Background
Among children aged 6 to 16 there is a clear association between attention-deficit/hyperactivity
disorder (ADHD) symptoms and academic attainment. This study explored if this association was
present in younger children.
Aims
To explore, in children aged 4 to 9, the relationship between probable ADHD status (predictor) ...
Background
Among children aged 6 to 16 there is a clear association between attention-deficit/hyperactivity
disorder (ADHD) symptoms and academic attainment. This study explored if this association was
present in younger children.
Aims
To explore, in children aged 4 to 9, the relationship between probable ADHD status (predictor) and
academic attainment, school attendance, behaviour in school, and reported attitudes towards school
(outcomes).
Sample
1152 children who were taking part in the Supporting Teachers and Children in Schools (STARS) cluster
randomised controlled trial.
Methods
Probable ADHD status was established by using the Strengths and Difficulties Questionnaire predictive
algorithm which combined teacher and parents SDQ reports. Using baseline data from the trial,
regression models were fitted to attainment, attendance, special educational needs (SEN) provision,
attitudes towards school and classroom behaviour. Models were also fitted to attainment at 9, 18 and
30 months after baseline.
Results
Children with probable ADHD (n=47) were more likely than the comparison group (n=1105) to have
below expected attainment in literacy (odds ratio (OR) 6.3, 95% CI 3.0 to 13.3), numeracy (OR 5.6, 95%
CI 2.9 to 10.8) and to be identified as having SEN (OR 35.8, 95% CI 16.1 to 79.7). Their attendance was
poorer with more unauthorised absences (rate ratio (RR) 2.2, 95% CI 1.8 to 2.7). They had more
teacher-reported behavioural problems (mean difference (MD) 5.0, 95% CI 4.6 to 5.4) and less positive
attitudes towards school (MD -1.2, 95% CI -0.5 to -1.8). Poorer attainment in literacy and numeracy
persisted at all follow-ups.
Conclusions
Children aged from 4 to 9 whose behaviour indicates probable ADHD struggle to cope at school in
terms of academic attainment, attendance, classroom behaviour and attitude towards school when
compared to other children. Early identification and intervention to help these children manage in
school is needed.