Eight-Year Latent Class Trajectories of Academic and Social Functioning in Children with Attention-Deficit/Hyperactivity Disorder

Abstract

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.

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Acknowledgements

Data used in the preparation of this article were obtained from the limited access datasets distributed from the NIH-supported “Multimodal Treatment Study of Children with Attention-Deficit/Hyperactivity Disorder” (MTA). This is a multisite, clinical trial and long-term follow-up study of children with ADHD who were randomly assigned to one of four treatment modalities. The study was conducted by the MTA Cooperative Group and supported by the National Institute of Mental Health with funds also contributed by the National Institute of Drug Abuse, the Department of Justice, and the Department of Education. The MTA Study has been supported by the following grant numbers: U01MH50440, U01MH50447, U01MH50453, U01MH50454, U01MH50461, U01MH50467; and the following contract numbers: N01MH19204, N01MH19207, N01MH19208, N01MH19209, N01MH19210, N01MH19211, N01MH19212, HHSN271920800003-C, HHSN271920800004-C, HHSN271920800005-C, HHSN271920800006-C, HHSN271920800007-C, HHSN271920800008-C, HHSN271920800009-C. The ClinicalTrials.gov identifier is NCT00000388. This manuscript reflects the views of the authors and may not reflect the opinions or views of the MTA 192 Study Investigators or the NIH.

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DuPaul, G.J., Morgan, P.L., Farkas, G. et al. Eight-Year Latent Class Trajectories of Academic and Social Functioning in Children with Attention-Deficit/Hyperactivity Disorder. J Abnorm Child Psychol 46, 979–992 (2018). https://doi.org/10.1007/s10802-017-0344-z

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Keywords

  • ADHD
  • GMM
  • Longitudinal functioning
  • Academic achievement
  • Social skills