Mayo Clinic Study Indicates Medication For AD/HD May Help Student Outcomes

In an
18-year-study on attention-deficit/hyperactivity disorder (AD/HD), Mayo
Clinic researchers found that treatment with prescription stimulants is
associated with improved long-term academic success of children with AD/HD.
The Mayo Clinic results are the first population-based data to show
stimulant drug therapy helps improve long-term school outcomes.



A related Mayo Clinic study reveals that compared to children without
AD/HD, children with AD/HD are at risk for poor long-term school outcomes
such as low achievement in reading, absenteeism, repeating a grade, and
dropping out of school. Both studies appear in the current edition of the
Journal of Development & Behavioral Pediatrics, (jrnldbp).



Nearly 2 million children, or approximately 3 percent to 5 percent of
young children in the United States, have AD/HD. This disorder affects a
child's ability to focus, concentrate and control impulsive behavior
(nimh.nih.gov/publicat/adhd.cfm). This disorder is so common
that most school classrooms have at least one child with
clinically-diagnosed AD/HD.



"In this study, treatment with stimulant medication during childhood
was associated with more favorable long-term school outcomes," explains
William Barbaresi, M.D., Mayo Clinic pediatrician and lead author of the
reports.



Significance of the Mayo Clinic Studies



The two Mayo Clinic studies are the first population-based, long-term
studies to investigate links between AD/HD, school performance and factors
that modify long-term school performance of children with AD/HD.
Researchers followed the children from the time they were born for, on
average, 18 years. Of the more than 5,000 children evaluated, 370 (277 boys
and 93 girls) were identified as having AD/HD. Researchers matched them by
age and gender to 740 children who did not meet the research criteria for
having AD/HD. In addition to medical stimulants such as methylphenidate,
also called Ritalin, the study examined the effects on school outcomes of
maternal age, socioeconomic background, and special education services the
students received.



School Outcome Results At a Glance



The children treated with stimulants typically began taking medication
in elementary school and received it for nearly three years -- on average,
for 30.4 months. Results indicate:



Gender: Girls and boys with untreated AD/HD were equally vulnerable to
poor school outcomes -- and girls may be at risk for being under-identified
as having AD/HD, and therefore undertreated.



Reading: By age 13, on average, stimulant dose was modestly correlated
with improved reading achievement scores.
















Absenteeism: Both treatment with stimulants and longer duration of
medication were associated with decreased absenteeism.



Grade Retention: Children with AD/HD who were treated with stimulants
were 1.8 times less likely to be retained a grade than children with AD/HD
who were not treated.



Implications for Parents and Caregivers




Dr. Barbaresi believes that both studies provide the first solid
evidence of the long-term negative academic performance associated with
untreated AD/HD -- as well as evidence for the best way to manage this
problem. Dr. Barbaresi says, "The finding that treatment with stimulant
medications is associated with long-term improvement in school outcomes is
significant. Previously, there was evidence that treatment with stimulant
medications improved short-term academic performance, but there was no good
evidence that long-term outcomes are better with stimulant treatment. Our
data can guide clinicians in their efforts to help children with AD/HD
succeed in school."



About the Studies



The Mayo Clinic team had a unique ability to identify groups of
children with and without AD/HD. Mayo Clinic has maintained a comprehensive
communitywide medical records database since 1935, and researchers had
access to all conditions, diagnoses and treatments the children received.
In addition, Mayo obtained a research agreement with Independent School
District #535, Rochester, Minn., including public and private schools, to
access non-identifiable school records of all children born in Rochester
between Jan. 1, 1976 and Dec. 31, 1982. This enabled researchers to
correlate school performance of both children with and without AD/HD in
terms of medical conditions, maternal age, socioeconomic status and special
education efforts.



Collaboration and Support



In addition to Dr. Barbaresi, the Mayo Clinic research team also
included Slavica Katusic, M.D.; Robert Colligan, Ph.D.; Amy Weaver, M.S.;
and Steven Jacobsen, M.D., Ph.D. Their work was supported by grants from
the U.S. Public Health Service; National Institutes of Health; McNeil
Consumer and Specialty Pharmaceuticals; and Mayo Clinic Foundation for
Biomedical Research.


Mayo Clinic

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