Functional Status in Children With ADHD at Age 6–8: A Controlled Community Study

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Children who have attentiondeficit/hyperactivity disorder (ADHD) attending clinical services have poorer outcomes in adolescence on a range of measures. However, it is unknown how early in development these impairments appear, particularly for community-ascertained samples.WHAT THIS STUDY ADDS: At age 6 to 8 years, children in the community with ADHD have significantly poorer mental health, academic performance and social function compared with control children. Children who have impairing ADHD symptoms should be referred early for assessment and intervention. abstract OBJECTIVES: To examine the functional status (mental health, academic performance, peer problems) of a community-based sample of children who have attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls, and to investigate gender and subtype differences. METHODS:Children aged 6 to 8 years were recruited through 43 Melbourne schools, using a 2-stage screening (parent and teacher Conners 3 ADHD index) and case confirmation (Diagnostic Interview Schedule for Children, Version IV; [DISC-IV]) procedure. Outcome measures were mental health disorders (DISC-IV), academic performance (Wide Range Achievement Test 4), and peer problems (Strength and Difficulties Questionnaire). Unadjusted and adjusted linear and logistic regression were used to compare ADHD and non-ADHD controls.RESULTS: A total of 179 children who have ADHD and 212 non-ADHD controls were recruited. Compared with controls, children who had ADHD had higher odds of externalizing (odds ratio [OR], 11.0; 95% confidence interval [CI], 5.6-21.6; P , .001) and internalizing (OR, 2.9; 95% CI, 1.2-7.2; P = .02) disorders; poorer reading (effect size, 20.66) and mathematics (effect size, 20.69) performance; and more peer problems (P , .001). Boys and girls who had ADHD were equally impaired. Only 17% of children in our ADHD group had been previously diagnosed. Previous diagnosis was higher in the Combined group and for boys. CONCLUSIONS:In their second year of school, children who had ADHD performed worse than controls across all functional domains, yet only a minority had been formally diagnosed with ADHD. Findings highlight the need for earlier diagnosis and intervention. Pediatrics 2014;134: e992-e1000 Dr Efron conceptualized and designed the study and drafted the initial manuscript; Dr Sciberras contributed to the conception and design of the study, carried out the analyses, reviewed and revised the manuscript, and provided critical input; Drs Anderson and Hazell contributed to the conception and design of the study, reviewed and revised the manuscript, and provided critical input; Dr Ukoumunne contributed to the conception and design of the study, reviewed and revised the manuscript, and provided statistical input; Dr Jongeling contributed to the conception and design of the study and reviewed and revised the manuscript; Mr Bisset and Ms Schilpzand coordinated the study, collected study data, and reviewed and revised the manuscript; Dr Nicholson contrib...

Comorbidity and correlates of disruptive mood dysregulation disorder in 6–8-year-old children with ADHD

“…Although previous research has found an association between parental mental health and irritability [37], we found little evidence of an association between parent mental health and DMDD status in our study. In the current sample, children with ADHD had parents with poorer mental health compared to non-ADHD controls [17]. Thus, it may be that DMDD does not add to the burden experienced by these already impaired families.…”

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Service use in children aged 6–8 years with attention deficit hyperactivity disorder

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Contribuição de múltiplos informantes para avaliação comportamental de adolescentes com queixas de desatenção e hiperatividade

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