Objective: The aim of this study was to synthesize published data regarding long-term effects of ADHD on information learned (measured via achievement tests) and success within the school environment (academic performance). Method: A systematic search identified 176 studies (1980-2012) of long-term (≥2 years) academic outcomes with ADHD. Results: Achievement test outcomes (79%) and academic performance outcomes (75%) were worse in individuals with untreated ADHD compared with non-ADHD controls, also when IQ difference was controlled (72% and 81%, respectively). Improvement in both outcome groups was associated with treatment, more often for achievement test scores (79%) than academic performance (42%), also when IQ was controlled (100% and 57%, respectively). More achievement test and academic performance outcomes improved with multimodal (100% and 67%, respectively) than pharmacological (75% and 33%) or non-pharmacological (75% and 50%) treatment alone. Conclusion: ADHD adversely affects long-term academic outcomes. A greater proportion of achievement test outcomes improved with treatment compared with academic performance. Both improved most consistently with multimodal treatment.
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
2.
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
3.
AntshelK. M.FaraoneS. V.MaglioneK.DoyleA.FriedR.SeidmanL.BiedermanJ. (2008). Temporal stability of ADHD in the high-IQ population: Results from the MGH longitudinal family studies of ADHD. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 817-825. doi:10.1097/CHI.0b013e318172eecf
4.
AntshelK. M.FaraoneS. V.MaglioneK.DoyleA.FriedR.SeidmanL.BiedermanJ. (2009). Is adult attention deficit hyperactivity disorder a valid diagnosis in the presence of high IQ?Psychological Medicine, 39, 1325-1335. doi:10.1017/s0033291708004959
5.
BanksS. R.GuyerB. P.GuyerK. E. (1995). A study of medical students and physicians referred for learning disabilities. Annals of Dyslexia, 45, 233-245.
6.
Barnard-BrakL.BrakV. (2011). Pharmacotherapy and academic achievement among children with attention-deficit/hyperactivity disorder. Journal of Child and Adolescent Psychopharmacology, 21, 597-603. doi:10.1089/cap.2010.0127
7.
BentalB.TiroshE. (2007). The relationship between attention, executive functions and reading domain abilities in attention deficit hyperactivity disorder and reading disorder: A comparative study. Journal of Child Psychology and Psychiatry, 48, 455-463. doi:10.1111/j.1469-7610.2006.01710.x
8.
BiedermanJ.PettyC. R.BallS. W.FriedR.DoyleA. E.CohenD.. . . FaraoneS. V. (2009). Are cognitive deficits in attention deficit/hyperactivity disorder related to the course of the disorder? A prospective controlled follow-up study of grown up boys with persistent and remitting course. Psychiatry Research, 170, 177-182. doi:10.1016/j.psychres.2008.09.010
9.
BirchwoodJ.DaleyD. (2012). Brief report: The impact of attention deficit hyperactivity disorder (ADHD) symptoms on academic performance in an adolescent community sample. Journal of Adolescence, 35, 225-231. doi:10.1016/j.adolescence.2010.08.011
10.
BreslauN.BreslauJ.PetersonE.MillerE.LuciaV. C.BohnertK.NiggJ. (2010). Change in teachers’ ratings of attention problems and subsequent change in academic achievement: A prospective analysis. Psychological Medicine, 40, 159-166. doi:10.1017/S0033291709005960
11.
ButterworthB.KovasY. (2013). Understanding neurocognitive developmental disorders can improve education for all. Science, 340, 300-305. doi:10.1126/science.1231022
12.
CurrieJ.StabileM.JonesL. E. (2013, June). Do stimulant medications improve educational and behavioral outcomes for children with ADHD? (NBER Working Paper No. 19105). Cambridge, MA: National Bureau of Economic Research.
13.
DennisM.FrancisD. J.CirinoP. T.SchacharR.BarnesM. A.FletcherJ. M. (2009). Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15, 331-343. doi:10.1017/s1355617709090481
14.
DuPaulG. J.GormleyM. J.LaracyS. D. (2013). Comorbidity of LD and ADHD: Implications of DSM-5 for assessment and treatment. Journal of Learning Disabilities, 46, 43-51. doi:10.1177/0022219412464351
15.
DuPaulG. J.WeyandtL. L.O’DellS. M.VarejaoM. (2009). College students with ADHD: Current status and future directions. Journal of Attention Disorders, 13, 234-250. doi:10.1177/1087054709340650
16.
FergussonD. M.HorwoodL. J. (1995). Early disruptive behavior, IQ, and later school achievement and delinquent behavior. Journal of Abnormal Child Psychology, 23, 183-199.
17.
FergussonD. M.HorwoodL. J.LynskeyM. T. (1993). The effects of conduct disorder and attention deficit in middle childhood on offending and scholastic ability at age 13. Journal of Child Psychology and Psychiatry, 34, 899-916.
18.
FergussonD. M.LynskeyM. T.HorwoodL. J. (1997). Attentional difficulties in middle childhood and psychosocial outcomes in young adulthood. Journal of Child Psychology and Psychiatry, 38, 633-644.
19.
FischerM.BarkleyR. A.EdelbrockC. S.SmallishL. (1990). The adolescent outcome of hyperactive children diagnosed by research criteria: II. Academic, attentional, and neuropsychological status. Journal of Consulting and Clinical Psychology, 58, 580-588.
20.
FitzgeraldM.KewleyG. (2005). Attention-deficit/hyperactivity disorder and Asperger’s syndrome?Journal of the American Academy of Child & Adolescent Psychiatry, 44, 210. doi:10.1097/01.chi.0000152633.75570.90
21.
FrazierT. W.YoungstromE. A.GluttingJ. J.WatkinsM. W. (2007). ADHD and achievement: Meta-analysis of the child, adolescent, and adult literatures and a concomitant study with college students. Journal of Learning Disabilities, 40, 49-65.
22.
HigginsJ.GreenS. (2009). Cochrane handbook for systematic reviews of interventions version 5.0.2. Available from www.cochrane-handbook.org
23.
HodgkinsP.CaciH.YoungS.KahleJ.ArnoldL. E. (2013, July). Attention deficit/hyperactivity disorder and psychiatric comorbidities: A systematic review of long-term outcomes. Paper presented at the 15th International Congress of the European Society for Child and Adolescent Psychiatry (ESCAP), Dublin, Ireland.
24.
JeffriesS.EverattJ. (2004). Working memory: Its role in dyslexia and other specific learning difficulties. Dyslexia, 10, 196-214. doi:10.1002/dys.278
25.
KesslerR. C.AdlerL.BarkleyR.BiedermanJ.ConnersC. K.DemlerO.. . . ZaslavskyA. M. (2006). The prevalence and correlates of adult ADHD in the United States: Results from the National Comorbidity Survey Replication. The American Journal of Psychiatry, 163, 716-723. doi:10.1176/appi.ajp.163.4.716
26.
KewleyG. D. (1999). Risperidone in comorbid ADHD and ODD/CD. Journal of the American Academy of Child & Adolescent Psychiatry, 38, 1327-1328. doi:10.1097/0000-4583-199911000-00002
27.
KleinR. G.MannuzzaS.Ramos OlazagastiM. A.Belsky RoizenE.HutchisonJ. A.Lashua-ShriftmanE.CastellanosF. X. (2012). Clinical and functional outcome of childhood ADHD 33 years later. Archives of General Psychiatry, 69, 1295-1303.
28.
LaasonenM.LehtinenM.LeppamakiS.TaniP.HokkanenL. (2010). Project DyAdd: Phonological processing, reading, spelling, and arithmetic in adults with dyslexia or ADHD. Journal of Learning Disabilities, 43, 3-14. doi:10.1177/0022219409335216
29.
LangbergJ. M.ArnoldL. E.FlowersA. M.EpsteinJ. N.AltayeM.HinshawS. P.. . . HechtmanL. (2010). Parent-reported homework problems in the MTA study: Evidence for sustained improvement with behavioral treatment. Journal of Clinical Child & Adolescent Psychology, 39, 220-233. doi:10.1080/15374410903532700
30.
LangbergJ. M.BeckerS. P. (2012). Does long-term medication use improve the academic outcomes of youth with attention-deficit/hyperactivity disorder?Clinical Child and Family Psychology Review, 15, 215-233.
31.
LangbergJ. M.MolinaB. S.ArnoldL. E.EpsteinJ. N.AltayeM.HinshawS. P.. . . HechtmanL. (2011). Patterns and predictors of adolescent academic achievement and performance in a sample of children with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 40, 519-531. doi:10.1080/15374416.2011.581620
32.
LoeI. M.FeldmanH. M. (2007). Academic and educational outcomes of children with ADHD. Journal of Pediatric Psychology, 32, 643-654. doi:10.1093/jpepsy/jsl054
33.
MassettiG. M.LaheyB. B.PelhamW. E.LoneyJ.EhrhardtA.LeeS. S.KippH. (2008). Academic achievement over 8 years among children who met modified criteria for attention-deficit/hyperactivity disorder at 4-6 years of age. Journal of Abnormal Child Psychology, 36, 399-410. doi:10.1007/s10802-007-9186-4
34.
McGrathL. M.PenningtonB. F.ShanahanM. A.Santerre-LemmonL. E.BarnardH. D.WillcuttE. G.. . . OlsonR. K. (2011). A multiple deficit model of reading disability and attention-deficit/hyperactivity disorder: Searching for shared cognitive deficits. Journal of Child Psychology and Psychiatry, 52, 547-557. doi:10.1111/j.1469-7610.2010.02346.x
35.
MerrellC.TymmsP. B. (2001). Inattention, hyperactivity and impulsiveness: Their impact on academic achievement and progress. British Journal of Educational Psychology, 71(Pt. 1), 43-56.
36.
MolinaB. S.HinshawS. P.SwansonJ. M.ArnoldL. E.VitielloB.JensenP. S.. . . HouckP. R. (2009). The MTA at 8 years: Prospective follow-up of children treated for combined-type ADHD in a multisite study. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 484-500. doi:10.1097/CHI.0b013e31819c23d0
37.
MurphyK.BarkleyR. A. (1996). Attention deficit hyperactivity disorder adults: Comorbidities and adaptive impairments. Comprehensive Psychiatry, 37, 393-401.
ParkS.ChoM. J.ChangS. M.JeonH. J.ChoS.-J.KimB.-S.. . . HongJ. P. (2011). Prevalence, correlates, and comorbidities of adult ADHD symptoms in Korea: Results of the Korean epidemiologic catchment area study. Psychiatry Research, 186, 378-383. doi:10.1016/j.psychres.2010.07.047
40.
ParkerJ.WalesG.ChalhoubN.HarpinV. (2013). The long-term outcomes of interventions for the management of attention-deficit hyperactivity disorder in children and adolescents: A systematic review of randomized controlled trials. Psychology Research and Behavioral Management, 6, 87-99. doi:10.2147/PRBM.S49114
41.
RaggiV.ChronisA. (2006). Interventions to address the academic impairment of children and adolescents with ADHD. Clinical Child and Family Psychology Review, 9, 85-111.
42.
SatterfieldJ. H.SatterfieldB. T.CantwellD. P. (1981). Three-year multimodality treatment study of 100 hyperactive boys. Journal of Pediatrics, 98, 650-655.
43.
SchefflerR. M.BrownT. T.FultonB. D.HinshawS. P.LevineP.StoneS. (2009). Positive association between attention-deficit/hyperactivity disorder medication use and academic achievement during elementary school. Pediatrics, 123, 1273-1279. doi:10.1542/peds.2008-1597
44.
ShawM.HodgkinsP.CaciH.YoungS.KahleJ.WoodsA. G.ArnoldL. E. (2012). A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: Effects of treatment and non-treatment. BMC Medicine, 10, Article 99.
45.
Sonuga-BarkeE. J.DalenL.DaleyD.RemingtonB. (2002). Are planning, working memory, and inhibition associated with individual differences in preschool ADHD symptoms?Developmental Neuropsychology, 21, 255-272.
46.
TymmsP.MerrellC. (2006). The impact of screening and advice on inattentive, hyperactive and impulsive children. European Journal of Special Needs Education, 21, 321-337. doi:10.1080/08856250600810856
47.
WagnerM.NewmanL.CametoR.LevineP. (2006). The academic achievement and functional performance of youth with disabilities: A Report From the National Longitudinal Transition Study–2 (NLTS2). Retrieved from http://ies.ed.gov/ncser/pdf/20063000.pdf
48.
WeithornC. J.MarcusM. (1985). High-active children and achievement tests: A two-year follow-up. Psychology in the Schools, 22, 449-458.
49.
YoungS.ChadwickO.HeptinstallE.TaylorE.Sonuga-BarkeE. J. (2005). The adolescent outcome of hyperactive girls: Self-reported interpersonal relationships and coping mechanisms. European Child & Adolescent Psychiatry, 14, 245-253. doi:10.1007/s00787-005-0461-z
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