ADHD medication can improve math and reading scores, study suggests
| 27 April 2009
BERKELEY — Pediatricians and educators have long known that psycho-stimulant medications can help children with Attention Deficit Hyperactivity Disorder (ADHD) concentrate on learning for short periods of time. But a new study from the University of California, Berkeley, has found evidence that grade schoolers with ADHD who take medications can actually improve their long-term academic achievement, and make greater gains in standardized math and reading scores than students with ADHD who do not take medications.
"Our study found that the children with ADHD who used the medication were several months ahead of their non-medicated peers in reading and math, which is significant because early progress in school is critical to ongoing academic success," said Richard Scheffler, distinguished professor of health economics and public policy at UC Berkeley's School of Public Health and director of the campus's Nicholas C. Petris Center on Health Care Markets and Consumer Welfare.
The study is published in the May issue of the journal Pediatrics.
ADHD is characterized by poor concentration, distractibility, hyperactivity, impulsiveness and other symptoms that are age-inappropriate. If untreated, it can result in learning difficulties, volatile peer relationships and poor organizational skills. Through standardized math and reading achievement scores, the study tracked the academic gains of nearly 600 U.S. children from kindergarten through the 5th grade who were diagnosed with ADHD. It then compared the scores of the students who were on ADHD medications with their non-medicated peers.
Researchers analyzed data from the U.S. Education Department's Early Childhood Longitudinal Study that included the academic progress of U.S. elementary school students from 1998-99 as well as information on each child's family and medical background. With this data, researchers were able to track six years of academic progress in the children diagnosed with ADHD.
The study found that students with ADHD who were on medication made gains in math that equated to about one-fifth of a school year, as well as gains in reading that were equivalent to the progress typically made in one-third of a school year. Reading improvements were noted in students who had been medicated for at least two rounds of the survey.
Scheffler co-authored the study along with UC Berkeley psychologist and Psychology Department chair Stephen Hinshaw; Susan Stone, associate professor of social welfare at UC Berkeley; Dr. Peter Levine, a pediatrician with Kaiser Permanente in Walnut Creek; Timothy Brown, associate director of research at the Petris Center; and Brent Fulton, a health services researcher at the Petris Center. The study was funded by the National Institute of Mental Health.
"After many years of short-term research in lab settings, it was time to move into the
real world and study kids with ADHD on actual achievement tests," said Hinshaw, an expert on psychopathology in children and adolescents who runs summer research programs and long-term follow-up studies for girls and boys with ADHD.
Researchers note, however, that psycho-stimulant medications alone cannot close the learning gap between children with and without ADHD. "Medication may help the child to focus and prepare for learning. But there is no substitute for a sound curriculum and clear expectations for student achievement. Without these, medications alone cannot work, Hinshaw said.
More than 4 million children in the United States have been diagnosed with ADHD. Compared to their non-ADHD peers, children with ADHD suffer lower grades and achievement scores, and higher dropout rates, the study points out. To help with attention and focus, just over half of them use medications such as methylphenidate and dextroamphetamine, which go by such trade names as Ritalin, Concerta and Adderall.
"As a clinician who sees many children with ADHD, I find it very encouraging to see these results," said Levine. "We know these medications help in school in the short term, and now we have evidence for long-term benefits, as measured by standardized math and reading scores."
While previous studies have shown that medication boosts the kind of attention and short-term memory needed for quizzes and other school exercises, very little is known about the effects of these drugs on long-term academic achievement. The current study repeatedly examined children throughout elementary school and used well-calibrated, standardized achievement tests.
These findings potentially could spur substantial gains in the academic achievement of children with ADHD, particularly among minority and low-income children, who tend to be medicated at rates below those of their white, middle-class peers.
"Access to ADHD medications is an important issue for low-income and minority children because they are more likely to be uninsured," said Scheffler. "In addition, a lack of knowledge about ADHD and treatment options, as well cultural differences, can serve as barriers for the families of these children."
The authors also point to the need for more research on how medication - in combination with treatments such as behavioral interventions and targeted school curriculums - can improve the academic achievement of children with ADHD.