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Impact of Attention-Deficit Hyperactivity Disorder on School Performance: What are the Effects of Medication?

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Abstract

Attention-deficit hyperactivity disorder (ADHD) affects an estimated 5–7 % of schoolchildren worldwide. School functioning and academic achievement are frequently impaired by ADHD and represent one of the main reasons children start ADHD medication. Multiple potential causal pathways exist between ADHD and impaired school performance. In this review, we decompose school performance into three components and assess the impact of ADHD and its treatments on academic performance (assessed by grade point average [GPA], time on-task, percentage of work completed as well as percent completed correctly), academic skills (as measured by achievement tests and cognitive measures), and academic enablers (such as study skills, motivation, engagement, classroom behavior and interpersonal skills). Most studies examined only the short-term effects of medication on school performance. In these, ADHD medications have been observed to improve some aspects of school performance, with the largest impact on measures of academic performance such as seatwork productivity and on-task performance. In a subset of children, these benefits may translate into detectable improvements in GPA and achievement testing. However, limited data exists to support whether these changes are sustained over years. Optimizing medication effects requires periodic reassessment of school performance, necessitating a collaborative effort involving patients, parents, school staff and prescribers. Even with systematic reassessment, behavioral-based treatments and additional school-based services may be needed to maximize academic performance for the many youth with ADHD and prominent impairments in school performance.

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  1. Department of Psychiatry, Penn State University College of Medicine, 500 University Drive, H073, Hershey, PA, 17033-0850, USA

    Raman Baweja, Richard E. Mattison & James G. Waxmonsky

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  1. Raman Baweja
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Dr. R. Baweja has no conflicts of interest or financial ties to report. Dr. R. Mattison has no conflicts of interest or financial ties to report. In the past 3 years, Dr. J. Waxmonsky has received research funding from NIMH, Shire Pharmaceuticals, and Janssen (drug donation); served on the advisory board for Noven and Ironshore Pharmaceuticals; and served as a speaker for CME talks provided by Quintiles.

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Baweja, R., Mattison, R.E. & Waxmonsky, J.G. Impact of Attention-Deficit Hyperactivity Disorder on School Performance: What are the Effects of Medication?. Pediatr Drugs 17, 459–477 (2015). https://doi.org/10.1007/s40272-015-0144-2

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