Use of the Children's Communication Checklist-2 for classification of language impairment risk in young school-age children with attention-deficit/hyperactivity disorder.

Purpose: Children with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk for language impairment (LI). This study examined the feasibility of using the Children's Communication Checklist-2 (CCC-2; Bishop, 2006) to classify risk for LI in young children, ages 5-8 years, with ADHD.

Method: Parents of 32 children with ADHD and 12 typically developing peers completed the CCC-2. The Clinical Evaluation of Language Fundamentals, Fourth Edition (Semel, Wiig, & Secord, 2003) and the Test of Narrative Language (Gillam & Pearson, 2004) were administered to diagnose LI. Language samples were collected to examine clinical markers of LI.

Results: CCC-2 General Communication Composite scores ≤ 85 correctly classified 10 participants with ADHD diagnosed with LI as defined by composite scores ≤ 85 on the Clinical Evaluation of Language Fundamentals, Fourth Edition, or on the Test of Narrative Language. Five of these participants demonstrated 1 or more clinical markers of LI in language samples. Three additional participants, who received a General Communication Composite score ≤ 85 yet scored above 85 on the language tests, demonstrated CCC-2 profiles suggestive of pragmatic impairment. Sensitivity and specificity rates were 100% and 85.29%, respectively. CCC-2 scores and most measures were significantly correlated.

Conclusion: The results support the feasibility of using the CCC-2 as a screener to identify children with ADHD who are at elevated risk for LI and need referral for comprehensive assessment.