October is ADHD Awareness Month
October is ADHD Awareness Month is a time to highlight both the challenges and the strengths of individuals with ADHD. Research shows that between 30–50% of children with ADHD experience broad executive function challenges, while as many as 80% struggle specifically with working memory. This month is an opportunity for educators, parents, and coaches to deepen understanding, reduce stigma, and share strategies that truly support students with unique brains.
A Story to Start
Years ago, I worked with a student who was struggling in ways that went far beyond academics. He missed social cues and often said things that came across as inappropriate. Group work was especially tough — peers didn’t want him in their groups, and he was left feeling isolated. Sadly, the problem wasn’t just social discomfort; it eventually escalated to the point where he was suspended for behavior that stemmed from impulse control and not reading the room.
We recommended a pragmatic language evaluation, expecting that to give us clarity. But here’s the twist: he didn’t meet criteria. That was baffling — especially given his struggles with humor, sarcasm, and conversational timing. He was smart and capable, yet the school didn’t fully see the social challenges, even when they led to real consequences. Eventually, it was written into his IEP that he would meet with the school social worker to work on social skills.
As his executive function coach, I stepped in to support him with the very skills that were tripping him up. And that’s where I learned something important: pragmatic speech isn’t just an autism concern — it’s deeply tied to executive function, and it shows up often in ADHD.
What Is Pragmatic Speech?
Pragmatic speech is the “social side” of communication — the unspoken rules that guide how we use language with others. It includes:
Conversational flow: turn-taking, staying on topic, shifting when the conversation shifts.
Social cues: reading body language, tone, facial expressions.
Context: knowing what’s appropriate to say (and what’s not) in different settings.
Flexibility: shifting from literal meaning to humor, sarcasm, or double meanings.
When pragmatic speech skills break down, students may interrupt, miss jokes, misunderstand sarcasm, or come across as blunt or inappropriate — even if they don’t intend to.
Why Do We See This in ADHD?
Pragmatic language challenges are most often discussed in the context of autism, but they’re also common in students with ADHD. Why? Because successful communication relies on executive functions.
Attention shifting: Conversations move quickly. If a student can’t shift focus, they miss the subtle changes in tone or topic.
Inhibition: It takes inhibition to not blurt out a thought, to pause before speaking, or to recognize that a joke might not land.
Flexibility: Understanding sarcasm, humor, or idioms requires cognitive flexibility — the ability to move beyond literal meanings.
Working memory: Keeping track of what was just said while planning your response depends on memory “in the moment.”
When EF skills are shaky, social communication often breaks down — and what looks like “rudeness” or “immaturity” is actually a brain-based challenge.
Back to the Story…
For my student, sarcasm was a minefield. He took jokes literally, responded in ways that confused peers, and then felt hurt when they pulled away. Since the pragmatic evaluation didn’t qualify him for direct services, it fell through the cracks in school — even though the struggles were real.
As his EF coach, I worked directly on these skills:
Breaking down sarcasm and humor. We practiced spotting tone, facial cues, and double meanings in TV shows and short scripts.
Role-playing. We acted out group work scenarios, pausing to reflect on what others might be thinking.
Impulse strategies. He practiced “the pause button” — waiting two seconds before speaking — to give his brain time to read the room.
Perspective-taking. We built conversations around “what do you think your classmate felt when you said that?” to strengthen his flexibility.
With time, he started noticing cues he’d always missed, and group participation became less stressful. The suspension still stung, but he began to rebuild his confidence.
Takeaways for Coaches and Educators
Don’t assume it’s only autism. ADHD + EF challenges can impact pragmatic language just as much.
Look beyond academics. A student can be bright and still deeply struggle with social communication.
Notice the EF link. If a student blurts, interrupts, or misses humor, consider inhibition, shifting, and flexibility as the drivers.
Intervene early. Even if formal evaluations don’t qualify a student for speech services, EF coaching can still target the same skills.
Final Thoughts
Pragmatic speech difficulties in ADHD can be subtle, overlooked, and sometimes dismissed because the student doesn’t “meet criteria.” But the impact on peer relationships, classroom participation, and self-esteem is very real.
As coaches and educators, we can play a crucial role in bridging that gap — teaching students to pause, shift, notice, and flex in conversations. Because when they can connect socially, they don’t just “fit in” better — they feel more confident, capable, and seen.
👉 Call to Action for Professionals: Next time you see a student missing cues, blurting, or misreading sarcasm, pause and ask: is this an executive function challenge in disguise? With the right scaffolds, you can help them build the social communication skills that evaluations might miss.
