Modifiers of long-term school outcomes for children with attention-deficit/hyperactivity disorder: Does treatment with stimulant medication make a difference? Results from a population-based study
Modifiers of long-term school outcomes for children with attention-deficit/hyperactivity disorder: Does treatment with stimulant medication make a difference? Results from a population-based study
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DOI：
10.1097/dbp.0b013e3180cabc28
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发表时间：
2007-08-01
影响因子：
2.4
通讯作者：
Jacobsen, Steven J.
中科院分区：
文献类型：
--
作者：
Barbaresi, William J.;Katusic, Slavica K.;Jacobsen, Steven J.
目的：本研究的目的是描述多动症（AD/HD）儿童长期学业结果的潜在修饰因素的意义，包括兴奋剂药物治疗。方法：研究对象包括370名研究确定的AD/HD儿童，来自1976-1982年以人口为基础的出生队列（N = 5718）。在一项配套研究中，研究人员回顾了每个受试者的完整学校记录，以获取阅读成绩、缺勤、成绩保留和辍学的信息。从所有受试者的医疗和学校记录中收集了兴奋剂类型、剂量、开始治疗时的年龄和开始/停止日期的数据。结果：兴奋剂治疗与缺勤率降低有关；治疗时间越长，缺勤率也越低。平均每日兴奋剂剂量与最后一次阅读评分之间存在适度正相关（r = 0.15, p = 0.012）。使用兴奋剂治疗的病例随后保留等级的可能性降低1.8倍（95%置信区间：1.01 -3.2;p = 0.047）。治疗组和未治疗组的辍学率相似（22.2% vs 25.8%,p = 0.54）。其他可能影响学业成绩的因素（社会人口风险因素、共病学习或精神障碍的存在以及接受特殊教育服务）也被检查并发现与较差的学业成绩有关。结论：在这个出生队列中，AD/HD儿童的兴奋剂治疗与阅读成绩的提高、缺勤率的降低和成绩保持率的降低有关。这项研究为确保患有AD/HD的儿童得到适当的长期治疗提供了支持。
Objective: The purpose of this study was to describe the significance of potential modifiers of long-term school outcomes among children with attention-deficit/hyperactivity disorder (AD/HD), including treatment with stimulant medication. Methods: Subjects included 370 children with research-identified AD/HD from a 1976-1982 population-based birth cohort (N = 5718). in a companion study, the complete school record for each subject was reviewed to obtain information on reading achievement, absenteeism, grade retention, and school dropout. Data on type of stimulant, dose, age at initiation of treatment, and start/stop dates were collected from medical and school records, available for all subjects. Results: Treatment with stimulants was associated with decreased rates of absenteeism; longer duration of treatment was also associated with decreased absenteeism rates. There was a modest positive correlation (r = .15, p = .012) between average daily stimulant dose and last reading score. Cases treated with stimulants were 1.8 times less likely to subsequently be retained a grade (95% confidence interval: 1.01 -3.2; p = .047). The proportion of school dropout was similar between treated and not treated cases (22.2% vs 25.8%,p = .54). Other potential modifiers of school outcomes (sociodemographic risk factors, presence of comorbid learning or psychiatric disorders, and receipt of special educational services) were also examined and found to be associated with poorer outcomes. Conclusions: In this birth cohort, stimulant treatment of children with AD/HD was associated with improved reading achievement, decreased school absenteeism, and decreased grade retention. This study provides support for efforts to ensure that children with AD/HD receive appropriate long-term medical treatment.