathy and patience, where mistakes are seen as opportunities for growth. Encouraging open communication and destigmatizing the challenges faced by ADHD individuals can significantly boost their confidence and motivation to engage with reading materials.

Main Take-Aways

• Over half of the studies included in the review indicated affected reading comprehension in ADHD individuals.
• The specific tasks used for reading assessment may impact the results.
• Individuals struggling with one task (e.g., story recall) may excel in another (e.g., narrative recognition).
• Task modifications hold promise for unlocking readers’ true potential.
• Educators and caregivers can mitigate reading comprehension difficulties through tailored tasks and extended time. 

You can access the full open access review article here: https://doi.org/10.1177/10870547211068047

Written by Leah Brainin