Advertisement

Academic and Educational Outcomes of Children With ADHD

      Attention-deficit/hyperactivity disorder (ADHD) is associated with poor grades, poor reading and math standardized test scores, and increased grade retention. ADHD is also associated with increased use of school-based services, increased rates of detention and expulsion, and ultimately with relatively low rates of high school graduation and postsecondary education. Children in community samples who show symptoms of inattention, hyperactivity, and impulsivity with or without formal diagnoses of ADHD also show poor academic and educational outcomes. Pharmacologic treatment and behavior management are associated with reduction of the core symptoms of ADHD and increased academic productivity, but not with improved standardized test scores or ultimate educational attainment. Future research must use conceptually based outcome measures in prospective, longitudinal, and community-based studies to determine which pharmacologic, behavioral, and educational interventions can improve academic and educational outcomes of children with ADHD.

      Key words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. World Health Organization. International Classification of Functioning, Disability, and Health (ICF). Available at: http://www3.who.int/icf/icftemplate Accessed April 18, 2006.

        • American Psychiatric Association
        Diagnostic and Statistical Manual of Mental Disorders. 4th rev ed. American Psychiatric Association, Washington, DC2000
        • Hinshaw S.P.
        Externalizing behavior problems and academic underachievement in childhood and adolescence: causal relationships and underlying mechanisms.
        Psychol Bull. 1992; 111: 127-155
        • DeShazo Barry T.
        • Lyman R.D.
        • Klinger L.G.
        Academic underachievement and attention-deficit/hyperactivity disorder: the negative impact of symptom severity on school performance.
        J School Psychol. 2002; 40: 259-283
        • Fergusson D.M.
        • Horwood L.J.
        Early disruptive behavior, IQ, and later school achievement and delinquent behavior.
        J Abnorm Child Psychol. 1995; 23: 183-199
        • Fergusson D.M.
        • Horwood L.J.
        • Lynskey M.T.
        The effects of conduct disorder and attention deficit in middle childhood on offending and scholastic ability at age 13.
        J Child Psychol Psychiatry. 1993; 34: 899-916
        • Hinshaw S.P.
        Academic underachievement, attention deficits, and aggression: comorbidity and implications for intervention.
        J Consult Clin Psychol. 1992; 60: 893-903
        • Rapport M.D.
        • Scanlan S.W.
        • Denney C.B.
        Attention-deficit/hyperactivity disorder and scholastic achievement: a model of dual developmental pathways.
        J Child Psychol Psychiatry. 1999; 40: 1169-1183
        • Biederman J.
        • Faraone S.
        • Milberger S.
        • et al.
        A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders.
        Arch Gen Psychiatry. 1996; 53: 437-446
        • LeFever G.B.
        • Villers M.S.
        • Morrow A.L.
        • Vaughn III, E.
        Parental perceptions of adverse educational outcomes among children diagnosed and treated for ADHD: a call for improved school/provider collaboration.
        Psychol Schools. 2002; 39: 63-71
        • Jensen P.S.
        • Eaton Hoagwood K.
        • Roper M.
        • et al.
        The services for children and adolescents-parent interview: development and performance characteristics.
        J Am Acad Child Adolesc Psychiatry. 2004; 43: 1334-1344
        • Carlson C.L.
        • Mann M.
        Attention-deficit/hyperactivity disorder, predominately inattentive subtype.
        Child Adolesc Psychiatr Clin N Am. 2000; 9: 499-510
        • Milich R.
        • Balentine A.C.
        • Lynam D.R.
        ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders.
        Clin Psychol. 2001; 8: 463-488
        • Murphy K.R.
        • Barkley R.A.
        • Bush T.
        Young adults with attention deficit hyperactivity disorder: subtype differences in comorbidity, educational and clinical history.
        J Nervous Mental Dis. 2002; 190: 147-157
        • Baumgaertel A.
        • Wolraich M.L.
        • Dietrich M.
        Comparison of diagnostic criteria for attention deficit disorders in a German elementary school sample.
        J Am Acad Child Adolesc Psychiatry. 1995; 34: 629-638
        • Barkley R.A.
        • DuPaul G.J.
        • McMurray M.B.
        Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria.
        J Consult Clin Psychol. 1990; 58: 775-789
        • DuPaul G.J.
        • Stoner G.
        ADHD in the Schools: Assessment and Intervention Strategies. 2nd ed. Vol 19. Guilford Press, New York, NY2003
        • Gadow K.D.
        • Sprafkin J.
        • Nolan E.E.
        DSM-IV symptoms in community and clinic preschool children.
        J Am Acad Child Adolesc Psychiatry. 2001; 40: 1383-1392
        • Mariani M.A.
        • Barkley R.A.
        Neuropsychological and academic functioning in preschool boys with attention deficit hyperactivity disorder.
        Dev Neuropsychol. 1997; 13: 111-129
        • DuPaul G.J.
        • McGoey K.E.
        • Eckert T.L.
        • VanBrakle J.
        Preschool children with attention-deficit/hyperactivity disorder: impairments in behavioral, social, and school functioning.
        J Am Acad Child Adolesc Psychiatry. 2001; 40: 508-515
        • Weiss G.
        • Hechtman L.T.
        Hyperactive Children Grown Up: ADHD in Children, Adolescents, and Adults. 2nd ed. Guilford Press, New York, NY1993
        • Weiss G.
        • Hechtman L.
        • Perlman T.
        • Hopkins J.
        • Wener A.
        Hyperactives as young adults: a controlled prospective ten-year follow-up of 75 children.
        Arch Gen Psychiatry. 1979; 36: 675-681
        • Weiss G.
        • Hechtman L.
        • Perlman T.
        Hyperactives as young adults: school, employer, and self-rating scales obtained during ten-year follow-up evaluation.
        Am J Orthopsychiatr. 1978; 48: 438-445
        • Gittelman R.
        • Mannuzza S.
        • Shenker R.
        • Bonagura N.
        Hyperactive boys almost grown up: I. Psychiatric status.
        Arch Gen Psychiatry. 1985; 42: 937-947
        • Barkley R.A.
        • Fischer M.
        • Edelbrock C.S.
        • Smallish L.
        The adolescent outcome of hyperactive children diagnosed by research criteria: I. An 8-year prospective follow-up study.
        J Am Acad Child Adolesc Psychiatry. 1990; 29: 546-557
        • Fischer M.
        • Barkley R.A.
        • Edelbrock C.S.
        • Smallish L.
        The adolescent outcome of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status.
        J Consult Clin Psychol. 1990; 58: 580-588
        • Mannuzza S.
        • Klein R.G.
        • Bessler A.
        • Malloy P.
        • et al.
        Adult outcome of hyperactive boys: educational achievement, occupational rank, and psychiatric status.
        Arch Gen Psychiatry. 1993; 50: 565-576
        • Weiss G.
        • Hechtman L.
        • Milroy T.
        • Perlman T.
        Psychiatric status of hyperactives as adults: a controlled prospective 15-year follow-up of 63 hyperactive children.
        J Am Acad Child Psychiatry. 1985; 24: 211-220
        • Barkley R.A.
        Major life activity and health outcomes associated with attention-deficit/hyperactivity disorder.
        J Clin Psychiatry. 2002; 63: 10-15
        • Barkley R.A.
        Attention-Deficit/Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 3rd ed. Guilford Press, New York, NY2006
        • Hechtman L.
        Subgroups of adult outcome of attention-deficit/hyperactivity disorder.
        in: Brown T.E. Attention-Deficit Disorders and Comorbidities in Children, Adolescents, and Adults. American Psychiatric Publishing Inc, Washington, DC2000: 437-452
        • Hinshaw S.P.
        Is ADHD an Impairing Condition in Childhood and Adolescence?.
        in: Jensen P.S. Cooper J.R. Attention Deficit Hyperactivity Disorder: State of the Science—Best Practices. Civic Research Institute, Kingston, NJ2002 (5-1–5-21)
        • Lambert N.M.
        Adolescent outcomes for hyperactive children.
        Am Psychol. 1988; 43: 786-799
        • Currie J.
        • Stabile M.
        Child Mental Health and Human Capital Accumulation: The Case of ADHD. National Bureau of Economic Research, Cambridge, Mass2004 (April)
        • Merrell C.
        • Tymms P.B.
        Inattention, hyperactivity and impulsiveness: their impact on academic achievement and progress.
        Br J Educ Psychol. 2001; 71: 43-56
        • Fergusson D.M.
        • Lynskey M.T.
        • Horwood L.J.
        Attentional difficulties in middle childhood and psychosocial outcomes in young adulthood.
        J Child Psychol Psychiatry. 1997; 38: 633-644
        • MTA Cooperative Group
        A 14-month randomized clinical trial of treatment strategies for attention-deficit/hyperactivity disorder. The MTA Cooperative Group. Multimodal Treatment Study of Children With ADHD.
        Arch Gen Psychiatry. 1999; 56: 1073-1086
        • Evans S.W.
        • Pelham W.E.
        • Smith B.H.
        • et al.
        Dose-response effects of methylphenidate on ecologically valid measures of academic performance and classroom behavior in adolescents with ADHD.
        Exp Clin Psychopharmacol. 2001; 9: 163-175
        • Rapport M.D.
        • Denney C.
        • DuPaul G.J.
        • Gardner M.J.
        Attention deficit disorder and methylphenidate: normalization rates, clinical effectiveness, and response prediction in 76 children.
        J Am Acad Child Adolesc Psychiatry. 1994; 33: 882-893
        • Forness S.R.
        • Cantwell D.P.
        • Swanson J.M.
        • Hanna G.L.
        • Youpa D.
        Differential effects of stimulant medication on reading performance of boys with hyperactivity with and without conduct disorder.
        J Learn Disabil. 1991; 24: 304-310
        • Forness S.R.
        • Swanson J.M.
        • Cantwell D.P.
        • Youpa D.
        • Hanna G.L.
        Stimulant medication and reading performance: follow-up on sustained dose in ADHD boys with and without conduct disorders.
        J Learn Disabil. 1992; 25: 115-123
        • Hechtman L.
        • Greenfield B.
        Long-term use of stimulants in children with attention deficit hyperactivity disorder: safety, efficacy, and long-term outcome.
        Paediatr Drugs. 2003; 5: 787-794
        • Hechtman L.
        • Weiss G.
        • Perlman T.
        Young adult outcome of hyperactive children who received long-term stimulant treatment.
        J Am Acad Child Psychiatry. 1984; 23: 261-269
        • Fischer M.
        • Barkley R.A.
        • Smallish L.
        • Fletcher K.
        Young adult follow-up of hyperactive children: self-reported psychiatric disorders, comorbidity, and the role of childhood conduct problems and teen CD.
        J Abnormal Child Psychol. 2002; 30 ([Erratum, J Abnorm Child Psychol. 2003;31:563]): 463-475
        • Reid R.
        • Hakendorf P.
        • Prosser B.
        Use of psychostimulant medication for ADHD in South Australia.
        J Am Acad Child Adolesc Psychiatry. 2002; 41: 906-913
        • Pelham Jr., W.E.
        • Wheeler T.
        • Chronis A.
        Empirically supported psychosocial treatments for attention deficit hyperactivity disorder.
        J Clin Child Psychol. 1998; 27: 190-205
        • March J.S.
        • Swanson J.M.
        • Arnold L.E.
        • et al.
        Anxiety as a predictor and outcome variable in the multimodal treatment study of children with ADHD (MTA).
        J Abnormal Child Psychol. 2000; 28: 527-541
        • Jensen P.S.
        • Hinshaw S.P.
        • Swanson J.M.
        • et al.
        Findings from the NIMH Multimodal Treatment Study of ADHD (MTA): implications and applications for primary care providers.
        J Dev Behav Pediatr. 2001; 22: 60-73
        • Hechtman L.
        • Abikoff H.
        • Klein R.G.
        • et al.
        Academic achievement and emotional status of children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment.
        J Am Acad Child Adolesc Psychiatry. 2004; 43: 812-819
        • DuPaul G.J.
        • Eckert T.L.
        Academic interventions for students with attention-deficit/hyperactivity disorder: a review of the literature.
        Reading Writing Q Overcoming Learning Difficulties. 1998; 14: 59-82
        • Hoffman J.B.
        • DuPaul G.J.
        Psychoeducational interventions for children and adolescents with attention-deficit/hyperactivity disorder.
        Child Adolesc Psychiatr Clin N Am. 2000; 9 (2000): 647-661
        • Forness S.R.
        • Kavale K.A.
        Impact of ADHD on school systems.
        in: Jensen P.S. Cooper J.R. Attention Deficit Hyperactivity Disorder: State of the Science—Best Practices. Civic Research Institute, Kingston, NJ2002 (24-1–24-20)
        • Reid R.
        • Katsiyannis A.
        Attention-deficit/hyperactivity disorder and Section 504.
        Remedial Spec Educ. 1995; 16: 44-52
        • Davila R.R.
        • Williams M.L.
        • MacDonald J.T.
        Clarification of Policy to Address the Needs of Children With Attention Deficit Disorders Within General and/or Special Education. US Department of Education, Office of Special Education and Rehabilitation, Washington, DC1991
        • Danielson L.
        • Henderson K.
        • Schiller E.
        Educational policy—educating children with attention deficit hyperactivity disorder.
        in: Jensen P.S. Cooper J.R. Attention Deficit Hyperactivity Disorder: State of the Science—Best Practices. Civic Research Institute, Kingston, NJ2002 (26-1–26-12)
        • Shinn M.R.
        Advanced Applications of Curriculum-Based Measurement. Guilford Press, New York, NY1998
        • Osborne J.W.
        Advantages of hierarchical linear modeling.
        Pract Assess Res Eval. 2000; 7
      2. LDonline.org AEL. ADHD-building academic success. Available at: http://www.ldonline.org/article.php?max=20&id=985&loc=17. Accessed April 19, 2006.

        • Pelligrini A.
        • Horvat M.
        A developmental contextualist critique of attention deficit hyperactivity disorder.
        Educ Res. 1995; 24: 13-19
        • DuPaul G.J.
        • Eckert T.L.
        The effects of school-based interventions for attention deficit hyperactivity disorder: a meta-analysis.
        School Psychol Rev. 1997; 26: 5-27
        • Rutter M.
        • Maughan B.
        School effectiveness findings 1979–2002.
        J School Psychol. 2002; 40: 451-475
        • Nye B.
        • Hedges L.V.
        • Konstantopoulos S.
        The effects of small classes on academic achievement: the results of the Tennessee class size experiment.
        Am Educ Res J. 2000; 37 (Spr): 123-151
        • Bussing R.
        • Gary F.A.
        • Leon C.E.
        • Wilson Garvan C.
        • Reid R.
        General classroom teachers’ information and perceptions of attention deficit hyperactivity disorder.
        Behav Disord. 2002; 27: 327-339
        • Nelson P.B.
        • Soli S.
        Acoustical barriers to learning: children at risk in every classroom.
        Language Speech Hearing Serv Schools. 2000; 31: 356-361
        • Nilsson M.
        • Soli S.D.
        • Sullivan J.A.
        Development of the Hearing in Noise Test for the measurement of speech reception thresholds in quiet and in noise.
        J Acoustical Soc Am. 1994; 95: 1085-1099
        • Stelmachowicz P.G.
        • Hoover B.M.
        • Lewis D.E.
        • Kortekaas R.W.
        • Pittman A.L.
        The relation between stimulus context, speech audibility, and perception for normal-hearing and hearing-impaired children.
        J Speech Language Hearing Res. 2000; 43: 902-914
        • DuPaul G.J.
        • Ervin R.A.
        Functional assessment of behaviors related to attention-deficit/hyperactivity disorder: linking assessment to intervention design.
        Behav Ther. 1996; 27: 601-622
        • Dunlap G.
        • dePerczel M.
        • Clarke S.
        • et al.
        Choice making to promote adaptive behavior for students with emotional and behavioral challenges.
        J Appl Behav Anal. 1994; 27: 505-518
        • Powell S.
        • Nelson B.
        Effects of choosing academic assignments on a student with attention deficit hyperactivity disorder.
        J Appl Behav Anal. 1997; 30: 181-183
        • DuPaul G.J.
        • Ervin R.A.
        • Hook C.L.
        • McGoey K.E.
        Peer tutoring for children with attention deficit hyperactivity disorder: effects on classroom behavior and academic performance.
        J Appl Behav Anal. 1998; 31: 579-592
        • DuPaul G.J.
        • Henningson P.N.
        Peer tutoring effects on the classroom performance of children with attention deficit hyperactivity disorder.
        School Psychol Rev. 1993; 22: 134-143
        • Greenwood C.R.
        • Terry B.
        • Utley C.A.
        • Montagna D.
        • et al.
        Achievement, placement, and services: middle school benefits of classwide peer tutoring used at the elementary school.
        School Psychol Rev. 1993; 22: 497-516
        • Xu C.
        • Reid R.
        • Steckelberg A.
        Technology applications for children with ADHD: assessing the empirical support.
        Educ Treatment Child. 2002; 25: 224-248
        • Kleiman GH H.
        • Linday P.
        Microcomputers and hyperactive children.
        Creative Comput. 1981; 7: 93-94
        • Ford MP V.
        • Cox J.
        Attending behaviors of children with ADHD in math and reading using various types of software.
        J Computers Childhood Educ. 1993; 4: 183-196
        • Ota K.R.
        • DuPaul G.J.
        Task engagement and mathematics performance in children with attention-deficit hyperactivity disorder: effects of supplemental computer instruction.
        School Psychol Q. 2002; 17: 242-257
        • Ridgway A.
        • Northup J.
        • Pellegrin A.
        • LaRue R.
        • Hightsoe A.
        Effects of recess on the classroom behavior of children with and without attention-deficit hyperactivity disorder.
        School Psychol Q. 2003; 18: 253-268
        • Allison D.B.
        • Faith M.S.
        • Franklin R.D.
        Antecedent exercise in the treatment of disruptive behavior: a meta-analytic review.
        Clin Psychol Sci Pract. 1995; 2 (Fall): 279-304