A groundbreaking study published in BMC Psychiatry in 2025 casts new light on the intricate relationship between developmental language disorder (DLD) and attention deficit hyperactivity disorder (ADHD) in preschool-aged children. This comprehensive investigation delves into the nuanced neurodevelopmental landscapes characterizing children diagnosed with DLD alone compared to their peers who grapple with the dual diagnosis of DLD and ADHD. The results reveal startlingly distinct profiles that challenge previous assumptions and highlight the urgency of multifaceted evaluation strategies in early childhood.
Developmental language disorder, a neurodevelopmental condition marked by persistent difficulties in acquiring and using language, affects a significant subset of the pediatric population. Prior research has established the frequent co-occurrence of ADHD, a neurobehavioral disorder known for inattention, hyperactivity, and impulsivity, among children with DLD. Yet, the detailed comparative characterization of neurodevelopmental domains and predictive markers for ADHD within this vulnerable group has remained underexplored until now.
Involving a cohort of 181 children aged between 24 and 60 months, the study embarked on an ambitious endeavor to distinguish neurodevelopmental trajectories in two subsets: 111 children with isolated DLD and 70 children diagnosed with both DLD and ADHD. Employing robust assessment tools including the Denver Developmental Screening Test II and the Turkish Early Language Development Test, alongside detailed parental interviews and comprehensive psychiatric evaluations anchored in the DC:0–5 criteria, the researchers painted a detailed portrait of developmental challenges.
One of the more striking revelations concerned sleep disturbances. Children with comorbid DLD and ADHD displayed markedly diminished sleep duration, heightened onset delays, pronounced resistance to bedtime, and increased nocturnal awakenings. These findings corroborate emerging theories that implicate dysfunctional sleep architecture as both a contributor to and a consequence of neurodevelopmental disorders, implicating restless sleep in the amplification of neurobehavioral symptoms.
Moreover, gastrointestinal complaints such as elevated incidences of diarrhea and constipation surfaced as notable differentiators in the comorbid group. Such somatic discomforts could exacerbate behavioral challenges, hinting at a potentially overlooked axis connecting gastrointestinal health to neurodevelopment through mechanisms like the gut-brain axis, which warrants further exploration.
Expressive language abilities and fine motor skills were profoundly diminished among children burdened with both DLD and ADHD. The convergence of diminished expressive linguistic capacity alongside impaired fine motor coordination underscores the multidimensional neurodevelopmental derailments characteristic of the dual diagnosis, reflecting disruptions beyond isolated language acquisition deficits.
Behaviorally and cognitively, children with comorbid DLD and ADHD exhibited amplified difficulties, as measured by standardized evaluation tools. Sensory processing anomalies, greater autistic-like traits, and intensified behavioral dysregulation collectively painted a complex developmental panorama wherein multiple neurodevelopmental domains interplay to shape the child’s functional profile.
Statistical analyses identified impaired fine motor skills, heightened autistic behavioral traits as gauged by the Social Responsiveness Scale (SRS), and elevated scores on the Aberrant Behavior Checklist (ABC) as potent predictors of ADHD comorbidity in the context of DLD. The identification of these predictive markers offers clinicians valuable early indicators to flag at-risk children for more tailored interventions.
This study’s compelling demonstration of neurodevelopmental and behavioral divergences in preschoolers with DLD, stratified by the presence or absence of ADHD, propels a paradigm shift in diagnostic and therapeutic approaches. Clinicians are urged to adopt a holistic assessment framework that transcends speech and language milestones, encompassing sleep health, motor coordination, gastrointestinal symptoms, and broader behavioral phenotypes to optimize early detection and intervention strategies.
Given the developmental window of 24 to 60 months, a critical epoch for neural plasticity, targeted interventions accommodating the complex comorbidity of DLD and ADHD could yield substantive improvements in lifelong functional outcomes. The elucidation of fine motor deficits as a harbinger for ADHD comorbidity invites incorporation of occupational therapy and motor skills training into standard care models.
The study also reinforces the importance of parental input through validated rating scales, which surfaced as crucial adjuncts to clinical assessment. Parents’ observations about sleep patterns, gastrointestinal issues, and atypical behaviors provided vital contextual data enriching the neurodevelopmental profile and informing individualized care pathways.
Furthermore, the observed association of autistic traits within this cohort invites a reconsideration of overlapping spectrum conditions and the necessity for nuanced differential diagnosis. These findings suggest that the clinical boundaries between ADHD, DLD, and autism spectrum disorder may be porous, necessitating refined diagnostic criteria and multimodal assessment protocols.
By integrating behavioral, cognitive, sensory, and somatic dimensions, the research pioneers a comprehensive lens for understanding the interplay of ADHD within the landscape of developmental language disorder. This multidimensional approach underscores the need for interdisciplinary collaboration encompassing pediatric neurology, psychiatry, speech-language pathology, and occupational therapy.
In summary, this seminal work lays the foundation for tailored, multidomain evaluations that capture the complexity of co-occurring ADHD in preschoolers diagnosed with DLD. As understanding deepens, it holds promise to transform clinical practice by enabling nuanced, early interventions that address the full spectrum of challenges encountered by these children, thus altering their developmental trajectories toward more favorable outcomes.
Subject of Research: Neurodevelopmental comorbidity of ADHD in preschool children with developmental language disorder, with a focus on comparative developmental profiles and predictive risk factors.
Article Title: ADHD comorbidity in preschoolers with developmental language disorder: comparative neurodevelopmental profiles and associated risk factors
Article References:
Esen Öksüzoğlu, M., Günal Okumuş, H. ADHD comorbidity in preschoolers with developmental language disorder: comparative neurodevelopmental profiles and associated risk factors. BMC Psychiatry (2025). https://doi.org/10.1186/s12888-025-07638-x
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