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ADHD in preschoolers linked to impaired school readiness, Stanford study finds

Preschoolers with ADHD are less likely than other children their age to be ready to succeed in elementary school, a new Stanford study has found.

Preschoolers with symptoms of attention-deficit hyperactivity disorder are less likely than other kids to have the skills needed to succeed in elementary school, a new Stanford study has found. The research appears in Pediatrics.

Even though the connection between academic struggles and ADHD is well-known in school-aged children, the gap in school readiness in younger kids with ADHD symptoms was startling. Our press release explains:

'We were pretty surprised at the proportion of kids within the ADHD group who were not school-ready,' said the study's senior author, Irene Loe, MD, assistant professor of pediatrics. Seventy-nine percent of children with ADHD had impaired school readiness compared with 13 percent of children in a control group, the study found. 'It's a really high number,' Loe said.

Loe and her colleagues performed comprehensive school-readiness assessments in 93 preschoolers, 48 of whom had high levels of ADHD symptoms or a formal diagnosis of ADHD. The 45 children in the comparison group did not have ADHD. Assessments covered the five areas of school readiness recommended by the American Academy of Pediatrics.

The biggest gap between the two groups of kids was seen in an area called "approaches to learning," which includes measures of executive function, or a person's ability to prioritize actions and tasks, use self-control, and regulate behavior to meet long-term goals. The study showed that preschoolers with ADHD were 73 times more likely to struggle in this area than children in the comparison group. Children with ADHD also were more likely to be impaired in three of the other four areas assessed.

One challenge in addressing the problem, Loe said, is that the main symptoms of ADHD -- inattention, hyperactivity and impulsivity -- are common in toddlers, and can sometimes persist in preschoolers who won't ultimately have the disorder. But the new findings suggest that identifying preschoolers at risk for ADHD is important, as it could allow these kids to receive early intervention that will help them succeed in school. Again, from our press release:

'We need to help general pediatricians figure out how they can flag kids who might be at risk for school failure,' Loe said. Families also need better access to behavioral therapy for preschoolers with ADHD, which is not always available or covered by insurance, even though it is recommended as the first-line ADHD treatment for this age group, she added.

Photo by Margaret Weir

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