The prevalence rates of speech and language disorders and ADD in 116 children referred for psychiatric services were determined at the Ontario Association of Children’s Mental Health Centres and the Dept of Psychiatry, Hospital for Sick Children, Toronto, Canada. Speech and language disorders were diagnosed in 65% and ADD in 73%. Only 16% had speech and language disorders alone and only 25% had ADD alone. The overall prevalence for the dual diagnosis was 48%. Three-quarters of those with language disorders also had ADD and two-thirds with ADD also had language disorders. The average age at evaluation was 5 yrs. Boys outnumbered girls for language disorders with or without ADD. The presence of language disorder was correlated with intact family status in lower socioeconomic classes, single-child families, and serious parent/child problems. 
COMMENT. This study suggests that pre-school children referred for psychiatric outpatient services are at high risk for language disorders. Failure to develop oral language on schedule is among the earliest concerns voiced by parents of children who later are identified as ADD or learning disabled. Speech and language evaluations should be included in any comprehensive examination of a child with ADD.