title: 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.
abstract: 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.
authors.affiliation: University of Nottingham, Nottingham, Nottinghamshire, UK. vibhore.prasad@nottingham.ac.uk
authors.forename: Vibhore
authors.initials: V
authors.lastname: Prasad
authors.forename: Ellen
authors.initials: E
authors.lastname: Brogan
authors.forename: Caroline
authors.initials: C
authors.lastname: Mulvaney
authors.forename: Matthew
authors.initials: M
authors.lastname: Grainge
authors.forename: Wendy
authors.initials: W
authors.lastname: Stanton
authors.forename: Kapil
authors.initials: K
authors.lastname: Sayal
mesh_terms: D000124:Achievement; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy* / Q000523:psychology; D000697:Central Nervous System Stimulants / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D004522:Educational Status; D006801:Humans; D007858:Learning / Q000187:drug effects*; D012574:Schools; D013334:Students / Q000523:psychology*; D016896:Treatment Outcome
chemical_list: D000697:Central Nervous System Stimulants