Skip to main content
Log in

The developmental course of inattention symptoms predicts academic achievement due to shared genetic aetiology: a longitudinal twin study

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Symptoms of attention-deficit hyperactivity disorder, in particular inattention symptoms, are associated with academic achievement. However, whether and why the developmental course of inattention symptoms (i.e. systematic decreases or increases of symptoms with age) predicts academic achievement remains unclear. A total of 5634 twin pairs born in the UK were included in the current study. We used latent growth curve modelling to estimate the baseline level and the developmental course of inattention symptoms (assessed at ages 8, 11, 14 and 16 years) and test whether they predicted the General Certificate of Secondary Education scores (GCSE, at age 16 years). We then implemented multivariate twin modelling to determine the role of genetic and environmental factors in explaining the relationship between inattention symptoms and GCSE scores. Increasing inattention symptoms across childhood and adolescence predicted poorer GCSE scores independently of the baseline level of inattention. Genetic factors explained most of this relationship, i.e. genetic factors contributing to individual differences in the developmental course of inattention also influenced GCSE scores. In conclusion, our study demonstrates that genetic factors underlying the developmental course of inattention symptoms across childhood and adolescence also influence academic achievement. This may result from indirect mechanism, whereby genetic factors explain systematic changes in inattention levels with age, which in turn impact academic achievement. The shared genetic aetiology may also suggest common neurobiological processes underlying both the developmental course of inattention symptoms and academic achievement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. American Psychiatric Association and American Psychiatric Association (2013) DSM-5 Task Force, Diagnostic and statistical manual of mental disorders: DSM-5. American Psychiatric Association, Washington

    Book  Google Scholar 

  2. Nikolas MA, Burt SA (2010) Genetic and environmental influences on ADHD symptom dimensions of inattention and hyperactivity: a meta-analysis. J Abnorm Psychol 119(1):1–17

    Article  PubMed  Google Scholar 

  3. Larsson H et al (2014) The heritability of clinically diagnosed attention deficit hyperactivity disorder across the lifespan. Psychol Med 44(10):2223–2229. https://doi.org/10.1017/S0033291713002493 Epub 2013 Oct 10

    Article  PubMed  CAS  Google Scholar 

  4. Larsson JO, Larsson H, Lichtenstein P (2004) Genetic and environmental contributions to stability and change of ADHD symptoms between 8 and 13 years of age: a longitudinal twin study. J Am Acad Child Adolesc Psychiatry 43(10):1267–1275

    Article  PubMed  Google Scholar 

  5. Pingault JB et al (2015) Genetic and environmental influences on the developmental course of attention-deficit/hyperactivity disorder symptoms from childhood to adolescence. JAMA Psychiatry 72(7):651–658

    Article  PubMed  PubMed Central  Google Scholar 

  6. McLoughlin G et al (2007) Genetic support for the dual nature of attention deficit hyperactivity disorder: substantial genetic overlap between the inattentive and hyperactive-impulsive components. J Abnorm Child Psychol 35(6):999–1008

    Article  PubMed  PubMed Central  Google Scholar 

  7. Greven CU, Rijsdijk FV, Plomin R (2011) A twin study of ADHD symptoms in early adolescence: hyperactivity-impulsivity and inattentiveness show substantial genetic overlap but also genetic specificity. J Abnorm Child Psychol 39(2):265–275

    Article  PubMed  Google Scholar 

  8. Kuntsi J et al (2014) The separation of ADHD inattention and hyperactivity-impulsivity symptoms: pathways from genetic effects to cognitive impairments and symptoms. J Abnorm Child Psychol 42(1):127–136

    Article  PubMed  PubMed Central  Google Scholar 

  9. Faraone SV et al (2003) The worldwide prevalence of ADHD: is it an American condition? World Psychiatry. 2(2):104–113

    PubMed  PubMed Central  Google Scholar 

  10. Polanczyk G et al (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164(6):942–948

    Article  PubMed  Google Scholar 

  11. Biederman J et al (1996) A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. Arch Gen Psychiatry 53(5):437–446

    Article  PubMed  CAS  Google Scholar 

  12. Loe IM, Feldman HM (2007) Academic and educational outcomes of children with ADHD. J Pediatr Psychol 32(6):643–654 (Epub 14 Jun 2007)

    Article  PubMed  Google Scholar 

  13. Garner AA et al (2013) The relationship between ADHD symptom dimensions, clinical correlates, and functional impairments. J Dev Behav Pediatr 34(7):469–477. https://doi.org/10.1097/DBP.0b013e3182a39890

    Article  PubMed  PubMed Central  Google Scholar 

  14. Marshall RM et al (1997) Academic underachievement in ADHD subtypes. J Learn Disabil 30(6):635–642

    Article  PubMed  CAS  Google Scholar 

  15. Massetti GM et al (2008) Academic achievement over 8 years among children who met modified criteria for attention-deficit/hyperactivity disorder at 4–6 years of age. J Abnorm Child Psychol 36(3):399–410 (Epub 17 Oct 2007)

    Article  PubMed  Google Scholar 

  16. Barkley RA et al (2006) Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry 45(2):192–202

    Article  PubMed  Google Scholar 

  17. Frazier TW et al (2007) ADHD and achievement: meta-analysis of the child, adolescent, and adult literatures and a concomitant study with college students. J Learn Disabil 40(1):49–65

    Article  PubMed  Google Scholar 

  18. Polderman TJ et al (2010) A systematic review of prospective studies on attention problems and academic achievement. Acta Psychiatr Scand 122(4):271–284

    Article  PubMed  Google Scholar 

  19. Daley D, Birchwood J (2010) ADHD and academic performance: why does ADHD impact on academic performance and what can be done to support ADHD children in the classroom? Child Care Health Dev 36(4):455–464

    Article  PubMed  CAS  Google Scholar 

  20. Greven CU et al (2014) Evidence for shared genetic risk between ADHD symptoms and reduced mathematics ability: a twin study. J Child Psychol Psychiatry 55(1):39–48

    Article  PubMed  Google Scholar 

  21. Breslau N et al (2010) Change in teachers’ ratings of attention problems and subsequent change in academic achievement: a prospective analysis. Psychol Med 40(1):159–166

    Article  PubMed  CAS  Google Scholar 

  22. Pingault JB et al (2014) The developmental course of childhood inattention symptoms uniquely predicts educational attainment: a 16-year longitudinal study. Psychiatry Res 219(3):707–709

    Article  PubMed  Google Scholar 

  23. Pingault JB et al (2011) Childhood trajectories of inattention and hyperactivity and prediction of educational attainment in early adulthood: a 16-year longitudinal population-based study. Am J Psychiatry 168(11):1164–1170

    Article  PubMed  Google Scholar 

  24. Krapohl E et al (2014) The high heritability of educational achievement reflects many genetically influenced traits, not just intelligence. Proc Natl Acad Sci USA 111(42):15273–15278

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  25. Oliver BR, Plomin R (2007) Twins’ early development study (TEDS): a multivariate, longitudinal genetic investigation of language, cognition and behavior problems from childhood through adolescence. Twin Res Hum Genet 10(1):96–105

    Article  PubMed  Google Scholar 

  26. Haworth CM, Davis OS, Plomin R (2013) Twins early development study (TEDS): a genetically sensitive investigation of cognitive and behavioral development from childhood to young adulthood. Twin Res Hum Genet 16(1):117–125

    Article  PubMed  Google Scholar 

  27. Conners CK et al (1998) The revised Conners’ Parent Rating Scale (CPRS-R): factor structure, reliability, and criterion validity. J Abnorm Child Psychol 26(4):257–268

    Article  PubMed  CAS  Google Scholar 

  28. Rimfeld K et al (2015) Pleiotropy across academic subjects at the end of compulsory education. Sci Rep 5:11713

    Article  PubMed  PubMed Central  Google Scholar 

  29. Olsen JA, Kenny DA (2006) Structural equation modeling with interchangeable dyads. Psychol Methods 11(2):127–141

    Article  PubMed  Google Scholar 

  30. Neale MC, Cardon LR (1992) Data summary. In: Methodology for genetic studies of twins and families. Springer, Netherlands, pp 35–53

  31. Bentler PM (1990) Comparative fit indexes in structural models. Psychol Bull 107(2):238–246

    Article  PubMed  CAS  Google Scholar 

  32. Hu L-T, Bentler PM (1998) Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychol Methods 3(4):424

    Article  Google Scholar 

  33. Jöreskog KG et al (1981) Analysis of covariance structures [with discussion and reply]. Scand J Stat 8(2):65–92

    Google Scholar 

  34. Core Team R (2014) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna

    Google Scholar 

  35. Rosseel Y (2012) Lavaan: an R package for structural equation modeling. J Stat Softw 48(2):1–36

    Article  Google Scholar 

  36. Pastura GM, Mattos P, Araujo AP (2009) Academic performance in ADHD when controlled for comorbid learning disorders, family income, and parental education in Brazil. J Atten Disord 12(5):469–473

    Article  PubMed  Google Scholar 

  37. de Zeeuw EL et al (2017) Attention deficit hyperactivity disorder symptoms and low educational achievement: evidence supporting a causal hypothesis. Behav Genet 47(3):278–289

    Article  PubMed  PubMed Central  Google Scholar 

  38. Davey Smith G, Hemani G (2014) Mendelian randomization: genetic anchors for causal inference in epidemiological studies. Hum Mol Genet 23(R1):R89–R98

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Pingault JB et al (2018) Using genetic data to strengthen causal inference in observational research. Nat Rev Genet. https://doi.org/10.1038/s41576-018-0020-3

    Article  PubMed  Google Scholar 

  40. Gunasekara FI et al (2014) Fixed effects analysis of repeated measures data. Int J Epidemiol 43(1):264–269

    Article  PubMed  Google Scholar 

  41. Shaw P et al (2009) Development of cortical asymmetry in typically developing children and its disruption in attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 66(8):888–896

    Article  PubMed  PubMed Central  Google Scholar 

  42. Darki F, Klingberg T (2015) The role of fronto-parietal and fronto-striatal networks in the development of working memory: a longitudinal study. Cereb Cortex 25(6):1587–1595

    Article  PubMed  Google Scholar 

  43. Hechtman L, Weiss G, Perlman T (1984) Young adult outcome of hyperactive children who received long-term stimulant treatment. J Am Acad Child Psychiatry 23(3):261–269

    Article  PubMed  CAS  Google Scholar 

  44. Powers RL et al (2008) Stimulant treatment in children with attention-deficit/hyperactivity disorder moderates adolescent academic outcome. J Child Adolesc Psychopharmacol 18(5):449–459

    Article  PubMed  PubMed Central  Google Scholar 

  45. Enns JE et al (2017) A multimodal intervention for children with ADHD reduces inequity in health and education outcomes. Can J Psychiatry 62(6):403–412

    Article  PubMed  PubMed Central  Google Scholar 

  46. Kan KJ et al (2013) Genetic and environmental stability in attention problems across the lifespan: evidence from the Netherlands twin register. J Am Acad Child Adolesc Psychiatry 52(1):12–25

    Article  PubMed  Google Scholar 

  47. Hoekstra RA, Bartels M, Boomsma DI (2007) Longitudinal genetic study of verbal and nonverbal IQ from early childhood to young adulthood. Learn Individ Diff 17(2):97–114

    Article  Google Scholar 

  48. Chang Z et al (2013) Developmental twin study of attention problems: high heritabilities throughout development. JAMA Psychiatry 70(3):311–318

    Article  PubMed  Google Scholar 

  49. Hart SA et al (2010) Exploring how symptoms of attention-deficit/hyperactivity disorder are related to reading and mathematics performance: general genes, general environments. Psychol Sci 21(11):1708–1715

    Article  PubMed  Google Scholar 

  50. Pingault JB et al (2015) Developmentally dynamic genome: evidence of genetic influences on increases and decreases in conduct problems from early childhood to adolescence. Sci Rep 5:10053. https://doi.org/10.1038/srep10053

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  51. Tucker-Drob EM, Briley DA (2014) Continuity of genetic and environmental influences on cognition across the life span: a meta-analysis of longitudinal twin and adoption studies. Psychol Bull 140(4):949–979

    Article  PubMed  PubMed Central  Google Scholar 

  52. Burt SA (2009) Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychol Bull 135(4):608–637

    Article  PubMed  Google Scholar 

  53. Merwood A et al (2013) Different heritabilities but shared etiological influences for parent, teacher and self-ratings of ADHD symptoms: an adolescent twin study. Psychol Med 43(9):1973–1984

    Article  PubMed  CAS  Google Scholar 

  54. Derks EM et al (2008) Genetic and environmental influences on the relation between attention problems and attention deficit hyperactivity disorder. Behav Genet 38(1):11–23

    Article  PubMed  Google Scholar 

  55. Groen-Blokhuis MM et al (2014) Attention-deficit/hyperactivity disorder polygenic risk scores predict attention problems in a population-based sample of children. J Am Acad Child Adolesc Psychiatry 53(10):1123.e6–1129.e6

    Article  Google Scholar 

  56. Chen W et al (2008) DSM-IV combined type ADHD shows familial association with sibling trait scores: a sampling strategy for QTL linkage. Am J Med Genet B Neuropsychiatr Genet 147B(8):1450–1460. https://doi.org/10.1002/ajmg.b.30672

    Article  PubMed  CAS  Google Scholar 

  57. Martin J et al (2014) Genetic risk for attention-deficit/hyperactivity disorder contributes to neurodevelopmental traits in the general population. Biol Psychiatry 76(8):664–671

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We gratefully acknowledge the ongoing contribution of the participants in the Twins Early Development Study and their families. The Twins Early Development Study is supported by Grant G0901245 (and previously G0500079) from the UK Medical Research Council. EV is supported by a Royal Society Wolfson Research Merit Award from the Royal Society and the Wolfson Foundation. JBP is a fellow of MQ Transforming Mental Health (MQ16IP16). CYL is supported by Overseas Research Scholarship from University College London.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jean-Baptiste Pingault.

Ethics declarations

Conflict of interest

King’s College London received payments for consultancy, speaker fees, or educational and research awards from Shire, Flynn, Eli-Lilly, Janssen and Novartis for work conducted by PA. PA receives educational/research awards from Shire, Lilly, QbTech and is speaker at sponsored events for Shire, Lilly and Novartis.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 28 kb)

Supplementary material 2 (DOCX 144 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Liu, CY., Li, Y., Viding, E. et al. The developmental course of inattention symptoms predicts academic achievement due to shared genetic aetiology: a longitudinal twin study. Eur Child Adolesc Psychiatry 28, 367–375 (2019). https://doi.org/10.1007/s00787-018-1200-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-018-1200-6

Keywords

Navigation