Academic Outcomes of Children With ADHD
ADHD Literature Review
Improving the Academic Outcomes of Children with Attention Deficit Hyperactivity Disorder
Improving the Academic Outcomes of Children with Attention Deficit Hyperactivity Disorder
According to the U.S. Centers for Disease Control and Prevention (CDC) (2014) Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition recognizable by attention deficits, hyperactivity, and impulsivity that manifest across multiple settings. The most recent version of the Diagnostic and Statistical Manual (DSM-V) describes ADHD as consisting of inattention, and/or hyperactivity/impulsivity, severe enough to interfere with day-to-day functioning and development. Common symptoms of inattention include poor listening skills, frequent mistakes, disorganized, avoidance of mentally challenging tasks, distracted, and forgetful. Hyperactivity/impulsivity symptoms include fidgeting, inappropriate physical activity, excessive talking, interrupting others, and an inability to play quietly. Children suffering from ADHD would therefore have a difficult time succeeding academically.
If ADHD were rare this would not be a significant problem, but the most recent statistics reveal that close to 11% of children between the ages of 4 and 17 were diagnosed with ADHD in 2011 (CDC, 2013). This is up from almost 8% in 2003. Among this age group, the number of children taking medications to treat ADHD increased from 4.8 to 6.1% between 2007 and 2011; however, nearly 18% of children suffering from ADHD are not receiving any form of treatment. These figures suggest that over 10% of children populating a classroom suffer from clinical ADHD and nearly 20% of these remain untreated. It naturally follows that ensuring ADHD is adequately treated, using evidence-based interventions, would optimize classroom outcomes for all children.
To better understand the impact ADHD has on academic achievement and how researchers, clinicians, and educators are addressing this issue, a review of the research literature will be conducted. Particular attention will be paid to family-school interventions designed to bring the expertise of multiple professions to bear on academic performance issues. This focus implies that psychosocial interventions may produce the best academic outcomes when compared to standard or no treatment.
ADHD in the Classroom
ADHD Diagnosis and Treatment
Parents and primary care physicians are advised to evaluate any child between the ages of 4 and 18 for ADHD if academic, attention, or hyperactivity/impulsivity problems persist across settings (Hauk, 2013). A total of six symptoms must be present for any child under the age of 17, but only five for any individual 17-years of age and older (CDC, 2014). Past recommendations were for symptoms to be apparent by the age of 6, but this cutoff has been moved to age 12. The symptoms have to be apparent in at least two different settings, persist for at least six months, and be unrelated to other psychiatric or medical conditions. Ideally, a diagnosis should be based on discussions with at least two teachers and at least one other person, preferably a mental health professional. Evidence-based guidelines have been published to help teachers, school nurses, and school psychologists make appropriate decisions when confronted with a child struggling with behavioral or academic problems (Dang, Warrington, Tung, Baker, & Pan, 2007). These guidelines are intended to improve early identification and treatment of children with ADHD.
The Chronic Care and Medical Home models are the recommended healthcare approaches for treating ADHD (Hauk, 2013). Behavioral therapy is the preferred treatment choice for all children and is the only first-line treatment administered to pre-school children. Should behavioral therapy fail to produce significant improvements then medications can be considered; however, as of 2012 the use of medications in young children has not been studied extensively. Stimulants are the preferred class of drugs to treat ADHD. Other drugs have been used to treat ADHD in children, but the scientific evidence supporting their use is not as strong. When treating adolescents, there is some concern of drug diversion; however, if diversion is suspected then drugs with little or no risk of abuse should be prescribed.
Family Factors
An investigation into the association between family dysfunction and children with ADHD found strong and consistent evidence to support this link (Kaplan, Crawford, Fisher, & Dewey, 1998). The control conditions were children with reading difficulties, reading difficulties plus ADHD, and healthy controls, but the only diagnosis linked to family dysfunction was a diagnosis of ADHD. The authors of this study hypothesized that family dysfunction would be a good predictor of a childhood ADHD diagnosis and the strength of prediction would be increased for a child suffering from ADHD and other neurodevelopmental disorders. The data did not support this hypothesis; therefore, the direction of causality could not be deduced. The family dysfunction problems associated with child ADHD were difficulty...
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