Comparing pragmatic abilities across multiple languages in adults with ADHD: Insights from a self-report questionnaire.

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) is associated with pragmatic language impairments in children, but less is known about the communicative abilities of adults with ADHD, especially when using a second or third language. In this study, we developed a questionnaire to collect self-report measures of a set of pragmatic skills in a person's first, second and third language, comparing adults with and without an ADHD diagnosis. One hundred seventy-nine multilingual adults with (N = 91) and without ADHD (N = 88) completed the survey. As predicted, adults with ADHD reported more pragmatic difficulties than the control group. More specifically, people with ADHD showed pronounced impairments in regulating their behaviour in spoken interactions in the form of excessive talking, frequently interrupting others, and speaking without thinking first. Notably, these types of hyperactive and impulsive behaviours were significantly reduced when people with ADHD communicated in a second or third language. For pragmatic difficulties related to inattention such as concentrating on a conversation, both groups tended to be more inattentive in their third language compared to their first and second language. The understanding of non-literal language was only affected by ADHD in the first language and was generally more taxing in a language with lower proficiency levels. Our study contributes to a more nuanced understanding of how ADHD affects different kinds of communicative abilities in multilingual adults. It also has implications for clinical practice, highlighting the importance of assessing symptoms of inattention, hyperactivity, and impulsivity in a person's dominant language.