Pre-school Hyperactivity Problems and Educational Outcomes in Adolescence


Are young children with behavioural problems and ADHD at risk of poor academic outcomes at 16?

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Authors: Elizabeth Washbrook, Carol Propper, University of Bristol, and Kapil Sayal, University of Nottingham

Published by: The British Journal of Psychiatry, August 2013

SUMMARY

Researchers, funded by the Economic and Social Research Council, set out to investigate whether pre-school children with behavioural problems and issues with inattention and hyperactivity - attention deficit hyperactivity disorder (ADHD) - are at risk of poor academic outcomes at age 16. They wanted to find out whether severe levels of early behaviour problems predict failure to achieve minimum school-leaving qualifications - five A*-C grades at GCSE.

The research team claim their study - Pre-School Hyperactivity/Attention Problems and Educational Outcomes in Adolescence: Prospective Longitudinal Study - is the largest follow-up study of the relationship between pre-school hyperactivity/inattention and conduct problems, and later academic performance. They analysed data from the Avon Longitudinal Study of Parents and Children, which tracks babies born between April 1991 and December 1992. Of those, 13,988 were still part of the study after a year. The children's records were matched to the National Pupil Database, which holds data on GCSE results, available for all children attending publicly-funded state schools. This resulted in a sample of 11,640 children, 83 per cent of the core group.

The researchers assessed pre-school hyperactivity, inattention and conduct problems using the questionnaire completed by parents when children reached 47 months. They took into account factors such as the child's IQ score, gender, and the social class of their parents, as well as the mothers' mental health, which can affect how they rate their child's behaviour.

The study found behavioural problems present at the age of three do have an impact on academic attainment at the age of 16. Boys who displayed high levels of hyperactivity/inattention at 47 months were 33 per cent more likely to not achieve a minimum level of five GCSE grades at A*-C at age 16. Both hyperactivity/inattention and conduct problems were associated with worse academic outcomes for boys. For example, on average, boys with abnormal hyperactivity/inattention scores at 47 months scored 10 fewer points at GCSE level, the equivalent of 1.67 GCSE grades, and boys with abnormal scores for conduct problems scored 15 fewer points, equivalent to 2.5 GCSE grades, than boys with normal scores.

For girls, the effect of conduct problems on educational achievement was comparable to that of boys. Abnormal hyperactivity/inattention scores at an early age had less impact on girls' later educational achievement than that of boys, with these girls scoring four points fewer at GCSE than girls with normal scores.

The researchers point out that GCSE results are also an indicator of future educational and employment paths, and say the consequences of early behavioural difficulties apply across the spectrum of social position and academic ability.

PRACTICE IMPLICATIONS

The researchers say that although there is little evidence that routine screening for ADHD-type problems in early school years is effective, teachers are well-placed to identify young children with high levels of behavioural problems. Teachers should be encouraged to become more aware of the implications of early behavioural difficulties, and to take parental concerns about behaviour seriously.

The researchers also call for health professionals to tell parents and teachers of young children with high levels of hyperactivity/inattention and conduct problems about the long-term academic risks, so that help can be offered at school. Early academic support for children with these difficulties may help reduce the long-term risk of poorer academic outcomes.

FURTHER READING

The Impact of Early Behavior Disturbances on Academic Achievement In High School, J Breslau, E Miller, N Breslau, K Bohnert, V Lucia, J Schweitzer, Pediatrics, June 2009. Researchers assessed children at six for behavioural problems and at 17 years for academic achievement, and concluded interventions that target attention problems at school entry should be tested as a potential avenue for improving educational achievement.

Impact of Early School-based Screening and Intervention Programs for ADHD on Children's Outcomes and Access to Services: Follow-up of a School-Based Trial at Age 10 Years. K Sayal, V Owen, K White, C Merrell, P Tymms, E Taylor, Archives of Paediatric and Adolescent Medicine, May 2010. The researchers looked at the effectiveness of different types of intervention for young children at risk of ADHD.

School Readiness and Later Achievement, GJ Duncan, CJ Dowsett, A Claessens, K Magnuson, AC Huston, P Kiebanov, Developmental Psychology, November 2007. This study found the strongest predictors of later achievement were school-entry maths, reading, and attention skills.

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