Long-Term School Outcomes for Children with Attention-Deficit/Hyperactivity Disorder: A Population-Based Perspective

Department of Pediatric and Adolescent Medicine, Division of Developmental and Behavioral Pediatrics, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
Journal of Developmental & Behavioral Pediatrics (Impact Factor: 2.13). 09/2007; 28(4):265-73. DOI: 10.1097/DBP.0b013e31811ff87d
Source: PubMed


The purpose of this study was to compare long-term school outcomes (academic achievement in reading, absenteeism, grade retention, and school dropout) for children with attention-deficit/hyperactivity disorder (AD/HD) versus those without AD/HD.
Subjects included 370 children with research-identified AD/HD from a 1976-1982 population-based birth cohort (N = 5718) and 740 non-AD/HD control subjects from the same birth cohort, matched by gender and age. All subjects were retrospectively followed from birth until a median age of 18.4 years (AD/HD cases) or 18.3 years (non-AD/HD controls). The complete school record for each subject was reviewed to obtain information on reading achievement (last available California Achievement Test reading score), absenteeism (number/percentage of school days absent at each grade level), grade retention (having to repeat an entire grade in the subsequent school year), and school dropout (failure to graduate from high school).
Median reading achievement scores at age 12.8 years (expressed as a national percentile) were significantly different for AD/HD cases and non-AD/HD controls (45 vs 73). Results were similar for both boys and girls with AD/HD. Median percentage of days absent was statistically significantly higher for children with AD/HD versus those without AD/HD, although the difference was relatively small in absolute number of days absent. Subjects with AD/HD were three times more likely to be retained a grade. Similarly, subjects with AD/HD were 2.7 times more likely to drop out before high school graduation (22.9%) than non-AD/HD controls (10.0%).
The results of this population-based study clearly demonstrate the association between AD/HD and poor long-term school outcomes.

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    • "Thirty-two percent of children in our sample had repeated a grade at least once, one third of which repeated the first year of primary school. Children with ADHD were 3 times more likely to repeat a grade than the gender-and age-matched controls in an American birth cohort study (Barbaresi, Katusic, Colligan, Weaver, & Jacobsen, 2007). There is strong crossnational variation with regard to grade repetition associated with contrasting systems of schooling (Pastor & Reuben, 2008). "
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    ABSTRACT: Objective: The objective of this study is to retrospectively describe the pathway toward ADHD diagnosis and treatment, and identify potential areas for improvement. Method: Parent-reported questionnaires were collected by a national sample of ADHD specialists. Results: In total, 473 complete questionnaires were analyzed. Initial onset of ADHD symptoms was reported at a mean age of 4.45 years. Mean age at diagnosis was 8.07 years, and half of the families had seen at least three health care professionals previously. Psychiatrists were most commonly consulted. A "combined" (89% boys) and inattentive (49% boys) profile was identified. Diagnosis was made 1 year later for the latter group. Two thirds of patients received pharmacological treatment. The delay in diagnosis was identified as the main source of concern for caregivers. Conclusion: The 4-year delay in diagnosis may represent a loss of opportunity. Training health care professionals in the core symptoms of ADHD may help reduce disparities and improve patient trajectory.
    Full-text · Article · Jan 2016 · Journal of Attention Disorders
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    • "some, but not others (Barbaresi et al. 2007; Barkley et al. 2002). Outside of stimulant medication (Abikoff et al. 2009), little is known about factors that may attenuate the severity of adolescent OTP deficits, serving as key intervention mechanisms. "
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    ABSTRACT: Organization, Time Management, and Planning (OTP) problems are a key mechanism of academic failure for adolescents with ADHD. Parents may be well positioned to promote remediation of these deficits; yet, almost nothing is known about OTP management behaviors among parents of middle and high school students with ADHD. In a sample of 299 well-diagnosed adolescents with ADHD, a measure of parental OTP management was psychometrically validated. Latent Class Analysis was conducted to detect distinct patterns of parental OTP management and yielded four unique classes: Parental Control (18.7 %), Parent-Teen Collaboration (20.4 %), Homework Assistance (20.4 %), and Uninvolved (40.5 %). Logistic Regression analyses indicated that mal-adaptive parental OTP strategies were related to higher levels of parent and adolescent psychopathology. Parental OTP management did not relate to current adolescent OTP skills or GPA, indicating that parents did not select OTP management strategies in immediate response to adolescent functioning. Implications for parent-directed intervention are discussed.
    Full-text · Article · Sep 2015 · Journal of Psychopathology and Behavioral Assessment
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    • "Caused by dysfunctional neural networks in the brain, ADHD is the most commonly diagnosed behavioral disorder in children, with an overall prevalence rate of 9.5% in those aged 4 to 17 (Centers for Disease Control and Prevention, 2010). In childhood, this diagnosis is associated with increased risk for academic failure (Barbaresi, Katusic, Colligan, Weaver, & Jacobsen, 2007), frequent parent–child conflicts, and accidental injuries (Danforth, Barkley, & Stokes, 1991). ADHD also increases the risk of becoming involved with the juvenile justice system (DeLisi et al., 2011; Eme, 2009; Pelham, Fabiano, & Massetti, 2005). "
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    ABSTRACT: Purpose The purpose of this study is to propose a mediational model for the mechanisms through which a diagnosis of Attention-Deficit/Hyperactivity Disorder between the ages of 10 and 12 predicts positive and negative early adult outcomes for African Americans. Methods The study sample (n = 211) was drawn from the Des Moines, Iowa subsample of the Family and Community Health Study. Participants were first assessed between the ages of 10 and 12, again between the ages of 12 and 18, and finally at 18 to 23. Results Findings indicate that a diagnosis of ADHD before age 13 indirectly predicted subsequent exclusionary school discipline and juvenile arrest in adolescence, and both arrests and educational attainment in young adulthood. Conclusions These findings offer support for the School to Prison Pipeline model, showing that for some African American children, a childhood diagnosis of ADHD can lead to negative school experiences that result in harsh school-based discipline, which in turn open the door to justice system involvement spanning several developmental stages.
    Full-text · Article · Mar 2014 · Journal of Criminal Justice
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