The association between cognitive disengagement syndrome and language in children with attention-deficit/hyperactivity disorder

Abstract

Aim This study aims to explore the association between cognitive disengagement syndrome (CDS) and three aspects of language (narrative coherence, core language, and pragmatic language) in children with ADHD, and to examine whether these associations differ from those observed in neurotypical children. Methods In this cross-sectional study, parents completed questionnaires about their child’s CDS and pragmatic language, while children with ADHD (n = 45) and neurotypical children (n = 38), aged 7–11 years, completed tasks of narrative coherence and core language. Results CDS, after adjusting for age and sex, was significantly associated with pragmatic language in children with ADHD with a large effect ( β = -0.51, p = .001), while CDS was significantly associated with core language in neurotypical children with a medium effect ( β = -0.34, p = .04). There was a significant group difference in the association between CDS and pragmatic language (χ²(1) = 4.44, p = .04), with a stronger association in the ADHD group. After performing sensitivity analyses including inattention as an additional covariate, the associations ceased to be significant in both groups and there were no longer significant between-group differences. Conclusion This study examined the association between CDS and language in children with and without ADHD. The findings suggest that there may be an association between CDS and pragmatic language in children with ADHD. However, sensitivity analyses including inattention as a covariate suggest that this association may largely reflect variance shared with inattention. Consequently, the association between CDS and language may partly reflect their shared association with ADHD symptoms. As this, to our knowledge, is the first study to investigate language in relation to CDS in children with ADHD, further research is warranted.

The authors' abstract, as published at the source. Frontiers in Psychiatry, 2026 · DOI ↗