European Child & Adolescent Psychiatry

, Volume 22, Issue 4, pp 203–216

How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis


    • University of Nottingham
  • Ellen Brogan
    • University of Nottingham
  • Caroline Mulvaney
    • University of Nottingham
  • Matthew Grainge
    • University of Nottingham
  • Wendy Stanton
    • University of Nottingham
  • Kapil Sayal
    • University of Nottingham

DOI: 10.1007/s00787-012-0346-x

Cite this article as:
Prasad, V., Brogan, E., Mulvaney, C. et al. Eur Child Adolesc Psychiatry (2013) 22: 203. doi:10.1007/s00787-012-0346-x


Attention-deficit hyperactivity disorder (ADHD) has a significant impact on children’s classroom behaviour, daily functioning and experience of school life. However, the effects of drug treatment for ADHD on learning and academic achievement are not fully understood. This review was undertaken to describe the effects of methylphenidate, dexamfetamine, mixed amfetamine salts and atomoxetine on children’s on-task behaviour and their academic performance, and to perform a meta-analysis to quantify these effects. Nine electronic databases were systematically searched for randomized controlled trials comparing drug treatment for ADHD against (i) no drug treatment, (ii) baseline (in crossover trials), or (iii) placebo; reporting outcomes encompassing measures of educational achievement within the classroom environment. Forty-three studies involving a pooled total of 2,110 participants were identified for inclusion. Drug treatment benefited children in the amount of school work that they completed, by up to 15 %, and less consistently improved children’s accuracy in specific types of academic assignments, such as arithmetic. Similar improvements were seen in classroom behaviour, with up to 14 % more of children’s time spent “on task”. Methylphenidate, dexamfetamine and mixed amfetamine formulations all showed beneficial effects on children’s on-task behaviour and academic work completion. Atomoxetine was examined in two studies, and was found to have no significant effect. These review findings suggest that medication for ADHD has the potential to improve children’s learning and academic achievement.


ADHDAttention-deficit hyperactivity disorderMedicationEducationAchievement

Supplementary material

787_2012_346_MOESM1_ESM.doc (205 kb)
Supplementary material 1 (DOC 205 kb)
787_2012_346_MOESM2_ESM.docx (40 kb)
Supplementary material 2 (DOCX 40 kb)
787_2012_346_MOESM3_ESM.doc (34 kb)
Supplementary material 3 (DOC 34 kb)
787_2012_346_MOESM4_ESM.docx (20 kb)
Supplementary material 4 (DOCX 20 kb)

Copyright information

© Springer-Verlag Berlin Heidelberg 2012