Children living with attention deficit hyperactivity disorder (ADHD) may never finish high school, attend university and could grow up to endure a lifelong trajectory of disadvantage, according to a new study from the University of Queensland.
A review of more than 100 longitudinal studies, conducted by UQ Centre for Clinical Research (UQCCR), shows that the condition is highly associated with disability beyond immediate health loss.
The study, published this week in the Journal of the American Academy of Child and Adolescent Psychiatry, shows that children with ADHD are six times more likely to miss out on attending tertiary education compared to their peers.
They are also four times more likely not to complete high school than children without the mental health issue, and significantly more likely to have been dismissed from employment or to experience unemployment.
“The findings indicated that the disorder was significantly associated with adverse outcomes across academic, employment, and service use domains, as well as several outcomes relating to mental and substance use disorders and criminality,” the study reads.
They are also four times more likely not to complete high school than children without a mental health issue, and significantly more likely to have been dismissed from employment or to experience unemployment.
The research also looked at conduct disorder (CD) in children, showing that it can also reap lifelong adverse consequences.
CD was found to be associated with a range of substance use disorders, violence, early pregnancy, antisocial personality disorder, and failure to complete high school.
“CD is a persistent disorder in children and adolescents characterised by disruptive behaviours that violate the rights of others, go against accepted norms of behaviour, and disrupt the child's or family's everyday life,” says UQ Centre for Clinical Research (UQCCR) Research Fellow, Dr Holly Erskine.
“The recent Young Minds Matter survey (the Australian national survey of mental health in children and adolescents) found prevalence of conduct disorder was approximately 2.5 per cent in males and 1.5 per cent in females aged 4-17 years.”
Unfortunately the signs are not always picked up and there is often stigma and ‘parent blaming’ involved.
The study did not investigate why some children with ADHD or CD will face lifelong barriers to education and employment.
However, Dr Erskine says children with ADHD or CD are more likely to have difficulties coping with the tasks of schooling and managing social relationships which then increases the risk of absenteeism, refusal and eventual early cessation of education.
UQCCR Associate Professor James Scott adds that ADHD and CD are not always identified in childhood or treated, and not all children will receive the educational help they require to succeed at school.
“Unfortunately the signs are not always picked up and there is often stigma and ‘parent blaming’ involved,” Associate Professor Scott says.
“This is not something these children will simply grow out of, and early intervention will give them the best possible chance of realising their potential.”
Dr Erskine stresses that although the report is based on rigorous research, the future of a child with ADHD and CD need not be defined by the statistics.
“The findings presented in the study relate to increased risk and does not mean that three out of four children will experience this outcome,” says Dr Erskine.
Any child, she says, can continue to live a positive and successful life with the right educational and workplace support.
Ensuring that both parents and teachers have the necessary resources to support children with ADHD is vital to keeping these children engaged in education.
In order for this to happen, ADHD and CD should be addressed early in life so that children can reach their potential throughout childhood and into adulthood.
“Ensuring that both parents and teachers have the necessary resources to support children with ADHD is vital to keeping these children engaged in education.
“Both of these disorders are treatable and the study demonstrates the psychosocial problems that can be avoided with appropriate intervention at the appropriate time.”
Dr Scott estimates that ADHD affects five per cent of the childhood population, and CD about three per cent.
The study grouped males and females together and did not distinguish between the sexes.
'Children' were defined for the purpose of this study as people aged under 18 years. They were followed for a minimum of two years in order to examine different longitudinal outcomes.