A Comparative Study on the Use of Cohesive Markers in Narrative and Expository Writing of School-Age Children With and Without ADHD

Objectives: The purpose of this study was to examine the characteristics of cohesive markers used in narrative and expository writing by children with Attention-Deficit/Hyperactivity Disorder (ADHD) in the 3rd and 4th grades of elementary school, and to compare these characteristics with those of typically developing (TD) children. Methods: The study participants included a total of 35 children: 18 typically developing children and 17 children with ADHD from elementary schools. Differences between the two groups were examined based on the frequency of cohesive markers produced, the accuracy rate of cohesive markers, and the types of cohesive marker errors in their narrative and expository writing. Results: Children with ADHD showed a significantly lower number of cohesive markers used and a significantly lower number of uses per T-unit compared to TD children, regardless of the text type. Specifically, significant differences were observed in conjunctive endings (e.g., subordinating/coordinate conjunctions), referential cohesion, and lexical cohesion. The accuracy rate of cohesive markers was also significantly lower for children with ADHD, and this difference was significant across all subtypes except for referential cohesion. While there was no statistically significant difference in the types of cohesive marker errors in narrative writing, children with ADHD showed a significantly higher frequency of information errors in expository writing. Conclusion: The results of this study show that children with ADHD use fewer cohesive markers in writing and exhibit a lower accuracy rate of cohesive markers compared to TD children. In particular, the difficulties in the lexical aspects were clearly evident. Therefore, to improve the writing ability of children with ADHD, it is necessary to provide differentiated intervention based on the specific ADHD symptoms the child exhibits, and to monitor the child’s functioning while adjusting the intervention accordingly.