title: Functional status in children with ADHD at age 6-8: a controlled community study.
abstract: OBJECTIVE
  To examine the functional status (mental health, academic performance, peer problems) of a community-based sample of children who have attention-deficit/hyperactivity disorder (ADHD) and non-ADHD controls, and to investigate gender and subtype differences.
  
  
  METHODS
  Children aged 6 to 8 years were recruited through 43 Melbourne schools, using a 2-stage screening (parent and teacher Conners 3 ADHD index) and case confirmation (Diagnostic Interview Schedule for Children, Version IV; [DISC-IV]) procedure. Outcome measures were mental health disorders (DISC-IV), academic performance (Wide Range Achievement Test 4), and peer problems (Strength and Difficulties Questionnaire). Unadjusted and adjusted linear and logistic regression were used to compare ADHD and non-ADHD controls.
  
  
  RESULTS
  A total of 179 children who have ADHD and 212 non-ADHD controls were recruited. Compared with controls, children who had ADHD had higher odds of externalizing (odds ratio [OR], 11.0; 95% confidence interval [CI], 5.6-21.6; P < .001) and internalizing (OR, 2.9; 95% CI, 1.2-7.2; P = .02) disorders; poorer reading (effect size, -0.66) and mathematics (effect size, -0.69) performance; and more peer problems (P < .001). Boys and girls who had ADHD were equally impaired. Only 17% of children in our ADHD group had been previously diagnosed. Previous diagnosis was higher in the Combined group and for boys.
  
  
  CONCLUSIONS
  In their second year of school, children who had ADHD performed worse than controls across all functional domains, yet only a minority had been formally diagnosed with ADHD. Findings highlight the need for earlier diagnosis and intervention.
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia; daryl.efron@rch.org.au.
authors.forename: Daryl
authors.initials: D
authors.lastname: Efron
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia;
authors.forename: Emma
authors.initials: E
authors.lastname: Sciberras
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; The Royal Children's Hospital, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia;
authors.forename: Vicki
authors.initials: V
authors.lastname: Anderson
authors.affiliation: Discipline of Psychiatry, The University of Sydney, Sydney, Australia;
authors.forename: Philip
authors.initials: P
authors.lastname: Hazell
authors.affiliation: PenCLAHRC, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom;
authors.forename: Obioha C
authors.initials: OC
authors.lastname: Ukoumunne
authors.affiliation: Joondalup Child Development Centre, Perth, Australia; and Department of Paediatrics, University of Western Australia, Perth, Australia.
authors.forename: Brad
authors.initials: B
authors.lastname: Jongeling
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia; Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia;
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Schilpzand
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia;
authors.forename: Matthew
authors.initials: M
authors.lastname: Bisset
authors.affiliation: Murdoch Childrens Research Institute, Melbourne, Victoria, Australia;
authors.forename: Jan M
authors.initials: JM
authors.lastname: Nicholson
mesh_terms: D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D015331:Cohort Studies; D004521:Educational Measurement / Q000379:methods*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D012111:Residence Characteristics; D012574:Schools; D012919:Social Behavior; D014739:Victoria / Q000453:epidemiology
keywords: attention-deficit/hyperactivity disorder; community sample; functional impairment