"Your Child Should Not Return": Preschool Expulsion Among Children With Attention-Deficit/Hyperactivity Disorder as
Angelika H Claussen1, Sara Beth Wolicki1,2, Melissa L Danielson1
1Division of Human Development and Disabilities, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA; and.
Summary
Preschool expulsion in children with attention-deficit/hyperactivity disorder (ADHD) is linked to more severe symptoms, earlier diagnosis, and academic difficulties. This history can signal a need for early intervention and support for affected families.
Area of Science:
- Child Psychology
- Neurodevelopmental Disorders
- Pediatric Health
Background:
- Challenging behaviors in young children with attention-deficit/hyperactivity disorder (ADHD) increase risks for preschool expulsion.
- Preschool expulsion is associated with adverse outcomes in child development, health, and education.
Purpose of the Study:
- To examine the association between preschool expulsion and ADHD symptoms, diagnosis, treatment, and functioning in children with ADHD.
Main Methods:
- Cross-sectional study using the National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome.
- Data from 2947 children aged 5-17 years ever diagnosed with ADHD.
- Parental reports on preschool expulsion, ADHD symptoms, diagnosis, treatment, and functioning; weighted analyses were used.
Main Results:
- 4.4% of children with ADHD experienced preschool expulsion (boys 5.7%; girls 1.5%).
- Preschool expulsion was associated with earlier ADHD diagnosis and medication initiation, more severe ADHD symptoms, and other mental, behavioral, or developmental disorders.
- Difficulties were noted in school performance, organized activities, handwriting, and parent-child relationships, but not in math, reading, or peer/sibling relationships.
Conclusions:
- Preschool expulsion in children with ADHD indicates higher risk for severe symptoms, co-occurring disorders, and academic/social impairment.
- Healthcare providers can utilize preschool expulsion history as a risk indicator for children with ADHD.
- Connecting families with effective treatments is crucial for children with a history of preschool expulsion.
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