Timing Of ADHD Medication Impacts Academic Performance
June 26, 2012

Timing Of ADHD Medication Impacts Academic Performance

Connie K. Ho for redOrbit.com

Timing can affect everything. This is a theme pursued by scientists who studied children with attention-deficit/hyperactivity disorder (ADHD).

A team of researchers recently found a connection between the ages of at which children with ADHD began taken medication and how they performed on standardized exams, particularly in the area of math.

The study, titled “A Population-Based Study of Stimulant Drug Treatment of ADHD and Academic Progress in Children,” was completed by investigators from Mount Sinai School of Medicine and the University of Iceland. The report is published in the July 2012 edition of Pediatrics.

"Their short-term efficacy in treating the core symptoms of ADHD -- the symptoms of hyperactivity and attention and impulsivity -- that has been established," noted Helga Zoega, the lead author on the new study from the Mount Sinai School of Medicine in New York, in a Reuters Health article. "With regard to more functional outcomes, for example academic performance or progress, there's not as much evidence there as to whether these drugs really help the kids academically in the long term."

The scientists utilized data from the Icelandic Medicines Registry and the Database of National Scholastic Examinations to study 11,872 Icelandic children who were born between 1994 and 1996. These children began to take medication for ADHD at various times between fourth and seventh grades.

"Children who began taking medications immediately after their fourth-grade standardized tests showed the smallest declines in academic performance," explained Zoega, also a Post Doctoral Fellow of Epidemiology at Mount Sinai's Institute for Translational Epidemiology, in a prepared statement. "The effect was greater in girls than boys and also greater for children who did poorly on their fourth grade test."

The results show that children who started drug treatment within 12 months of their fourth-grade test had 0.3 percent lower math scores by the time they took the test again in seventh grade. Children who started medication for ADHD 25 to 36 months after the fourth grade showed a decline of 9.4 percent in math scores. In terms of gender, girls benefited only in math while boys had benefits in both math and language arts.

According to ABC News, ADHD is a development disorder that includes erratic behaviors and difficulties in focusing. The U.S. Centers for Disease Control Prevention (CDC) reported that, since 2007, 5.4 million children between the ages of 4 and 17 have been diagnosed with ADHD and 66 percent stated that they were taking medication to help treat their symptoms. Stimulants, such as Concerta, Ritalin, and Vyvanse are used in the United States as an option to treat hyperactivity, inattention, and impulsivity related to ADHD. Other treatments for ADHD include behavioral intervention, education plans, and parental training; many times, intervention may be the first step before medication.

"Although ADHD medications do not make a child smarter, they do improve those target symptoms that can hinder academic performance and progress, namely distractibility, attentional weaknesses, and impulsivity," remarked Dr. Stefani Hines, the director of the center for human development at Beaumont Children's Hospital in Royal Oak, in the ABC News article.

Some in the mental health arena believe that parents generally seek stimulants to help their children who have ADHD stay out of trouble in school and to do better academically.

"There are obvious benefits of getting started sooner rather than later," commented J. Russell Ramsay, a researcher who examines ADHD at the University of Pennsylvania´s Perelman School of Medicine and is unaffiliated with the study, in the Reuters Health article. "Especially if students are struggling later on, this study would suggest it may be at the very least useful to explore and consider certain treatment options."

According to Reuters Health, the investigators states that they didn´t have data regarding the kids´ exact ADHD diagnosis or the level of ADHD. They also weren´t able to gather if behavioral treatment or extra school assistance benefited the students along the stimulants. They believe that there are other options besides medication.

"Not all kids need medication," Zoega told Reuters Health. "It's important to think about whether alternative treatment options, whether earlier intervention with those could have a beneficial effect."

Furthermore, there are few results that look at long-term effects of stimulant use and academic performance and this study is a step in that direction.

"At a time when medication for ADHD is under considerable controversy and scrutiny, I think it's important to note that there aren't just improvements in terms of ADHD symptoms, but here's further proof that there's some benefit academically," explained Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center in New York, in a WebMD article.