Leanne Sherred, M.S., CCC-SLP
ADHD does not directly cause a speech delay, but the two can be linked. Children with ADHD may have difficulty with attention, memory, and processing, which can affect how they learn and use language. Language difficulties can also appear before an ADHD diagnosis. Learn what speech and language signs to watch for and how speech therapy can help.
Key takeaways
ADHD does not directly cause a speech delay, but attention, memory, and processing challenges can affect how a child learns and uses language.
Children with ADHD are more likely to have language difficulties, including challenges with expressive, receptive, and social communication. They may have trouble finding words, organizing stories, following directions, taking turns, or picking up on social cues.
The CDC reports that the average age of ADHD diagnosis is 7, but language difficulties can appear earlier.
A speech evaluation can help identify your child’s communication strengths and needs. Speech therapy can support language skills alongside other ADHD treatments and services.
Could your child have a speech delay?
Take our screenerWhat is ADHD?
ADHD is a neurodevelopmental condition that affects 11% of children ages 4 to 17. If ADHD is not addressed and supported, it may affect a child’s ability to succeed at school, build relationships, and develop confidence.
The main symptoms of ADHD include:
Difficulty focusing on a specific task
Forgetfulness or problems with memory
Acting without thinking
Impatience or trouble waiting their turn
Struggling with impulse control
High amount of energy or activity
Interrupting or speaking at inappropriate times
Trouble following instructions
Fidgeting or squirming in their seat
“Many of these symptoms can be found in your average toddler—have you ever met a 2-year-old who didn’t have a short attention span?” notes Expressable speech therapist Alexis Irazoque, M.S., L/SLP. “However, the key difference is that toddlers who don’t have ADHD (or another disorder) tend to grow out of these behaviors.”
It’s important to note that ADHD also comes with strengths. People with ADHD report that these qualities can be benefits, whether at school, at work, or socially:
Hyperfocus
Resilience
Creativity
High energy
Spontaneity and adventurousness
Strong conversational skills
Strong executive function skills help your child succeed in school. Find easy ways to help your child plan, organize, and stay focused.
The link between ADHD and speech development
ADHD can affect speech and language development. That’s because the skills we use to learn language (such as attention, memory, and planning) are executive function skills, which can be challenging for people with ADHD.
According to the CDC, the average age of ADHD diagnosis is 7. But speech and language delays can be noticeable at a much younger age. This means a speech-language pathologist (SLP), also known as a speech therapist, may be one of the first professionals to notice signs that a child is struggling.
Research also suggests that problems with early language may be linked to later ADHD symptoms. For example, a 2016 study found that children with poor language skills at age 3 were more likely to show symptoms of inattention and hyperactivity at age 5½. This is one of many studies exploring the connection between ADHD and speech and language development.
Many children with ADHD lack the core skills needed to learn language. They struggle to process information and stay focused.
“When you consider how children learn to speak—by listening to others, remembering new words, and copying the sounds and words they hear—it’s easy to see how attention and memory challenges can affect this process,” Irazoque adds.
Children with ADHD may have a hard time staying focused, processing information, or remembering what they’ve learned. As a result, they may struggle to keep up with language milestones or build new communication skills.
Can ADHD cause a speech delay?
ADHD does not directly cause a speech delay, but it can affect the skills children use to learn and use language.
As mentioned above, one theory is that since ADHD affects a child’s ability to organize their thoughts, stay focused, and memorize new information, they may learn to speak more slowly or mispronounce words. Children with ADHD also have difficulty following directions or understanding what’s said to them, which can make it harder for them to learn new words.
As a result, kids with ADHD may be misunderstood, become frustrated, and talk less. This can make a young child less likely to join in conversations. If they don’t practice their language skills in this way, it could cause a speech delay.
Is it normal for my child to have a short attention span? Learn the typical attention span for toddlers by age and tips for increasing your child’s attention.
How to recognize an ADHD-related speech delay in toddlers
It can be hard to tell if your toddler has ADHD. However, the signs of a speech delay are a little easier to spot.
Studies show that children with ADHD are more likely to struggle with expressive language skills. That means your toddler might take longer to start talking or have a hard time using words to express themselves, especially when compared to other kids their age.
Children with ADHD may also have receptive speech delays. Receptive language refers to the language we understand. For example, toddlers might not respond to simple directions like “come here” or “wave bye-bye.” If they answer questions inappropriately (like saying “yes” when the right answer would be “no”), this could be a sign of a receptive speech delay.
Learn the causes and signs of an expressive, receptive, or mixed language disorder, along with speech therapy exercises to practice at home.
Finally, there’s quite a bit of research showing that children with ADHD might have problems with pragmatic language. Pragmatic language skills (also known as social communication skills) refer to a child’s ability to follow the “rules of a conversation.”
For example, a child with ADHD might often interrupt people or give answers before a question is finished. For toddlers, pragmatic language issues might include misunderstanding verbal cues or avoiding eye contact.
Signs of ADHD-related speech delay by age
ADHD-related speech and language issues can look different at each age, as children’s communication skills grow and change. While every child develops at their own pace, here are some signs to watch for from ages 2 through 5.
At age 2
A 2-year-old with speech or language differences may have fewer than 50 spoken words. They may not be combining two words, like “more milk.” They may have trouble pointing to objects when you name them, responding to their name, or paying attention during storytime. They may also lose interest in imitation or social games, like peek-a-boo.
Keep in mind that ADHD is not typically diagnosed at age 2. If you have concerns about your child’s communication, a speech-language evaluation is a helpful first step.
At age 3
A 3-year-old may know many words but have trouble finding the right word or using longer phrases. While many 3-year-olds are beginning to use 4- or 5-word sentences, a child with language differences may use shorter phrases. Or they might use general words like “thing” when they can’t find a specific word.
You may also notice that they have trouble following two-step directions (for example, “Put your coat on the hook and come sit down”). They may interrupt often or switch topics quickly during conversations. They may not notice other people’s conversational cues.
At age 4
By age 4, a child with ADHD-related communication differences is often easy for others to understand. However, they may have trouble organizing their thoughts when telling a story. They might leave out important details, tell events out of order, or go off on long tangents.
Your child might have a hard time following group directions at preschool, answering “why” or “how” questions, or waiting until someone finishes speaking before they talk. At this age, speech therapists and preschool teachers may begin to notice signs that your child might need further evaluation.
At age 5
A 5-year-old with ADHD-related communication differences may have a strong vocabulary but still struggle with storytelling and conversation skills. They may interrupt other children, talk for long periods without noticing others’ cues, or have trouble explaining what happened in a clear order.
Some children may use general words like “stuff” or “whatever” when they have trouble finding the right word. At this age, a combination of communication and attention-related challenges may lead caregivers or teachers to recommend a formal ADHD evaluation.
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Get startedWhen to see a speech therapist for ADHD and speech delay
You don’t need to wait for an ADHD diagnosis before having a speech evaluation. You also don’t need a doctor’s referral. Schedule a speech evaluation if you notice any of these signs:
Your 2-year-old has fewer than 50 words or is not yet combining two words.
Your 3- or 4-year-old is easy for family to understand but hard for strangers. They may also tell disorganized stories or jump between topics.
Your 5-year-old knows plenty of words but struggles with conversation. They may interrupt, dominate conversations, miss social cues, or lose track of what they’re saying.
A preschool teacher or pediatrician has raised concerns about your child’s focus, impulsivity, or hyperactivity.
Your child becomes frustrated or shuts down when trying to explain something.
A speech evaluation for young children is usually play-based. The speech therapist will ask questions about your child’s language development. “They’ll observe how your child communicates with others and assess their knowledge of vocabulary or receptive language concepts,” Irazoque says. If speech therapy is recommended, your speech therapist will create a personalized treatment plan to develop your child’s communication skills.
If ADHD is later diagnosed, speech therapy can be part of your child’s larger support team. It can work alongside behavioral therapy, occupational therapy, and medication when appropriate.
“Parents don’t need to wait for an ADHD diagnosis to address communication concerns,” Irazoque says. “ A speech evaluation can help identify what’s making communication difficult and give families ways to support their child right away.”
Occupational therapy for ADHD helps children build focus, routines, emotional regulation, and independence. Learn how therapy works.
Get matched with a speech therapist
Knowing about the link between ADHD and speech development can help you identify your child’s symptoms sooner rather than later. With the right diagnosis and treatment, your child will have the tools they need to grow and thrive.
If you’d like to explore speech therapy for your toddler, Expressable can match you with a licensed speech therapist who fits your needs. Get started here!
Frequently asked questions (FAQs)
Research has shown that a speech delay can be an early sign of ADHD. Children with ADHD often struggle with the skills needed to learn language, such as attention and focus. As a result, they can fall behind and miss crucial language milestones.
Children with ADHD are more likely to struggle with expressive and receptive language skills. They might take longer to say their first words, have difficulty sharing their thoughts, or have a tough time following directions. They also may have problems with social interactions.
Toddlers have lots of energy, which is one reason ADHD is rarely diagnosed before a child is 4 years old. ADHD is most often diagnosed around the age of 6 or 7.
How Expressable Can Help
Concerned your child isn't reaching age-expected milestones? Looking for communication support from a professional? Expressable is a national online speech and occupational therapy practice serving children and adults. We treat all major areas of communication, feeding, and developmental skills, offer flexible hours including evenings and weekends, and accept most major health insurance plans. We’re proud to have earned more than 4,500 5-star reviews from our clients (4.83/5 average).
Our therapy model is centered on parent and caregiver involvement. Research proves that empowering caregivers to participate in their loved one’s therapy leads to better outcomes. That’s why we combine live, 1-on-1 speech and occupational therapy with personalized education and home practice activities for faster progress.
