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Early Medication May Help Grades in Kids With ADHD

Study Finds Stimulant Medications May Prevent Academic Declines in Children With Attention Deficits
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WebMD Health News

June 25, 2012 -- Kids with attention deficit hyperactivity disorder, or ADHD, struggle in school. Their wandering concentration makes it tough to follow directions, absorb lessons, and finish homework. Now, new research may offer a partial solution.

The large new study funded by the government of Iceland suggests that stimulant medications like Ritalin may help to prevent some of those academic declines.

The study, published in the journal Pediatrics, found that the earlier kids get started on drug treatment, the less their academic performance was likely to suffer between fourth and seventh grades, especially in math. And girls saw a bigger benefit than boys did from early drug treatment.

"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," says Andrew Adesman, MD, chief of developmental and behavioral pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y.

Adesman reviewed the study for WebMD, but was not involved in the research.

Tracking the Effects of Early ADHD Medication on Test Scores

For the study, researchers tracked nearly 12,000 students in Iceland who took standardized tests in the fourth and seventh grades. The tests included sections on math and language skills.

Because Iceland has a national database that records all outpatient prescriptions, researchers were able to see which kids were prescribed medications to treat ADHD and when the kids started their drug treatment.

In total, 286 children began treatment between their fourth- and seventh-grade tests. Nearly all were prescribed methylphenidate, or Ritalin.

Overall, test scores in children without ADHD changed very little between the fourth and seventh grade. They climbed about half a percentage point for math and stayed flat for language arts.

In contrast, kids with ADHD who were prescribed medications during this time saw their scores slip.

However, the study also showed that kids treated for ADHD at a younger age saw a much smaller drop in test scores compared to kids started on medications later. Math test scores dropped an average of .3% when treatment was started within one year of fourth grade. Kids started on treatment more than two years later saw their math scores drop by almost 10%.

The effect of earlier, rather than later medication, was more pronounced in girls than in boys.

"We had not really anticipated the gender differences," researcher Helga Zoega, PhD, tells WebMD. She is a post-doctoral fellow at the Mount Sinai School of Medicine in New York City, and the University of Iceland, in Reykjavik.

Zoega says the gender effects they saw could also reflect the fact that girls with ADHD seem to have more trouble with attention and less hyperactivity than boys with ADHD. And the medication helps them where they are weakest, academically.

Medications seemed to mainly stop the slip of math test scores. Scores on the language arts portion of the test improved slightly, but the change was so small researchers say they can't be certain it wasn't due to chance alone.

"Early intervention and consistent treatment seems to matter for the long-term academic progress in these children with ADHD," Zoega says.

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