Assessment of pragmatic skills in adults with ADHD

Abstract

Although Attention Deficit Hyperactivity Disorder (ADHD) is among the most common diagnoses in childhood, a formal diagnosis, frequently, is delayed until adulthood. As a result, the individuals who are not diagnosed in childhood miss out on the early treatment and may experience considerable social and pragmatic challenges, culminating in factors that impact their daily living, educational achievements and professional performance. Children and adolescents who do not receive an ADHD treatment carry their symptoms into adulthood, that typically result in functional and pragmatical difficulties. However, assessing pragmatic deficits in adults with ADHD presents challenges, stemming from various factors such as educational backgrounds, under-resourced family environments, compensatory mechanisms in individuals with high intelligence and the presence of other comorbid conditions. Consequently, overlooking pragmatic and functional difficulties can lead to significant social difficulties, which in turn may negatively impact their daily living, educational achievements and career progression. This study proposes a comprehensive and cost-effective approach to evaluating pragmatic skills in adults with ADHD, by adapting a systematic and standardized method, for the assessment of the pragmatic abilities, originally developed for neurotypical individuals by Acara and Bambini (2016). The results show the importance of incorporating this assessment tool into the diagnostic procedures for ADHD that can be further applied in the intervention programs. This assessment tool provides a valid onset criterion for advancing effective intervention programs that are focused on the pragmatic skills. Thus, this evaluation tool, first, can pinpoint pragmatic deficits within the ADHD community, and, second, can foster the development of the targeted intervention programs concentrated on enhancing pragmatic skills in the individuals with ADHD.