Assessment & Research

The reading difficulties in Chinese for individuals with attention deficit hyperactivity disorder: the role of executive function deficits

Wei et al. (2025) · PeerJ 2025
★ The Verdict

Chinese kids with ADHD plus reading disability show sharp drops in visuospatial working memory and response inhibition, and these EF gaps drag reading scores down.

✓ Read this if BCBAs assessing Chinese-speaking elementary clients with ADHD and reading problems.
✗ Skip if Practitioners serving only English readers or clients without ADHD.

01Research in Context

01

What this study did

Feng et al. (2025) looked at Chinese-reading kids with ADHD. Some also had reading disability.

They gave short tests of Chinese reading and executive function. Then they compared scores.

02

What they found

Kids with ADHD plus reading disability scored lower on every test. Their visuospatial working memory and response inhibition were weakest.

Lower EF scores tracked with lower reading scores. The link was strong and negative.

03

How this fits with other research

Poon et al. (2014) saw the same pattern in older delinquent teens. Both studies show that when ADHD and reading problems mix, interference control and visual memory take the biggest hit.

Kanevski et al. (2023) found weaker visuospatial working memory in kids with ADHD plus movement problems, yet math scores stayed flat. Wei now shows the same memory weakness hurts reading instead. The memory marker is stable; the academic domain changes.

Ceruti et al. (2025) split kids by learning-deficit type and tied each to its own EF profile. Wei narrows the lens to Chinese ADHD readers and names the same two culprits: working memory and inhibition.

04

Why it matters

If a Chinese-speaking client with ADHD stalls in reading, screen visuospatial working memory and response inhibition first. Brief table-top tasks like backward block span or stop-signal games give you the data. Train those skills and reading can rise even when phonics is intact.

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Run a five-minute backward block-span task; if span is below age norm, add visuospatial working-memory drills before the next reading lesson.

02At a glance

Intervention
not applicable
Design
quasi experimental
Sample size
160
Population
adhd
Finding
negative
Magnitude
medium

03Original abstract

Attention-deficit/hyperactivity disorder (ADHD) and reading disability (RD) are prevalent childhood conditions that together affect millions of children worldwide. In China, the prevalence of ADHD is approximately 6.4%, whereas the prevalence of RD ranges from 3.45% to 8%. Approximately 18–45% of children with ADHD also display comorbid RD, which further compromises their academic success and social functioning. Executive-function (EF) deficits are a core feature of ADHD and are known to affect reading in RD, yet their specific impact on Chinese reading remains under-explored. This study investigated how EF deficits influence Chinese reading in children with ADHD, with the goal of informing diagnosis and intervention for ADHD-RD comorbidity. This study recruited 160 Chinese-speaking children who met DSM-5 criteria for ADHD and allocated them to two groups—ADHD-only (n = 80) and ADHD + RD (n = 80). ADHD symptoms were rated with the Swanson, Nolan and Pelham Teacher and Parent Rating Scale (SNAP-IV), whereas Chinese reading was evaluated with the Dyslexia Checklist for Chinese Children (DCCC). Executive functions were measured with tasks tapping visuospatial working memory, verbal working memory, and response inhibition (Go/No-Go). Both groups showed no significant differences in ADHD symptom scores. Compared with the ADHD-only group, the ADHD + RD group obtained higher total and subscale DCCC scores and lower accuracies on EF tasks. Total DCCC scores correlated negatively with EF performance, especially on visuospatial working-memory and response-inhibition tasks. This study suggests that individuals with ADHD comorbid with Chinese reading disabilities (RD) exhibit more pronounced deficits in executive function, particularly in verbal and visual-spatial working memory, and response inhibition tasks, compared to individuals with ADHD alone. These cognitive deficits are significantly negatively correlated with Chinese reading abilities, emphasizing the importance of not only focusing on traditional ADHD symptoms but also prioritizing training to enhance executive functions, especially visual-spatial working memory and response inhibition, when diagnosing and treating patients with ADHD comorbid with RD, in order to improve their reading abilities.

PeerJ, 2025 · doi:10.7717/peerj.19679