A population-based study of stimulant drug treatment of ADHD and academic progress in children
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A population-based study of stimulant drug treatment of ADHD and academic progress in children. / Zoëga, Helga; Rothman, Kenneth J; Huybrechts, Krista F; Ólafsson, Örn; Baldursson, Gísli; Almarsdóttir, Anna B; Jónsdóttir, Sólveig; Halldórsson, Matthías; Hernández-Diaz, Sonia; Valdimarsdóttir, Unnur A.
I: Pediatrics, Bind 130, Nr. 1, 07.2012, s. e53-62.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - A population-based study of stimulant drug treatment of ADHD and academic progress in children
AU - Zoëga, Helga
AU - Rothman, Kenneth J
AU - Huybrechts, Krista F
AU - Ólafsson, Örn
AU - Baldursson, Gísli
AU - Almarsdóttir, Anna B
AU - Jónsdóttir, Sólveig
AU - Halldórsson, Matthías
AU - Hernández-Diaz, Sonia
AU - Valdimarsdóttir, Unnur A
PY - 2012/7
Y1 - 2012/7
N2 - OBJECTIVE: We evaluated the hypothesis that later start of stimulant treatment of attention-deficit/hyperactivity disorder adversely affects academic progress in mathematics and language arts among 9- to 12-year-old children.METHODS: We linked nationwide data from the Icelandic Medicines Registry and the Database of National Scholastic Examinations. The study population comprised 11,872 children born in 1994-1996 who took standardized tests in both fourth and seventh grade. We estimated the probability of academic decline (drop of ≥ 5.0 percentile points) according to drug exposure and timing of treatment start between examinations. To limit confounding by indication, we concentrated on children who started treatment either early or later, but at some point between fourth-grade and seventh-grade standardized tests.RESULTS: In contrast with nonmedicated children, children starting stimulant treatment between their fourth- and seventh-grade tests were more likely to decline in test performance. The crude probability of academic decline was 72.9% in mathematics and 42.9% in language arts for children with a treatment start 25 to 36 months after the fourth-grade test. Compared with those starting treatment earlier (≤ 12 months after tests), the multivariable adjusted risk ratio (RR) for decline was 1.7 (95% confidence interval [CI]: 1.2-2.4) in mathematics and 1.1 (95% CI: 0.7-1.8) in language arts. The adjusted RR of mathematics decline with later treatment was higher among girls (RR, 2.7; 95% CI: 1.2-6.0) than boys (RR, 1.4; 95% CI: 0.9-2.0).CONCLUSIONS: Later start of stimulant drug treatment of attention-deficit/hyperactivity disorder is associated with academic decline in mathematics.
AB - OBJECTIVE: We evaluated the hypothesis that later start of stimulant treatment of attention-deficit/hyperactivity disorder adversely affects academic progress in mathematics and language arts among 9- to 12-year-old children.METHODS: We linked nationwide data from the Icelandic Medicines Registry and the Database of National Scholastic Examinations. The study population comprised 11,872 children born in 1994-1996 who took standardized tests in both fourth and seventh grade. We estimated the probability of academic decline (drop of ≥ 5.0 percentile points) according to drug exposure and timing of treatment start between examinations. To limit confounding by indication, we concentrated on children who started treatment either early or later, but at some point between fourth-grade and seventh-grade standardized tests.RESULTS: In contrast with nonmedicated children, children starting stimulant treatment between their fourth- and seventh-grade tests were more likely to decline in test performance. The crude probability of academic decline was 72.9% in mathematics and 42.9% in language arts for children with a treatment start 25 to 36 months after the fourth-grade test. Compared with those starting treatment earlier (≤ 12 months after tests), the multivariable adjusted risk ratio (RR) for decline was 1.7 (95% confidence interval [CI]: 1.2-2.4) in mathematics and 1.1 (95% CI: 0.7-1.8) in language arts. The adjusted RR of mathematics decline with later treatment was higher among girls (RR, 2.7; 95% CI: 1.2-6.0) than boys (RR, 1.4; 95% CI: 0.9-2.0).CONCLUSIONS: Later start of stimulant drug treatment of attention-deficit/hyperactivity disorder is associated with academic decline in mathematics.
KW - Achievement
KW - Age Factors
KW - Amphetamine
KW - Atomoxetine Hydrochloride
KW - Attention Deficit Disorder with Hyperactivity
KW - Central Nervous System Stimulants
KW - Child
KW - Educational Measurement
KW - Female
KW - Humans
KW - Iceland
KW - Language Arts
KW - Male
KW - Mathematics
KW - Methylphenidate
KW - Multivariate Analysis
KW - Odds Ratio
KW - Propylamines
KW - Registries
KW - Sex Factors
KW - Treatment Outcome
KW - Evaluation Studies
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
U2 - 10.1542/peds.2011-3493
DO - 10.1542/peds.2011-3493
M3 - Journal article
C2 - 22732167
VL - 130
SP - e53-62
JO - Pediatrics
JF - Pediatrics
SN - 0031-4005
IS - 1
ER -
ID: 170602193