Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, hyperactivity and impulsivity that begins in childhood and can persist into adulthood (1). One of the key symptoms of ADHD that can significantly impact day-to-day functioning is difficulty sustaining attention during tasks or play activities (2). This includes trouble focusing during conversations. Individuals with ADHD often have problems listening carefully, following verbal instructions, processing information as it is communicated, and recalling conversations later on (3). Understanding the link between ADHD and challenges with following conversations is important for managing functional impairments.
Do people with ADHD generally have issues following conversations?
Yes, research indicates that many individuals with ADHD do tend to have significant difficulties following conversations (4,5). There are several reasons why people with ADHD struggle to fully engage in and keep up with conversations:
Attention problems
A hallmark characteristic of ADHD is difficulty sustaining attention, including during social interactions like conversations. Individuals with ADHD are easily distracted and have trouble maintaining focus, which can make it hard to stay tuned in to what someone is saying (6). Their attention may drift after just a few seconds, causing them to miss pieces of information.
Working memory deficits
Many people with ADHD have impairments with working memory – the system that briefly stores and manages information for comprehension and learning (7). Working memory is vital for following conversations because it allows us to hold onto the thread of what is being discussed as it unfolds. Deficits in working memory make it hard for those with ADHD to keep up with the flow of a conversation.
Impulsiveness
Those with ADHD often struggle with impulsiveness which can include interrupting others or blurting things out during conversations (8). This impulsive behavior disrupts the give-and-take flow of typical conversations.
Slow processing speed
Some research indicates that delays in processing speed may contribute to conversational challenges in ADHD (9). When the brain has difficulty processing verbal information quickly, it can be hard to follow the rapid pace of conversational turn-taking.
What areas of following conversations are most problematic?
While ADHD can cause general difficulties participating in and following conversations, some key areas that are especially problematic include:
Grasping main ideas
Due to distractibility and working memory problems, many with ADHD struggle to grasp the primary topic or main ideas being conveyed during longer exchanges (10). They miss crucial pieces of information that provide context.
Recalling details
Individuals with ADHD commonly have trouble recalling specifics and important details from a conversation, even just minutes after it has occurred (11). Their memory of the discussion is likely to be incomplete.
Tracking multiple speakers
When there are multiple participants in a conversation, those with ADHD tend to have more difficulty tracking who is saying what as speakers change (12). The increased demands of following multiple voices can quickly exceed their attentional capacity.
Linking ideas together
Making connections between various ideas or concepts being covered during a conversation can also be challenging for those with ADHD (13). They may struggle to integrate the overall meaning derived from linking different pieces of information.
How does this impact functioning and social interactions?
For many with ADHD, conversational challenges can significantly impact school, work, and social functioning. Some of the most common areas affected include:
Academic struggles
In the classroom, students with ADHD may have trouble following lectures, class discussions, and verbal instructions from teachers (14). This puts them at a disadvantage for learning.
Workplace impairments
Adults with ADHD report problems participating in meetings at work, leading to difficulties performing job tasks that rely on instructional conversations with bosses, coworkers, and clients (15).
Relationship stress
In social settings, conversational struggles can strain relationships for those with ADHD (16). Friends and family members may feel ignored, dismissed or interrupted.
Low self-esteem
The inability to fully partake in conversations can be socially isolating for those with ADHD, negatively impacting self-esteem and increasing anxiety in social situations (17).
Family conflicts
Among families affected by ADHD, issues following conversations can heighten conflicts and misunderstandings between parents and children (18).
Are some people with ADHD less impaired?
While the majority of people with ADHD experience challenges following conversations, there is individual variability in the type and severity of impairments. Some factors that influence the degree to which conversational abilities are affected include:
ADHD presentation
Those with predominantly inattentive ADHD are more likely to have significant listening and conversational impairments compared to those with predominantly hyperactive/impulsive presentations (19).
Comorbid conditions
Certain co-occurring conditions like auditory processing disorder and specific learning disabilities can compound conversational difficulties for those with ADHD (20).
Intellectual abilities
Individuals with ADHD who have higher general intellectual abilities and cognitive resources tend to have less trouble keeping up with conversations (21).
Environmental factors
Conversations that occur in environments with minimal distractions and effective communication strategies can be easier to follow for many with ADHD (22).
So while some individuals with ADHD may have relatively mild conversational challenges, most struggle significantly in this area.
What strategies help improve the ability to follow conversations?
Using certain strategies and supports can help people with ADHD have an easier time keeping up with the flow of information during conversations. Helpful tips include:
Reduce distractions
Have important conversations in quiet spaces without too much sensory stimulation or activity in the background (23).
Maintain eye contact
Looking directly at the speaker can help reinforce attention and listening (24).
Take notes
Writing down key points as they are spoken provides reference points to look back on (25).
Ask for clarification
Don’t hesitate to ask for a repeat or rephrasing if something is confusing or you miss a piece of information (26).
Paraphrase content
Repeating back main ideas in your own words helps solidify understanding (27).
Review afterwards
Briefly discussing the conversation again afterwards fills in any gaps in recall (28).
Manage interruptions
Polite reminders from conversation partners can help limit impulsive interruptions (29).
Practice active listening
Work on techniques like focused attention, avoiding interruptions, and asking relevant questions (30).
Conclusion
In summary, a wealth of research indicates that many individuals with ADHD have significant difficulties following conversational exchanges due to problems like distractibility, forgetfulness, impulsiveness and slow processing speed. These issues with conversations can lead to academic, workplace and social impairments. While some people with ADHD have only mild symptoms in this area, most struggle to fully engage in and comprehend ongoing discussions. Implementing accommodations and adaptive strategies can help mitigate these conversational challenges. With the right supports, those with ADHD can improve their conversational abilities and reduce functional problems related to verbal comprehension.
| Conversation Topic | Main Points Covered |
|---|---|
| Introduction | – ADHD overview and link to conversational challenges |
| ADHD and conversation issues | – Research confirms common difficulties – Explanations for problems following conversations |
| Most problematic areas | – Grasping main ideas – Recalling details – Tracking multiple speakers – Linking ideas together |
| Functional impacts | – Academic – Workplace – Social relationship – Self-esteem – Family conflicts |
| Individual variation | – ADHD presentations – Comorbid conditions – Intellectual abilities – Environmental factors |
| Helpful strategies | – Reducing distractions – Eye contact – Taking notes – Asking for clarification – Paraphrasing – Reviewing afterwards – Managing interruptions – Practicing active listening |
| Conclusion | – Summary of main points |