Medication improves academic performance

Mental health problems in childhood can have a negative impact on learning and academic performance, resulting in considerable consequences for later life.

One of these mental health problems is ADHD, which has been associated with a range of short- and long-term negative outcomes including lower academic attainment, an increased use of school-based services, and higher rates of detention and expulsion, among others.

Despite scepticism toward the use of ADHD medication in children, research has consistently shown that medical treatment can reduce ADHD symptoms in individuals aged 6 to 18 years, with over 200 Randomised Control Trials demonstrating positive effects since the 1960s [1]. Importantly, adverse events, including sleep and eating problems or cardiovascular complaints, are commonly reported among individuals who take ADHD medication [2, 3], and little is known about the long-term outcomes on medication on educational achievement in children with ADHD.

A new study…

The recently published study by Keilow, Holm, and Fallsen assessed the effects of pharmacological treatment on long-term academic performance in children with ADHD [4]. The researchers utilised data from Danish administrative registers collected by Statistics Denmark. Grade Point Average (GPA) and teacher-evaluated academic performance data from 2659 individuals who had started medical treatment for ADHD between the ages of 12 and prior to their final compulsory exams were included.

These were further divided into three groups: Continued Pharmacological Treatment (CPT) – individuals who purchased medication on a regular basis, Discontinued Pharmacological Treatment (DPT) – individuals who purchased medication for a maximum of three months only, and Ambiguous Pharmacological Treatment (APT) – individuals who could not be classed as CPT or DPT. An additional group of 3785 individuals with ADHD who commenced treatment after taking their final compulsory exams were also included for comparability purposes.

What were their findings?

Analyses revealed poorer GPA and teacher-evaluated academic performance in both DPT and APT groups, relative to the CPT group. Importantly, there were no differences between CPT, DPT, and APT in those who had commenced treatment after taking their final exams. The authors propose that the findings are therefore not due to selection bias, but rather, reveal a causal link between regular pharmacological treatment and improved academic performance.

Importantly, academic performance has been positively associated with improved long-term outcomes, including higher employment and income rates. Taken together, the findings support the notion that efficient pharmacological treatment has beneficial effects on long-term educational achievement in children with ADHD.

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[1] Vaughan, B. S., March, J. S., & Kratochvil, C. J. (2012). The evidence-based pharmacological treatment of paediatric ADHD. International Journal of Neuropsychopharmacology, 15(1), 27-39. doi: 10.1017/S1461145711000095
[2] Graham, J., Banaschewski, T., Buitelaar, J., Coghill, D., Danckaerts, M., Dittmann, R. W., … & Taylor, E. (2011). European guidelines on managing adverse effects of medication for ADHD. European Child and Adolescent Psychiatry, 20(1), 17-37.
[3] Hammerness, P. G., Perrin, J. M., Shelley-Abrahamson, R., & Wilens, T. E. (2011). Cardiovascular risk of stimulant treatment in pediatric attention-deficit/hyperactivity disorder: update and clinical recommendations. Journal of the American Academy of Child and Adolescent Psychiatry, 50(10). 978-990.
[4] Keilow, M., Holm, A., & Fallesen, P. (2018). Medical treatment of Attention Deficit/Hyperactivity Disorder (ADHD) and children’s academic performance. PLoS One, 13(11). doi: 10.1371/journal.pone.0207905

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