Children treated with medication for attention-deficit/hyperactivity disorder during their elementary school years score higher on standardized tests for mathematics and reading, compared with their ADHD peers who are not medicated, data from a longitudinal study of 594 children show.
However, the gains did not close the test-score gap between children with and without the condition, Richard M. Scheffler, Ph.D., of the University of California, Berkeley, and his colleagues reported.
They also noted that children who were medicated for a longer time had reading scores of just over 5 points higher than those of their unmedicated peers. And although they did not find a significant interaction with gender, they did find that the medication-reading association was lower in children with an individualized education program than it was for those with no such program.
ADHD affects about 8% of school-aged children in the United States, of whom about 56% are treated with a prescription medication. The condition is marked by inattention and impulsivity, and by atypical levels of physical activity. This population often also grapples with lower academic achievement, compared with non-ADHD peers, as well as higher grade retention, special education placement, and dropout rates. However, the association between medication use and academic achievement is “largely unknown,” the authors wrote (Pediatrics 2009;123:1272-9).
The investigators drew on data from the Early Childhood Longitudinal Study–Kindergarten Class of 1998-1999 (ECLS-K), which tracks the academic progress of a nationally representative sample of children who attended kindergarten in the United States during that period. The full ECLS-K sample was 8,370, of whom 594 were diagnosed with ADHD. Of those with ADHD, 75% were boys, 71.6% were white, 12.2% black, 11.0% Hispanic, and 1.4% Asian/Pacific islander.
The data were collected at five waves between kindergarten and fifth grade–in the fall and spring of kindergarten and in the spring of the first, third, and fifth grades, over a 6-year period.
Dr. David Fassler, who was not involved with the study, said in an interview that the results are consistent with general clinical experience. However, because of the methodology used, he said, the results should be “interpreted with caution. For example, the authors rely on the parents' reports of both diagnosis and medication,” said Dr. Fassler, a child and adolescent psychiatrist, and clinical professor of psychiatry at the University of Vermont, Burlington. “Nonetheless, I expect the findings will prove somewhat reassuring to parents and physicians evaluating treatment options for children with ADHD.”
The authors reported that they had no relevant disclosures. The study was funded by a grant from the National Institute of Mental Health.