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Kids Taking ADHD Medication Fared Worse in School Than Their Peers

Treatment doesn’t prevent children with ADHD — particularly girls — from struggling and dropping out of school.




May 12, 2017

Medication helps children with ADHD manage impulsivity and distractibility, but it’s not a cure-all. Now, a new study finds that, despite medication use, children with ADHD still do poorly in school compared to their peers without ADHD — most likely due to additional special needs or social problems. The study shows that girls struggle even more than boys.

The research, published May 1 in JAMA Pediatrics, looked at a sample of UK-based children between the ages of four and 19 who attended school in Scotland between 2009 and 2013. Of the 766,244 children involved in the study, just 1 percent — or 7,413 children —took ADHD medication. This is likely due to the fact that medication is not recommended as a first-line treatment in the UK. About 85 percent of the children taking ADHD medications were boys, the researchers said.

Even after adjusting for several possibly confounding factors, the researchers determined that the children taking ADHD medication were still much more likely than children without ADHD to get poor grades — boys were three times as likely, while girls were five times as likely. Both genders were at an increased risk of dropping out of school; about 64 percent of the students taking ADHD medication dropped out before they turned 16, compared to just 28 percent of their neurotypical peers. Of these, boys were 40 percent more likely to be unemployed six months after dropping out; girls were 59 percent more likely.

Since ADHD medication is rarely used in the UK, it’s likely that the children in the study had more severe ADHD to begin with, the researchers said, which could have contributed to the negative outcomes. But the magnified struggles of the children in the study — particularly the girls — even after they received treatment was still disturbing, the researchers said.

“Fewer girls are treated for ADHD, but when girls are diagnosed they fare worse than boys with ADHD,” said senior study author Dr. Jill Pell, of the University of Glasgow in Scotland. “Having ADHD had a bigger effect on girls than boys in terms of having special education needs, being excluded from school, doing worse on exams, being unemployed, and needing to be admitted to the hospital.”

The study adds to recent findings from the Multimodal Treatment of Attention Deficit Hyperactivity Disorder (MTA) study that showed that over the long-term, ADHD medication may not always have a positive effect. (To put that study in perspective, see “The Latest MTA Study in Context.”)

“Childhood ADHD leads to a host of negative outcomes later in life,” said Dr. William Pelham, director of the Center for Children and Families at Florida International University in Miami, who was not involved in the study. “Interventions that help with the three major domains that predict later functioning — parenting, peer relationships, and academic success — need to be used.”

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