Drug treatment helps children with ADHD keep up at school
Publication Date:21/09/2007
Children with ADHD tend to do worse at school than other children, but treatment may help them keep up with their classmates, a big new study from the US shows.
What do we know already?
Attention deficit hyperactivity disorder (ADHD) is a medical condition. Children with ADHD find it hard to concentrate, are overactive and impulsive. ADHD can affect how well children do at school.
Stimulant medicines have been used for many years to treat ADHD. The most commonly used is methylphenidate, better known by the brand name Ritalin.
Studies show that drugs like Ritalin help children concentrate more, feel calmer and think more before acting. But until now we haven't had long-term studies to show what effect these drugs have on the whole of a child's school career.
What does the new study say?
Compared to children without ADHD, children with ADHD:
- Had much lower reading test scores at the age of 13
- Were absent from school for slightly more days in the school year
- Were three times as likely to have to repeat a school year (in the US, children who fail exams or miss a lot of school have to repeat the same school year again)
- Were almost three times as likely to drop out of school before the age of 18.
However, a second study by the same researchers found that, for children with ADHD, taking stimulant medicines:
- Reduced the amount of time they were absent from school, by around a day a year
- Meant they were less likely to have to repeat a school year.
Tell me more about the study's findings
Researchers looked at the medical and school records of more than 5,000 children from birth to age 18, to see whether they had ADHD, what treatment they had, and how they did at school. During the study, 370 children were diagnosed with ADHD, mostly by the age of 10.
The researchers found:
- Children with ADHD missed an average of one extra day of school a year at age 12, and an average 2.7 days a year extra at 15 and 18 years, compared to children without ADHD. Treatment with stimulant drugs meant children with ADHD missed around one day a year less than untreated children with ADHD.
- By the age of 18, more than 20 percent of children with ADHD who weren't treated with stimulants had needed to repeat a year of school, compared to around 15 percent who were treated. Only about 7 percent of children without ADHD had needed to repeat a year.
- 23 percent of children with ADHD didn't graduate from high school at age 18, compared to 10 percent of children without. Treatment with stimulant drugs made no difference.
- Average reading scores at age 13 were 45/100 for children with ADHD and 73/100 for children without ADHD. Treatment with stimulant drugs didn't make much difference. Treated children had slightly better scores, but the difference was so small it could have been down to chance.
Where do the studies come from?
The studies were carried out by researchers from the Mayo Clinic, a medical centre with hospitals in three US states. The research was carried out on children in Minnesota. It was published in the Journal of Developmental and Behavioral Pediatrics.
How reliable are the findings?
These are good-quality studies carried out by researchers who were able to use a lot of detailed data about a large group of children over a long period. Because they followed a group of children from birth to age 18, they are likely to be a good reflection of what happens in real life in the US.
However, there are some things that might make the studies less reliable. For example, the researchers relied on school and medical records for the children, rather than carrying out tests for reading and ADHD themselves. So they can't be completely sure the records were accurate.
What does this mean for me?
If you have a child with ADHD, or if you are a child or young person with ADHD, you may find these figures alarming. Remember that they are only average figures for a large group of children. They don't necessarily mean you will have problems at school. But they do suggest that many children with ADHD need extra help or treatment to keep up with their classmates.
If you are considering stimulant drugs for ADHD, the study gives you some extra information to think about. But it's important to remember that the school system is different in the US, so some of the results might not apply directly to children with ADHD in the UK.
Drugs aren't the only thing that affects how children with ADHD do at school. For example, the thing that made the biggest difference to how well children with ADHD could read was how much education their mother had received. Children with ADHD whose mothers had graduated from college had reading scores almost as high as children without ADHD. So it's possible that encouraging your child's reading at home may be more helpful than stimulant drugs.
What should I do now?
There's no need to take immediate action as a result of this study.
If you are concerned that your child may have ADHD, talk to your child's teachers. If they agree there may be a problem, make an appointment with your GP to discuss the matter. Diagnosing ADHD takes time, because doctors don't want to put children on medicines that have side effects unless they are sure they are needed.
If you are considering treatment for ADHD, you'll need to weigh up all the risks and benefits. Stimulant drugs are not the only ADHD treatment available. Talk to your GP about all the options for treatment before making a decision.
If your child has been diagnosed with ADHD and you are concerned about problems at school, it's important to talk to the school. They probably have a lot of experience in how to help children with this condition. They may be able to suggest things that can help.
To find out more, see our information on ADHD.
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© BMJ Publishing Group Limited ("BMJ Group") 2007. All rights reserved
This information does not replace medical advice. If you are concerned you might have a medical problem please ask your Boots pharmacy team in your local Boots store, or see your doctor.
