Long-Term Outcomes of ADHD: Academic Achievement and Performance

Objective: The aim of this study was to synthesize published data regarding long-term effects of ADHD on information learned (measured via achievement tests) and success within the school environment (academic performance). Method: A systematic search identified 176 studies (1980-2012) of long-term (≥2 years) academic outcomes with ADHD. Results: Achievement test outcomes (79%) and academic performance outcomes (75%) were worse in individuals with untreated ADHD compared with non-ADHD controls, also when IQ difference was controlled (72% and 81%, respectively). Improvement in both outcome groups was associated with treatment, more often for achievement test scores (79%) than academic performance (42%), also when IQ was controlled (100% and 57%, respectively). More achievement test and academic performance outcomes improved with multimodal (100% and 67%, respectively) than pharmacological (75% and 33%) or non-pharmacological (75% and 50%) treatment alone. Conclusion: ADHD adversely affects long-term academic outcomes. A greater proportion of achievement test outcomes improved with treatment compared with academic performance. Both improved most consistently with multimodal treatment.

[1]  Janet Currie,et al.  Do Stimulant Medications Improve Educational and Behavioral Outcomes for Children with Adhd? , 2013, Journal of health economics.

[2]  Brian Butterworth,et al.  Understanding Neurocognitive Developmental Disorders Can Improve Education for All , 2013, Science.

[3]  G. DuPaul,et al.  Comorbidity of LD and ADHD , 2013, Journal of learning disabilities.

[4]  F. Castellanos,et al.  Clinical and functional outcome of childhood attention-deficit/hyperactivity disorder 33 years later. , 2012, Archives of general psychiatry.

[5]  H. Caci,et al.  A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment , 2012, BMC Medicine.

[6]  Joshua M. Langberg,et al.  Does Long-Term Medication Use Improve the Academic Outcomes of Youth with Attention-Deficit/Hyperactivity Disorder? , 2012, Clinical child and family psychology review.

[7]  L. Barnard‐Brak,et al.  Pharmacotherapy and academic achievement among children with attention-deficit/hyperactivity disorder. , 2011, Journal of child and adolescent psychopharmacology.

[8]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[9]  Joshua M. Langberg,et al.  Patterns and Predictors of Adolescent Academic Achievement and Performance in a Sample of Children with Attention-Deficit/Hyperactivity Disorder , 2011, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[10]  B. Pennington,et al.  A multiple deficit model of reading disability and attention-deficit/hyperactivity disorder: searching for shared cognitive deficits. , 2011, Journal of child psychology and psychiatry, and allied disciplines.

[11]  H. Jeon,et al.  Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: Results of the Korean epidemiologic catchment area study , 2011, Psychiatry Research.

[12]  Michele Tarsilla.  Cochrane Handbook for Systematic Reviews of Interventions , 2010, Journal of MultiDisciplinary Evaluation.

[13]  Joshua M. Langberg,et al.  Parent-Reported Homework Problems in the MTA Study: Evidence for Sustained Improvement with Behavioral Treatment , 2010, Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53.

[14]  M. Laasonen,et al.  Project DyAdd: Phonological Processing, Reading, Spelling, and Arithmetic in Adults With Dyslexia or ADHD , 2010, Journal of learning disabilities.

[15]  S. Faraone,et al.  Are cognitive deficits in attention deficit/hyperactivity disorder related to the course of the disorder? A prospective controlled follow-up study of grown up boys with persistent and remitting course , 2009, Psychiatry Research.

[16]  L. Weyandt,et al.  College Students With ADHD , 2009, Journal of attention disorders.

[17]  J. Nigg,et al.  Change in teachers' ratings of attention problems and subsequent change in academic achievement: a prospective analysis , 2009, Psychological Medicine.

[18]  M. Barnes,et al.  Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders , 2009, Journal of the International Neuropsychological Society.

[19]  Brent D. Fulton,et al.  Positive Association Between Attention-Deficit/ Hyperactivity Disorder Medication Use and Academic Achievement During Elementary School , 2009, Pediatrics.

[20]  J. Swanson,et al.  The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. , 2009, Journal of the American Academy of Child and Adolescent Psychiatry.

[21]  S. Faraone,et al.  Is adult attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ? , 2008, Psychological Medicine.

[22]  S. Faraone,et al.  Temporal stability of ADHD in the high-IQ population: results from the MGH Longitudinal Family Studies of ADHD. , 2008, Journal of the American Academy of Child and Adolescent Psychiatry.

[23]  Benjamin B. Lahey,et al.  Academic Achievement Over 8 Years Among Children Who Met Modified Criteria for Attention-deficit/Hyperactivity Disorder at 4–6 Years of Age , 2008, Journal of abnormal child psychology.

[24]  H. Feldman,et al.  Academic and educational outcomes of children with ADHD. , 2007, Journal of pediatric psychology.

[25]  E. Tirosh,et al.  The relationship between attention, executive functions and reading domain abilities in attention deficit hyperactivity disorder and reading disorder: a comparative study. , 2007, Journal of child psychology and psychiatry, and allied disciplines.

[26]  Marley W. Watkins,et al.  ADHD and Achievement , 2007, Journal of learning disabilities.

[27]  Veronica L. Raggi,et al.  Interventions to Address the Academic Impairment of Children and Adolescents with ADHD , 2006, Clinical child and family psychology review.

[28]  P. Tymms,et al.  The impact of screening and advice on inattentive, hyperactive and impulsive children , 2006 .

[29]  M. Wagner,et al.  The Academic Achievement and Functional Performance of Youth with Disabilities. A Report from the National Longitudinal Transition Study-2 (NLTS2). NCSER 2006-3000. , 2006 .

[30]  R. Kessler,et al.  The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. , 2006, The American journal of psychiatry.

[31]  M. Fitzgerald,et al.  Attention-deficit/hyperactivity disorder and Asperger's syndrome? , 2005, Journal of the American Academy of Child and Adolescent Psychiatry.

[32]  John Everatt,et al.  Working memory: its role in dyslexia and other specific learning difficulties. , 2004, Dyslexia.

[33]  E. Sonuga-Barke,et al.  Are Planning, Working Memory, and Inhibition Associated With Individual Differences in Preschool ADHD Symptoms? , 2002, Developmental neuropsychology.

[34]  P. Tymms,et al.  Inattention, hyperactivity and impulsiveness: their impact on academic achievement and progress. , 2001, The British journal of educational psychology.

[35]  G. Kewley.  Risperidone in comorbid ADHD and ODD/CD. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[36]  D. Fergusson,et al.  Attentional difficulties in middle childhood and psychosocial outcomes in young adulthood. , 1997, Journal of child psychology and psychiatry, and allied disciplines.

[37]  R. Barkley,et al.  Attention deficit hyperactivity disorder adults: comorbidities and adaptive impairments. , 1996, Comprehensive psychiatry.

[38]  D. Fergusson,et al.  Early disruptive behavior, IQ, and later school achievement and delinquent behavior , 1995, Journal of abnormal child psychology.

[39]  D. Fergusson,et al.  The effects of conduct disorder and attention deficit in middle childhood on offending and scholastic ability at age 13. , 1993, Journal of child psychology and psychiatry, and allied disciplines.

[40]  R. Barkley,et al.  The adolescent outcome of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status. , 1990, Journal of consulting and clinical psychology.

[41]  C. Weithorn,et al.  High-Active Children and Achievement Tests: A two-year follow-up† , 1985 .

[42]  D. Cantwell,et al.  Three-year multimodality treatment study of 100 hyperactive boys. , 1981, The Journal of pediatrics.

[43]  M. Carter.  Diagnostic and Statistical Manual of Mental Disorders, 5th ed. , 2014 .

[44]  D. Daley,et al.  The impact of Attention De fi cit Hyperactivity Disorder ( ADHD ) symptoms on academic performance in an adolescent community sample , 2012 .

[45]  E. Taylor,et al.  The adolescent outcome of hyperactive girls. Self-reported interpersonal relationships and coping mechanisms. , 2005, European child & adolescent psychiatry.

[46]  Steven R. Banks,et al.  A study of medical students and physicians referred for learning disabilities , 1995, Annals of dyslexia.

[47]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[48]  V. Harpin,et al.  Psychology Research and Behavior Management Dovepress the Long-term Outcomes of Interventions for the Management of Attention-deficit Hyperactivity Disorder in Children and Adolescents: a Systematic Review of Randomized Controlled Trials , 2022 .