Department of Education and Human Services, Lehigh University, 111 Research Drive, Bethlehem, PA, 18015, USA.
Pennsylvania State University, State College, PA, USA.
J Abnorm Child Psychol. 2018 Jul;46(5):979-992. doi: 10.1007/s10802-017-0344-z.
We examined trajectories of academic and social functioning in children with attention-deficit/hyperactivity disorder (ADHD) to identify those who might be at risk for especially severe levels of academic and social impairment over time. We estimated a series of growth mixture models using data from two subsamples of children participating in the NIMH Collaborative Multisite Multimodal Treatment Study of Children with ADHD (MTA) including those with at least baseline and 96-month data for reading and mathematics achievement (n = 392; 77.3% male; M age = 7.7; SD = 0.8) or social skills ratings from teachers (n = 259; 74.9% male; M age = 7.6; SD = 0.8). We compared latent trajectories for children with ADHD to mean observed trajectories obtained from a local normative (i.e., non-ADHD) comparison group (n = 289; 80.6% male; M age = 9.9; SD = 1.1). Results indicated six latent trajectory classes for reading and mathematics and four classes for teacher social skills ratings. There was not only a relationship between trajectories of inattention symptoms and academic impairment, but also a similarly strong association between trajectory classes of hyperactive-impulsive symptoms and achievement. Trajectory class membership correlated with socio-demographic and diagnostic characteristics, inattention and hyperactive-impulsive symptom trajectories, externalizing behavior in school, and treatment receipt and dosage. Although children with ADHD display substantial heterogeneity in their reading, math, and social skills growth trajectories, those with behavioral and socio-demographic disadvantages are especially likely to display severe levels of academic and social impairment over time. Evidence-based early screening and intervention that directly address academic and social impairments in elementary school-aged children with ADHD are warranted. The ClinicalTrials.gov identifier is NCT00000388.
我们研究了注意缺陷多动障碍（ADHD）儿童的学业和社会功能轨迹，以确定那些随着时间的推移可能面临严重学业和社会功能障碍的风险的儿童。我们使用来自参加 NIMH 合作多地点多模式治疗 ADHD 儿童研究（MTA）的两个子样本的数据，估计了一系列增长混合模型，这些数据包括至少有基线和 96 个月阅读和数学成绩数据的儿童（n=392；77.3%为男性；平均年龄=7.7；标准差=0.8）或教师社会技能评分数据（n=259；74.9%为男性；平均年龄=7.6；标准差=0.8）。我们将 ADHD 儿童的潜在轨迹与从当地正常（即非 ADHD）对照组获得的平均观察轨迹（n=289；80.6%为男性；平均年龄=9.9；标准差=1.1）进行比较。结果表明，阅读和数学有六个潜在轨迹类别，教师社会技能评分有四个类别。不仅注意缺陷症状的轨迹与学业障碍之间存在关系，而且多动冲动症状的轨迹类别与成绩之间也存在同样强烈的关联。轨迹类别与社会人口统计学和诊断特征、注意缺陷和多动冲动症状轨迹、学校外化行为以及治疗的接受和剂量相关。尽管 ADHD 儿童在阅读、数学和社会技能的发展轨迹上存在显著的异质性，但那些具有行为和社会人口统计学劣势的儿童随着时间的推移，尤其可能出现严重的学业和社会功能障碍。有必要对小学年龄的 ADHD 儿童进行基于证据的早期筛查和干预，直接解决他们的学业和社会功能障碍问题。该研究的 ClinicalTrials.gov 标识符是 NCT00000388。
