Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. May 19, 2025; 15(5): 100731
Published online May 19, 2025. doi: 10.5498/wjp.v15.i5.100731
Subsequent psychiatric disorders in attention deficit and hyperactivity children receiving speech therapy
Ruu-Fen Tzang, Yu-Wen Lin, Kai-Liang Kao, Yue-Cune Chang, Hui-Chun Huang, Shang-Yu Wu, Shu-I Wu, Robert Stewart
Ruu-Fen Tzang, Shu-I Wu, Department of Psychiatry, Mackay Memorial Hospital, Taipei 104, Taiwan
Ruu-Fen Tzang, Hui-Chun Huang, Department of Nursing and Management, Mackay Junior College of Medicine, Taipei 252, Taiwan
Yu-Wen Lin, Hui-Chun Huang, Department of Medical Research, Mackay Memorial Hospital, New Taipei City 251, Taiwan
Kai-Liang Kao, Department of Pediatrics, Far Eastern Memorial Hospital, Taipei 220, Taiwan
Yue-Cune Chang, Department of Mathematics, Tamkang University, Taipei 251, Taiwan
Hui-Chun Huang, Department of Public Health, China Medical University, Taichung 404, Taiwan
Shang-Yu Wu, Department of Audiology and Speech Pathology, Mackay Medical College, Taipei 252, Taiwan
Shu-I Wu, Department of Medicine, Mackay Medical College, Taipei 252, Taiwan
Robert Stewart, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London WC2R 2LS, United Kingdom
Author contributions: Tzang RF, Chang YC, Kao KL, Lin YW, and Wu SI designed the study and wrote the protocol; Lin YW and Wu SI undertook the statistical analysis; Tzang RF wrote the first draft of the manuscript; Wu SY is the primary SLP advisor for this study; Tzang RF, Lin YW, Kao KL, Chang YC, Huang HC, Wu SY, Wu SI, and Stewart R contributed to this manuscript and have approved the final manuscript.
Institutional review board statement: The present study was approved by the Research Ethics Committee of China Medical University and Hospital, Taichung, Taiwan, No. CMUH104-REC2-115(CR-3).
Informed consent statement: Our study subjects were identified from the Taiwan National Health Insurance Research Database. Due to the anonymization and encryption of all information from the National Health Insurance Research Database, patient personal identities were not revealed.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: Since very simple statistics were used in this study, it did not require a review by a statistician.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shu-I Wu, MD, PhD, Professor, Department of Medicine, Mackay Medical College, No. 92, Section 2, Zhongshan Road, Taipei 252, Taiwan. t140@mmc.edu.tw
Received: August 29, 2024
Revised: December 16, 2024
Accepted: March 7, 2025
Published online: May 19, 2025
Processing time: 244 Days and 8 Hours
Abstract
BACKGROUND

Speech and language therapy (ST) might moderate the prognosis in children with attention deficit and hyperactivity disorder (ADHD) comorbid with speech delay. This study investigated whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.

AIM

To investigate whether ST in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders.

METHODS

The population-based National Health Insurance Research Database in Taiwan was used. Hazards of subsequent psychiatric disorders were compared between those who received ST and a propensity-score matched comparison group by Cox regression analyses.

RESULTS

Of 11987 children with ADHD identified from the dataset, 2911 (24%) had received ST. The adjusted hazard ratio for any subsequent recorded psychiatric disorder was 0.72 (95% confidence interval: 0.63-0.82) in children who received ST compared to the matched counterparts. This protective association was only statistically significant in the subgroup that received both medication and behavioral interventions.

CONCLUSION

ST can moderate the effects of integrated early interventions in ADHD children with speech delay.

Keywords: Non-Western country; Attention deficit and hyperactivity disorder; Psychiatric disorders; Speech and language therapy; Adjustment disorder

Core Tip: Speech therapy can moderate the treatment effect for attention deficit and hyperactivity disorder (ADHD) children with speech delay problem. Speech therapy in children with ADHD is associated with a decreased risk of subsequent psychiatric disorders. Multi-modal managements including medication and behavioral intervention may help strengthen the protective effect in addition to getting speech therapy.