Attainment, attendance, and school difficulties in UK primary schoolchildren with probable ADHD

Abstract

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.