In order to figure out which particular skill or skills are to train you need to understand why exactly was it hard for your son to answer questions about a story that was read to him. There could be problems with auditory attention, working memory, language development, and/ or verbal reasoning, just to name a few. In the summary section of your report the deficient skills have to be highlighted. If you have troubles finding them, you need to contact the psychologist who did the assessment and clarify that. Since your child was diagnosed with ADHD there are likely some issues with attention. For kids with this condition it is very hard to focus on verbal information alone. Try to give him something to focus his eyes on too while you are reading a story, may be the text of the story or an outline, the questions that he will be asked afterwards or some pictures related to the story. Try to present him with shorter portions of the text and see if it helps. Try to give him possible answers in a multiple choice format, so that he does not have to formulate the answer and uses his recognition memory versus recall. This way you can isolate the skills that you want to practice and help your son experience success with it, so that he feels more confident about this activity. However, if language is delayed or verbal reasoning is low, you need to tackle these skills. You’d also need to adjust the difficulty level of your training to your child’s current level and go from there. It might not be the same level as what they are doing in class. Finally, you can look into some computerized training programs. For example, Cogmed is a brain training program that has been shown to improve attention and working memory, leading to better academic skills.
Hope this helps,
Dr. Tali Shenfield, C.Psych.
With story recall tests, it can be hard to distinguish why the child had trouble. It can be due to a number of factors such as distractability, slow processing speed, trouble with working memory,or language comprehension/expression issues. The 16th percentile looks terribly low, but it is actually within normal limits (it is the lower bound of the Average range).
Kids with ADHD and executive functioning weaknesses often struggle with story memory tasks, which often indicates that they are missing a lot of verbal instruction provided in the classroom. I would recommend two possibilities for helping your son--first would be to consider working with a cognitive behavioral psychologist who can teach him to gain greater control over his attention. This will probably make the most difference long term. If you are not in a position to take him to therapy, the book Hunter and His Amazing Remote Control is an excellent workbook that you can use at home. The book teaches children to be more mindful of their attention and helps them learn to control it.
You may also want to consult with your pediatrician to determine if your son's symptoms could be reduced with medication. If you suspect that there is a language comprehension or expressive language issue, you may wish to consult a speech language pathologist. Your testing report should explain how he is doing in the area of language.
One treatment that is not supported by research is theraputic listening (sometimes called the Tomatis technique). This one is not supported as efficacious by the American Academy of Peds and the American Speech and Hearing Association.
I have heard people recommend a treatment called interactive metranome. While some occupational therapists I know find this beneficial, it is not well supported by the research. This one should be considered to have possible benefit but "the jury is still out."
Dr. Rebecca Resnik
Disclaimer: this post was written for educational purposes only. It is never intended to replace face to face mental health or medical care.