# The Impact of Executive Functions on Metaphonological Skills: Correlation and Treatment Implication for ADHD Children

**Authors:** Adriana Piccolo, Margherita La Fauci, Carmela De Domenico, Marcella Di Cara, Alessia Fulgenzi, Noemi Mancuso, Lilla Bonanno, Maria Tresoldi, Rosalia Muratore, Caterina Impallomeni, Emanuela Tripodi, Francesca Cucinotta

PMC · DOI: 10.3390/jcm15020906 · Journal of Clinical Medicine · 2026-01-22

## TL;DR

This study explores how executive functions affect phonological skills in children with ADHD and suggests combining EF training with phonological interventions to improve learning outcomes.

## Contribution

The study identifies specific correlations between executive functions and metaphonological skills in ADHD children and proposes integrated intervention strategies.

## Key findings

- Rhyme is positively correlated with processing speed and negatively with response inhibition.
- Phonemic segmentation is significantly related to auditory attention and response inhibition.
- Age is a significant predictor of phonemic synthesis and final syllable deletion.

## Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder frequently associated with impairments in executive functions (EF). These deficits have been linked to difficulties across various cognitive domains, including metaphonological skills (MS), essential for phonological awareness and processing abilities. Background/Objectives: This pilot study examines the correlations between EF and MS in ADHD children. Methods: A total of 84 children aged 6–14 years, diagnosed with ADHD and an IQ ≥ 70, were assessed using the NEPSY-II test to evaluate executive functions and the Assessment of Metaphonological Skills Test to assess phonological processing abilities. Results: Correlational analyses and multiple regression models were employed to explore the relationships between EF and MS, focusing on attention, cognitive flexibility, and response inhibition. Rhyme was positively correlated with processing speed and negatively correlated with response inhibition. Phonemic segmentation was significantly related to auditory attention and response inhibition. Age emerged as a significant predictor of phonemic synthesis and final syllable deletion, consistent with the developmental maturation of executive and phonological abilities. Conclusions: The findings suggest that deficits in executive functioning in ADHD children are closely linked to metaphonological abilities, which play a crucial role in the acquisition of reading and writing skills. Integrating EF training into phonological interventions can help reduce learning difficulties and improve cognitive and language outcomes.

## Linked entities

- **Diseases:** Attention-deficit/hyperactivity disorder (MONDO:0007743)

## Full-text entities

- **Diseases:** impairments in executive functions (MESH:D003072), learning difficulties (MESH:D007859), neurodevelopmental disorder (MESH:D002658), ADHD (MESH:D001289)

## Full text

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## Figures

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## References

94 references — full list in the complete paper: https://tomesphere.com/paper/PMC12842362/full.md

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Source: https://tomesphere.com/paper/PMC12842362