Our study adds to this research and our results indicate that medical treatment can improve the educational trajectories of children diagnosed with moderate to severe symptoms ADHD. In this section, we present main results estimating Eq (1) on the sample of children diagnosed with ADHD. However, as the results for the placebo sample are almost identical we only show the more statistically efficient estimates with adjustment for selection. If ADHD affects educational outcomes negatively, successful treatment could reduce the negative educational consequences caused by ADHD. Attention Deficit/Hyperactivity Disorder (ADHD) represents one such mental health problem, which infers substantial individual and societal costs if left untreated . Yet, delayed cognitive maturation may not be the only cause driving the relationship between ADHD and low educational achievement. Take-up rates of prescriptions have a social gradient due to economic constraints for poorer families to finance medication consistently, and at-risk families may be less inclined to follow medical advice or to comply with medical treatment despite negative side effects. The regression coefficient γ1 measures the average difference in outcomes between those continuing medication (CPT) and those discontinuing medication (DPT) from the onset of diagnosis and until completing compulsory school, where GPA is measured. However, for differences in background characteristics to be important confounding factors, background characteristics should both correlate with the allocation into treatment patterns and simultaneously have a direct effect on the GPA outcomes . Hence, it is unlikely that the differences in estimated effects with and without controls are important for comparing the differences between DPT, APT and CPT across the treatment and placebo sample. We use Danish administrative register data to study the impact of medical treatment of ADHD on children’s academic performance assessed by student grade point average (GPA). Citation: Keilow M, Holm A, Fallesen P (2018) Medical treatment of Attention Deficit/Hyperactivity Disorder (ADHD) and children’s academic performance. Recent work has further shown that both externalizing behaviors and attention deficits contribute to the lower educational attainment . The neurobiological findings dovetail with studies of educational performance among children with ADHD, which find that both inattention and externalizing behavior predicts worse educational outcomes [5,7,28–30]. All empirical models use GPAs standardized within the population sample. Warren, Stephen 2008. and The effect thus both depends on the effectiveness of the medication (generating a difference between those with an ambiguous and a continuous medical consumption) and it depends on the distribution of the ambiguous treatment patterns in the data. https://doi.org/10.1371/journal.pone.0207905, Editor: Nouchine Hadjikhani, Harvard Medical School, UNITED STATES, Received: April 17, 2017; Accepted: November 8, 2018; Published: November 29, 2018. To test whether a causal interpretation of the results is plausible and to account for any social gradient in treatment patterns, we estimate the effect of treatment with and without a rich set of potential confounders and perform placebo regressions on a sample of children, who initiate medical treatment after graduation (i.e. Data on any comorbid diagnoses are not, however, available. Attention Deficit/Hyperactivity Disorder (ADHD) is negatively associated with a range of academic achievement measures. We find significant effects of treatment on both exam and teacher evaluated GPAs: Compared to consistent treatment, part or full discontinuation of treatment has large significant negative effects reducing teacher evaluation and exam GPA with .18 and .22 standard deviations, respectively. Much of the current research and publications focuses on the biomedical aspects of this disorder and its treatment. No, Is the Subject Area "Schools" applicable to this article? Jung, In-Kwa here. Relative to a decade ago, there has been extensive research into understanding the factors underlying ADHD, leading to far more treatment options available for both adolescents and adults with … evidence for a familial subtype, Attending to adult ADHD: a review of the neurobiology behind adult ADHD, Sense of time in children with ADHD: Effects of duration, Harpin, Valerie Myttas, Nikos  show substantial delay in the maturation of the pre-frontal cortex among children with ADHD. Hence, if controlling for medication dosage alters the estimated effect of treatment continuation this is evidence that severity and continuation are correlated. The RMPS is found to have a high completeness and validity, which is mainly due to reimbursement-driven record-keeping with automated bar-code-based data [40–41]. Full text views reflects the number of PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views. Gudjonsson, Gisli H. Note you can select to send to either the @free.kindle.com or @kindle.com variations. Yang, Jae-Won Had they been different, we should have seen marked differences between the estimates because different selection processes would have yielded different selection bias in the estimated coefficients. To identify medically treated children (irrespective of their subsequent treatment pattern), we select children, who redeem at least one prescription for any type of ADHD medication (methylphenidate, atomoxetine, or modafinil) between age twelve and prior to school-leaving exams (treatment sample). The ROCKWOOL Foundation, Copenhagen, Denmark, One may argue that the placebo sample is not entirely comparable with the treatment sample, as they are diagnosed a considerable time after their exams. 2006. However, selection out of treatment may be an issue. and Unfortunately, many of the symptoms of, So, yes, there are some cases in which children may be on too high of a dose of medication, but a good, 4501 Cartwright Road #102, Missouri City, TX 77459, USA. Poole, Lynne Funding: This work was supported by the Danish Strategic Research Council, grant no.  for a similar design). In our study, we have no selection into treatment as all individuals in our analysis initiate treatment. To further test whether we can view treatment patterns as an exogenous indicator of nonresponse to medical treatment, we use the availability of a placebo treatment group: students, who commence medical treatment after graduation (thus after receiving their grades) and for whom we should expect no treatment effect on their GPA (see Johansen et al. Teacher evaluation GPA reflects students’ academic performance in class as evaluated by the teacher, whereas exam GPA reflects assessments made by the students’ teacher as well as an external examiner during the school-leaving exams (oral and written). The definition of discontinuation (DPT) follows strict restriction rules: we define DPT as having purchased medication for maximum three months within the data window, which just allows for initial medicine trial and dose titration. In sum, we find evidence of a positive effect of medical treatment on school-leaving exam and teacher evaluation GPAs for students diagnosed with ADHD, who enter treatment. Panel A in Table 3 shows estimation results for standardized exam GPA, whereas panel B shows estimation results for standardized teacher evaluation GPA. Although random nonresponse is supported by empirical evidence, drop out from medical treatment in observed data may be nonrandom for a number of other reasons. More recent work by Sripada, Kessler and Angstadt  further renders probable that children with ADHD also experience delayed maturation of deeper parts of the brain’s architecture and pathways, which are associated with attention, control of impulsivity, disregard of irrelevant stimuli, and other cognitive tasks.
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