Does artificial intelligence-supported rhythm-enhanced phonological awareness training improve early reading in children with attention-deficit/hyperactivity disorder? A randomised controlled intervention study

Introduction Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of reading-related difficulties, and phonological awareness (PA) plays a vital role in early reading development. Rhythm may serve as a temporal scaffold for PA, yet whether rhythm-enhanced PA training produces additional benefits beyond typical PA training for children with ADHD remains unclear. This study examined whether rhythm-enhanced PA training, delivered through an artificial intelligence (AI)-supported and research-assistant-facilitated interactive teaching model, could improve early reading-related abilities and rhythm discrimination in Mandarin-speaking kindergarten children with ADHD. Methods A total of 165 eligible kindergarten children with ADHD were stratified by gender and randomly allocated in a 1:1:1 ratio to the rhythm-based phonological awareness (RPA) intervention group, the phonological-awareness-only (PAO) intervention group, or the control group. Of these, 146 children completed the intervention and were included in the final analysis. Both intervention groups received AI-supported instruction for 8 weeks, with two 30-min sessions per week, while the control group received AI-supported oral storybook activities. Outcome measures included character reading, four PA measures (syllable, rhyme, tone, and phoneme-level awareness), and rhythm discrimination. Results Significant time × group interactions were found for character reading, all four PA measures, and rhythm discrimination (all p s η p 2 = 0.11–0.53). Bonferroni-adjusted comparisons showed that both intervention groups outperformed the control group on syllable, rhyme, tone, and phoneme-level awareness ( p s p = 0.003), syllable awareness (mean difference = 1.72, p = 0.004), rhyme awareness (mean difference = 1.54, p p Discussion Within the shared AI-supported and human-facilitated interactive teaching model, PA intervention improved PA-related outcomes, while rhythm enhancement provided additional benefits for character reading, syllable awareness, rhyme awareness, and rhythm discrimination. This study further extends the Temporal Sampling Framework by demonstrating that rhythm may serve as a temporal scaffold for PA and early reading development in children with ADHD.