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.