Beyond ADHD: The Hidden Language Challenges Behind Academic Struggles
Written By:
By Tatyana Elleseff MA CCC-SLP
Rutgers University
When a student struggles academically with listening comprehension, following verbal instructions, or impulsively responding, ADHD is often assumed to be the primary cause of their difficulties. However, this assumption overlooks the possibility of underlying language deficits that may be contributing to their academic challenges. While ADHD can certainly impact learning, it is not the sole or even primary cause of many academic struggles. The real culprit for many students? Developmental Language Disorder (DLD).
DLD is a brain-based condition affecting how children understand and use language, impacting comprehension, oral expression, reading, writing, and even social communication. But because DLD and ADHD share overlapping symptoms, many students with undiagnosed language impairments are mistakenly assumed to have attention deficits—leading to the wrong interventions and missed opportunities for effective support.
Misconception #1: If a student is Inattentive, ADHD Must Be the Problem
Students with DLD often appear inattentive in class—not because they aren’t paying attention, but because they struggle to process and retain what is being said. A child with undiagnosed language deficits may:
· Miss key words in spoken instructions and appear “distracted”
· Struggle with multi-step directions, seeming forgetful or disorganized
· Avoid reading and writing tasks due to difficulty processing language
· Have difficulty following class discussions, leading to apparent “daydreaming”
Many of these behaviors mimic ADHD, but the root cause is different. Language challenges create attentional overload, making it harder for students to stay engaged—yet the issue isn’t attention, it’s comprehension.
Misconception #2: General Educational Tests Can Identify the Problem
Another common mistake is assuming that standard academic achievement tests, like the Woodcock-Johnson IV (WJ-IV) or the Wechsler Individual Achievement Test (WIAT-4), are enough to diagnose language-based learning difficulties. However, diagnosis of DLD requires administration of specific to language psychometrically sound language instruments such as the Test of Integrated Language & Literacy Skills (TILLS). In fact, without psychometrically strong language assessments students with DLD may score within the average range on general tests, masking their deficits. This can lead schools to misattribute their struggles to attention rather than language processing.
Misconception #3: Discrepancies in Testing Mean the Student Wasn’t Paying Attention
When students exhibit significant score variations across different assessments, it can be tempting to attribute these discrepancies to inattention or lack of effort. However, these differences often reflect what each test is actually evaluating, rather than a student’s engagement level.
For instance:
A student who scores within the average range on the WIAT-4 but low on the TILLS is likely experiencing underlying language processing deficits, not simply struggling with focus.
A student who performs well on multiple-choice questions but has difficulty with open-ended written responses may have underlying expressive language challenges, rather than a problem with attention.
Misinterpreting these discrepancies as signs of inattentiveness overlooks the presence of a language disorder—one that requires specialized intervention rather than behavioral strategies or accommodations alone.
Why This Matters: Misdiagnosis Leads to Misguided Interventions
When a language disorder is mistaken for ADHD, students are often given behavioral interventions, extra time on tests, or stimulant medication—none of which address their actual learning needs. Instead, they require:
· Speech-language therapy to build oral language and pragmatic language abilities
· Structured literacy approaches to support reading, spelling and writing development
Conclusion:
ADHD is not the default explanation for academic struggles. If a student is struggling with comprehension, expression, reading and writing, a thorough language assessment is critical.
Instead of assuming that inattention is the root of poor academic performance, we must ask:
· Does this student understand language as well as their peers?
· Have they been assessed with language-specific tests, or only broad academic measures?
By shifting our focus from ADHD to language and literacy, we can ensure that students with DLD receive the interventions they actually need—setting them up for success in school and beyond.
References:1. Andreou, G., Lymperopoulou, V., & Aslanoglou, V. (2022). Developmental Language Disorder (DLD) and Autism Spectrum Disorder (ASD): similarities in pragmatic language abilities. A systematic review. International Journal of Developmental Disabilities, 70(5), 777–791.
2. National Institute on Deafness and Other Communication Disorders. (n.d.). Developmental language disorder. Retrieved March 13, 2025, from https://www.nidcd.nih.gov/health/developmental-language-disorder
3. Parks, K. M. A., Hannah, K. E., Moreau, C. N., Brainin, L., & Joanisse, M. F. (2023). Language abilities in children and adolescents with DLD and ADHD: A scoping review. Journal of Communication Disorders, 106, 106381.
4. Snowling, M. J., & Hulme, C. (2021). Annual research review: Reading disorders revisited – The critical importance of oral language. Journal of Child Psychology and Psychiatry, 62(5), 635-653.