Modifiers of long-term school outcomes for children with attention-deficit/hyperactivity disorder: does treatment
William J Barbaresi1, Slavica K Katusic, Robert C Colligan
1Department of Pediatric and Adolescent Medicine, Division of Developmental and Behavioral Pediatrics, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. barbaresi.william@mayo.edu
Insights
Stimulant medication for attention-deficit/hyperactivity disorder (AD/HD) in children is linked to better reading, fewer absences, and less grade retention. Long-term treatment shows improved school outcomes.
Area of Science:
- Child Psychology
- Neurodevelopmental Disorders
- Educational Psychology
Background:
- Attention-deficit/hyperactivity disorder (AD/HD) significantly impacts long-term academic and social functioning.
- Identifying factors that modify school outcomes in children with AD/HD is crucial for effective interventions.
- Stimulant medication is a common treatment for AD/HD, but its long-term effects on school performance require further investigation.
Purpose of the Study:
- To examine the role of stimulant medication and other factors in modifying long-term school outcomes for children with AD/HD.
- To assess the association between stimulant treatment parameters (type, dose, duration) and specific academic achievements.
- To identify potential modifiers, including sociodemographic risks and comorbidities, influencing school success in this population.
Main Methods:
- A population-based birth cohort of 370 children with diagnosed AD/HD was studied.
- Comprehensive review of school records provided data on reading achievement, absenteeism, grade retention, and dropout rates.
- Medical records were analyzed for stimulant medication details, including type, dosage, and treatment duration.
Main Results:
- Stimulant treatment was associated with reduced absenteeism and a lower likelihood of grade retention.
- A positive correlation was observed between stimulant dosage and reading scores.
- Sociodemographic risk factors, comorbidities, and special educational services were linked to poorer school outcomes.
Conclusions:
- Stimulant medication for AD/HD is associated with improved reading achievement, decreased absenteeism, and reduced grade retention.
- Longer duration of stimulant treatment correlated with decreased absenteeism.
- Findings support the importance of consistent medical management for children with AD/HD to enhance educational trajectories.
Objective:
The purpose of this study was to describe the significance of potential modifiers of long-term school outcomes among children with attention-deficit/hyperactivity disorder (AD/HD), including treatment with stimulant medication.
Methods:
Subjects included 370 children with research-identified AD/HD from a 1976-1982 population-based birth cohort (N = 5718). In a companion study, the complete school record for each subject was reviewed to obtain information on reading achievement, absenteeism, grade retention, and school dropout. Data on type of stimulant, dose, age at initiation of treatment, and start/stop dates were collected from medical and school records, available for all subjects.
Results:
Treatment with stimulants was associated with decreased rates of absenteeism; longer duration of treatment was also associated with decreased absenteeism rates. There was a modest positive correlation (r = .15, p = .012) between average daily stimulant dose and last reading score. Cases treated with stimulants were 1.8 times less likely to subsequently be retained a grade (95% confidence interval: 1.01-3.2; p = .047). The proportion of school dropout was similar between treated and not treated cases (22.2% vs 25.8%, p = .54). Other potential modifiers of school outcomes (sociodemographic risk factors, presence of comorbid learning or psychiatric disorders, and receipt of special educational services) were also examined and found to be associated with poorer outcomes.
Conclusions:
In this birth cohort, stimulant treatment of children with AD/HD was associated with improved reading achievement, decreased school absenteeism, and decreased grade retention. This study provides support for efforts to ensure that children with AD/HD receive appropriate long-term medical treatment.
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