“Is it a Language Disorder? Or is it ADHD? How Schools Evaluate Students”
As a speech-language pathologist (SLP) in a public school, I commonly evaluate for language disorders, which can look a lot like ADHD and other conditions. An accurate student evaluation necessitates having a strong understanding of these similar conditions and of the student’s particular challenges, which requires extensive information gathering and analysis.
He always says, “Huh? I don’t know, I forgot.”
She doesn’t seem to understand the lessons.
They can’t repeat back what is said to them.
She reads okay, but her reading comprehension is poor.
When parents hear these comments from school, they may wonder: What’s going on? Do my child’s struggles stem from ADHD? Or are they having trouble understanding language? Could it be both? Or something else entirely? And who can help us figure this out?
As a speech-language pathologist (SLP) in a public school, I commonly evaluate for language disorders, which can look a lot like ADHD and other conditions. An accurate special education evaluation necessitates having a strong understanding of these similar conditions and of the student’s particular challenges, which requires extensive information gathering and analysis. Here’s a quick overview of these conditions, and the general process I follow to evaluate students.
Language Disorders vs. ADHD: Overview
A language disorder often manifests as deficits that may include (but are not limited to):
- narrative skills
- reading and writing
- expression (speaking)
- reception (understanding)
- social communication
A language disorder can create challenges in a variety of school subjects. It can look like difficulty with answering open-ended questions in social studies, interpreting story problems in math, grasping the teacher’s lessons in science, following multistep directions in PE, and learning a foreign language.
ADHD may affect similar areas. But contrary to a child with just a language disorder, a child with ADHD may excel in these common areas of difficulty when they are particularly interested in a topic. There are also, of course, the standard behavioral signs of ADHD to consider: inattentiveness, hyperactivity, and impulsivity.
Moreover, children with ADHD often have difficulty with social skills, such as making and keeping friends or controlling the impulses that may lead to mischief and conflict. And let’s not forget all the executive functioning challenges that come with ADHD, such as initiating and completing tasks, keeping materials organized, and planning and time management.
How are Language Disorders and Other Conditions Evaluated in School?
For a formal school evaluation, the building screening committee (BSC) or team will gather information on your child and proceed from there. And parents? You’re the star member of the team.
As a member of the special education team, I start by talking with the family to get a thorough developmental history of the child. I consider things like the following:
- Is the child meeting language milestones on time?
- Is the family bilingual?
- Is there a history of speech-language delays in the family?
- Does the child have any health issues or past trauma?
- When is the last time they had their hearing and vision checked?
The parent interview is crucial for uncovering clues that might make the school team pivot or loop in different specialists. For example, anxiety and mood disorders or adverse childhood experiences can all cause similar symptoms, and need to be ruled out in the evaluation. A child who is an emergent bilingual also displays characteristics that may make them appear delayed when they are simply in the normal process of second language acquisition.
Secondly, I look at educational data. What are the student’s past and current grades, report card comments, test results, and attendance history? I also ask teachers to fill out checklists to see if the student is meeting academic expectations. Are there areas in which they are excelling? And where are they struggling?
Third and finally, the special education team reviews information collected by the BSC and decides on next steps. Perhaps it will decide to proceed with testing from the SLP to assess for a communication disorder. Or it may recommend testing from the school psychologist for ADHD (ADHD may fall under a different umbrella eligibility, such as Other Health Impairment).
Alternatively, the team may have unearthed another special education eligibility entirely; it may conclude that there are several suspected disorders and test for each of them at the same time; it may suggest a quick screening instead of comprehensive testing; or it may refer the family to medical professionals in order to gain more insights before proceeding.
Evaluating for Language Disorders and Other Conditions: It Takes a Village
I have learned, sometimes the hard way, not to jump to conclusions. I have had students whom we initially suspected of having one of the more common eligibilities — Communication Disorder, ADHD, Autism Spectrum Disorder, and Specific Learning Disability — but it turned out they had undiagnosed hearing or vision impairment, post-concussion syndrome, absence seizures, selective mutism, sleep disturbance, or another primary underlying condition entirely.
The takeaway message is that we need to slow down and take a measured, team approach in determining special-education eligibilities. The things said about your child (e.g., “He doesn’t follow directions”) are important to note, but they don’t automatically tell us what’s going on. Bring up your concerns with the school and your pediatrician and ask for help figuring out the underlying issues.
It takes a village to raise a child… and a really solid team to make village life accessible, meaningful, livable, and fruitful for the child.
*These are my own observations and experiences from 18+ years as an SLP working on special education teams in the public school setting. These views may not reflect the opinions or practices of other colleagues, organizations, or institutions.
Language Disorders and ADHD: Next Steps
- Free Download: 9 Conditions Often Linked to ADHD
- Read: Myths and Realities About Language Disorders
- Read: How to Treat Language Processing Disorders
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