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.
Similar content being viewed by others
References
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
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
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
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
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
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
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
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
Faraone SV et al (2003) The worldwide prevalence of ADHD: is it an American condition? World Psychiatry. 2(2):104–113
Polanczyk G et al (2007) The worldwide prevalence of ADHD: a systematic review and metaregression analysis. Am J Psychiatry 164(6):942–948
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
Loe IM, Feldman HM (2007) Academic and educational outcomes of children with ADHD. J Pediatr Psychol 32(6):643–654 (Epub 14 Jun 2007)
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
Marshall RM et al (1997) Academic underachievement in ADHD subtypes. J Learn Disabil 30(6):635–642
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)
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
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
Polderman TJ et al (2010) A systematic review of prospective studies on attention problems and academic achievement. Acta Psychiatr Scand 122(4):271–284
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
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
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
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
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
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
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
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
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
Rimfeld K et al (2015) Pleiotropy across academic subjects at the end of compulsory education. Sci Rep 5:11713
Olsen JA, Kenny DA (2006) Structural equation modeling with interchangeable dyads. Psychol Methods 11(2):127–141
Neale MC, Cardon LR (1992) Data summary. In: Methodology for genetic studies of twins and families. Springer, Netherlands, pp 35–53
Bentler PM (1990) Comparative fit indexes in structural models. Psychol Bull 107(2):238–246
Hu L-T, Bentler PM (1998) Fit indices in covariance structure modeling: sensitivity to underparameterized model misspecification. Psychol Methods 3(4):424
Jöreskog KG et al (1981) Analysis of covariance structures [with discussion and reply]. Scand J Stat 8(2):65–92
Core Team R (2014) R: a language and environment for statistical computing. R Foundation for Statistical Computing, Vienna
Rosseel Y (2012) Lavaan: an R package for structural equation modeling. J Stat Softw 48(2):1–36
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
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
Davey Smith G, Hemani G (2014) Mendelian randomization: genetic anchors for causal inference in epidemiological studies. Hum Mol Genet 23(R1):R89–R98
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
Gunasekara FI et al (2014) Fixed effects analysis of repeated measures data. Int J Epidemiol 43(1):264–269
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
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
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
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
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
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
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
Chang Z et al (2013) Developmental twin study of attention problems: high heritabilities throughout development. JAMA Psychiatry 70(3):311–318
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
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
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
Burt SA (2009) Rethinking environmental contributions to child and adolescent psychopathology: a meta-analysis of shared environmental influences. Psychol Bull 135(4):608–637
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
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
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
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
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
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
Corresponding author
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.
Rights and permissions
About this article
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
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-018-1200-6