A Picture is Worth How Many Words? The Impact of Visual Cues on the Story Retelling of Children with and without ADHD

Children with attention deficit hyperactivity disorder (ADHD) evidence poorer language skills than their neurotypical (NT) peers, including their narrative (storytelling) abilities. Available narrative studies include a circumscribed number of variables, with limited attention to the effect of task demands on performance. We compared the story retelling skills of children with and without ADHD under different memory loads. Ninety-six 8-12-year-old children, 50 meeting DSM-5-TR criteria for ADHD (54.9% boys) and 46 NT children (39.1% boys) completed a story retelling task under two conditions, i.e., with and without visual story cues. The children's stories were coded across a range narrative dimensions, with performance compared across groups and conditions. Children with ADHD produced less complete and coherent stories that included higher rates of dysfluencies and linguistic errors than NT children. Across groups, performance was better in the presence of visual story cues, with larger effects for the ADHD group on some variables. Findings highlight the extent of narrative production difficulties in children with ADHD and the positive effects of visual cues. Given the importance of narrative skills for communication and social interactions, their inclusion in the comprehensive assessment of children with ADHD is recommended.