Reading comprehension is a common problem affecting both children and adults with ADHD, resulting in poor tests scores, bad grades, and missed assignments.
However, poor reading comprehension doesn’t always originate from an attentional disorder; instead, there may be other underlying issues present as well, such as an auditory or language processing disorder. Auditory processing disorders prohibit language, both spoken and written, from being processed efficiently causing incoming information to be more confusing and difficult to follow.
Unfortunately, when faced with complaints of poor focus or reading comprehension, many physicians will simply prescribe stimulant ADHD medications, without first identifying the root of the problem. These difficulties are often caused by dysregulation in regions of the brain that are involved in attention and language processing, and in cases in which these areas are already overactive, the blind prescription of stimulant medications may actually make these problems worse.
At the Drake Institute, we believe there's a better way to treat these symptoms. For 3 decades, we have utilized advanced, non-drug treatment protocols utilizing quantitative EEG (qEEG) brain map-guided Neurofeedback and more recently Neuromodulation as well to help both children and adults find long-term symptom relief.
In this article, we will further discuss the effects of poor reading comprehension, explaining where it originates in the brain, the impact it has on daily functioning, and how to increase abilities both in the classroom and in the workplace, without always needing to resort to the use of ADHD medications.
While the prevalence estimates vary, the research consistently points to a high rate of comorbidity between ADHD and auditory processing deficits, with estimates varying from 45% to 70% of children with ADHD also demonstrating language processing impairments.
In addition to the attentional problems, these children also cannot fully utilize their potential due to an auditory or language processing weakness. An analogy would be if you are on your cell phone and the signal keeps going in and out: not only would you have to exert extra energy to pay closer attention to attempt to decipher the information, but you’re also going to miss out on parts of the conversation due to the signal completely being missed.
This is similar to what an ADHD child with a language processing problem experiences in the classroom when the teacher is lecturing and they are simply unable to keep up with the rate of information being presented to them.
And when we take into the account the fact that about 85% of what goes on in the classroom is the teacher talking or lecturing, we can easily see why an ADHD child with a language processing deficit might fail to perform executive functioning tasks like following instructions, turning in their homework on time, or organizing their calendar. They are functioning on incomplete information due to the language processing disorder.
In imaging studies, patients struggling with reading comprehension are found to have dysregulation (i.e., under- or overactivation) in specific regions of their brain—regions that are responsible for critical functions like processing the sounds of language, paying attention, and maintaining a short-term working memory.
Indeed, reading comprehension is a complex process involving 4 distinct regions of the brain. And when all 4 of these regions work together in a manner that is fast and seamless, the individual can better identify speech sounds while linking sounds to letters and words, and then sounds to visual word forms (reading).
If for any reason this process is compromised, the individual will find the experience of reading confusing, uncomfortable, boring, frustrating, and ultimately fruitless.
This is the reason why many children who struggle with reading don’t see a great deal of improvement when their parents hire a tutor. Indeed, the child’s brain is naturally less receptive to therapeutic intervention, and as a result, they are unable to make significant progress because their brain functioning is compromised. Quite simply, their brain does not have the capacity, due to impaired functioning brain networks, to efficiently process the information that they are being asked to read.
Even though some individuals may experience symptom relief from stimulant ADHD medications, their efficacy can vary greatly from person to person.
What’s more, many of these ADHD medications carry a significant number of potential negative side-effects, which for some, might not be worth facing if their primary issue can be addressed in other ways.
And in addition, the effectiveness of ADHD medications may ultimately decrease over time as the individual’s brain builds up a tolerance, which means that the dosage of the medication will have to be increased, leading to even possibly worse side-effects.
Finally, once the individual stops taking their ADHD medications, their symptoms are likely to return, which creates an unhealthy dependency that’s difficult to break.
As mentioned, processing speed that is slow (even in bright children) can contribute to language deficiencies.
A child must be able to process the information at the rate that it is coming at them or they will have problems with speech-sound discrimination and can end up missing verbal information.
Kids with a language processing deficit may simply be missing instructions from the teacher in the classroom, and may actually be misunderstood as "not paying attention." In fact, what is at times attributed as inattention can actually largely be the result of an auditory processing problem causing the individual to simply “give up” and stop trying to stay focused. This occurs because they cannot keep up with the rate of information being presented. What is observed as poor focus, could instead be a deficit in processing and comprehension that is discouraging the child from continuing to stay on task.
So how does a parent know if their child has an auditory or language processing problem? Below are a few of the most common symptoms of an auditory or language processing problem.
Because of a characteristic that all our brains possess called "neuroplasticity,” the brain can reorganize, develop new connections, and strengthen connections between neurons or brain cells. This is the process that the brain utilizes to increase its own capacity, but also to learn new skills and abilities.
In fact, you can utilize and train the brain's neuroplasticity, and improve the brain's wiring to improve the brain’s processing speed and help reduce symptoms.
For example, when learning how to hit a baseball, you start off with the ball being thrown at you at a slower speed. As you master hitting a baseball at that slower speed, the speed can be gradually increased as you improve your processing speed for hitting a baseball.
The principle is the same with language processing skills, but the training needs to be frequent and intense to develop the brain's connections for improved functioning.
At the Drake Institute, through our brain map-guided Neurofeedback/Neuromodulation and a computerized auditory-visual processing training program, a patient can improve their ADHD and reading fluency processing speed, auditory processing accuracy, memory, reading skills, and sequencing skills (important for math and language).
Our patients learn to train their brain to process sounds more clearly and at a faster rate, which ultimately improves their reading and listening skills.
At the Drake Institute, a quantitative qEEG brain map is performed first to identify the weak areas or connections that are linked to the patient's symptoms. Subsequently, the patient undergoes neurofeedback training and treatment to improve and strengthen those areas and connections.
If there is a language processing weakness, a secondary auditory-visual computerized training program is administered which helps the patient develop language processing and reading skills that they were lacking.
Our language processing training program is one of the most scientifically validated programs in the world. What’s more, because our treatment protocols don’t rely on the use of temporary acting drugs, symptom reduction can be experienced long after treatment has ended.
Remember, ADHD children who struggle with reading and listening may not be struggling solely from an attention disorder; the problem may only be partially coming from ADHD or ADD.
An auditory or language processing problem may be a contributing or even primary cause of the child's struggle with reading comprehension and listening. An auditory or language processing problem is separate from ADHD and reading difficulties, but they frequently do run together.
Parents can be frustrated or confused sometimes about their child not listening to them and mistakenly think that this is intentional behavior, when it really isn’t. The child may be doing the best that he or she can if they have an untreated auditory or language processing problem, and may simply need assistance with that problem or disorder.
If your child is struggling with ADD and reading comprehension or other symptoms related to ADD, please call us today to schedule a no-cost screening consultation.
If you or a family member need help, please fill out our confidential online form. After completing the form, someone from our Clinical Team will contact you in the next 3 hours.
Interview with Dr. David Velkoff
Interview with Dr. David Velkoff
Spanish News Feature
“David F. Velkoff, M.D., our Medical Director and co-founder, supervises all evaluation procedures and treatment programs. He is recognized as a physician pioneer in using biofeedback, qEEG brain mapping, neurofeedback, and neuromodulation in the treatment of ADHD, Autism Spectrum Disorders, and stress related illnesses including anxiety, depression, insomnia, and high blood pressure. Dr. David Velkoff earned his Master’s degree in Psychology from the California State University at Los Angeles in 1975, and his Doctor of Medicine degree from Emory University School of Medicine in Atlanta in 1976. This was followed by Dr. Velkoff completing his internship in Obstetrics and Gynecology with an elective in Neurology at the University of California Medical Center in Irvine. He then shifted his specialty to Behavioral Medicine and received his initial training in biofeedback/neurofeedback in Behavioral Medicine from the leading doctors in the world in biofeedback at the renown Menninger Clinic in Topeka, Kansas. In 1980, he co-founded the Drake Institute of Behavioral Medicine. Seeking to better understand the link between illness and the mind, Dr. Velkoff served as the clinical director of an international research study on psychoneuroimmunology with the UCLA School of Medicine, Department of Microbiology and Immunology, and the Pasteur Institute in Paris. This was a follow-up study to an earlier clinical collaborative effort with UCLA School of Medicine demonstrating how the Drake Institute's stress treatment resulted in improved immune functioning of natural killer cell activity. Dr. Velkoff served as one of the founding associate editors of the scientific publication, Journal of Neurotherapy. He has been an invited guest lecturer at Los Angeles Children's Hospital, UCLA, Cedars Sinai Medical Center-Thalians Mental Health Center, St. John's Hospital in Santa Monica, California, and CHADD. He has been a medical consultant in Behavioral Medicine to CNN, National Geographic Channel, Discovery Channel, Univision, and PBS.”