Grammatical complexity and cohesion mechanisms in the communicative pragmatics of children with attention deficit hyperactivity disorder

The purpose of this study was to compare the grammatical structures and cohesion used in the narrative sequencing of real events by children with and without attention deficit hyperactivity disorder. A total of 27 children, between the ages of seven and eight, took part in the study; 15 of them had the combined subtype of ADHD and 12 participated as a control group. To obtain the narration the children were asked to talk about two real events they had experienced: 'What happened the last time you went to the doctor's?' and 'Have you ever been bitten by an insect?' An analysis of their narrations allowed us to obtain the following variables: the total number of communication units, their average length, the syntactic complexity index, the rate of lexical diversity, the lexical type referential cohesion procedures, the deictic and anaphoric grammatical procedures, the conjunctive procedures, discourse markers, changes of subject matter and dysfluency. Results show that there are significant differences between the two groups in the narrative cohesion indicators used, the group of normal children being those that were favoured by these differences. The most striking pragmatic peculiarities were difficulties in the use of conversational markers and the changes in the subject being discussed. The narratives of children with attention deficit hyperactivity disorder are more difficult to understand, which means that the listener has to adopt a more active role in order to make up for the missing information and has to infer a great deal more. This is an aspect that can have social implications and may make communication more difficult, especially with their peers, since these usually make less effort to understand the conversations than adults do.