How Do Symptoms and Academic Performance Predict Post-Secondary Enrollment for Teens with ADHD?

What you need to know

• Teens with ADHD who enrolled in post-secondary education had less severe ADHD symptoms in adolescence, but differences were modest compared to those who did not enroll.

• Academic achievement scores were consistently lower for teens with ADHD compared to peers without ADHD, regardless of later enrollment.

• School performance (grades) in high school, rather than academic achievement test scores, was most predictive of eventual post-secondary enrollment for teens with ADHD.

ADHD symptoms and academic outcomes in adolescence

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that often begins in childhood and continues into adulthood for many people. While ADHD is associated with challenges in school, some teens with ADHD do go on to enroll in post-secondary education like college or university. This study aimed to understand how ADHD symptoms and academic performance in adolescence relate to whether teens with ADHD eventually enroll in post-secondary education.

The researchers analyzed data from a long-term study that followed children with and without ADHD from ages 7-9 up to age 25. They looked at trajectories of ADHD symptoms, standardized test scores, and school grades from ages 9-17 for four groups:

1. Teens with childhood ADHD who enrolled in post-secondary education
2. Teens with childhood ADHD who did not enroll
3. Teens without ADHD who enrolled
4. Teens without ADHD who did not enroll

ADHD symptom trajectories

The study found that teens with ADHD who eventually enrolled in post-secondary education had somewhat less severe ADHD symptoms in adolescence compared to those who did not enroll. However, the differences in symptom levels were relatively modest.

For inattention symptoms, teens in all groups showed increases from ages 9-13, except the ADHD group that enrolled in post-secondary, whose symptoms remained stable. From ages 13-17, inattention symptoms decreased for both ADHD groups but remained stable for the non-ADHD groups.

Hyperactivity-impulsivity symptoms followed a different pattern. From ages 9-13, these symptoms decreased for the ADHD group that enrolled in post-secondary, increased slightly for the non-ADHD group that enrolled, and remained stable for the other two groups. From ages 13-17, hyperactivity-impulsivity symptoms decreased for all groups except the non-ADHD group that did not enroll.

While there were some differences, the overall symptom trajectories were fairly similar between teens with ADHD who did and did not enroll in post-secondary education. This suggests that symptom severity alone may not be the key factor determining post-secondary enrollment for teens with ADHD.

Academic achievement trajectories

The researchers measured academic achievement using standardized test scores in math, reading, and spelling. Across all ages from 9-17, teens with ADHD had lower academic achievement scores compared to teens without ADHD. Additionally, teens who eventually enrolled in post-secondary education had higher scores than those who did not enroll, regardless of ADHD status.

Interestingly, academic achievement scores declined slightly over time for all groups from ages 9-17. The declines ranged from about one-quarter to three-quarters of a standard deviation, depending on the subject and group. The only exception was spelling scores for the non-ADHD group that did not enroll, which remained stable.

These achievement trajectories were fairly stable and parallel between groups over time. This means that differences in standardized test scores between groups were established early and maintained, rather than diverging during adolescence. The researchers suggest this stability may be related to the strong connection between academic achievement tests and IQ.

School performance trajectories

In contrast to the stable achievement test scores, school grades showed more variation over time, particularly in high school. The researchers looked at math grades, English grades, and overall grade point average (GPA).

For math and English grades in middle school (grades 6-8), teens without ADHD who enrolled in post-secondary had significantly higher grades than those who did not enroll. However, there were no significant differences between the two ADHD groups at this stage.

In high school (grades 9-12), math and English grades were higher for both ADHD and non-ADHD groups that enrolled in post-secondary compared to those who did not, but these differences were not statistically significant after accounting for multiple comparisons.

The most notable finding was for overall GPA trajectories in high school. For teens with ADHD who enrolled in post-secondary, GPAs improved slightly from grades 9-12. In contrast, GPAs declined for teens with ADHD who did not enroll. By 12th grade, there was a substantial GPA gap of about three-quarters of a point between these two ADHD groups.

Even with this improvement, teens with ADHD who enrolled in post-secondary still had lower GPAs on average than their non-ADHD peers who enrolled. However, the gap narrowed over the high school years.

Implications for supporting teens with ADHD

These findings have several important implications for supporting the academic success of teens with ADHD:

1. Symptom management alone may not be enough to ensure post-secondary enrollment. While lower symptom severity was associated with enrollment, the differences were modest. Other factors like academic support and developing study skills may be crucial.

2. Early academic achievement differences tend to persist, so interventions starting in childhood may be beneficial. However, achievement test scores alone do not tell the whole story of a student’s potential.

3. School performance, particularly in high school, appears to be a key factor in post-secondary enrollment for teens with ADHD. Supporting these students to improve their grades and GPA in high school could make a significant difference.

4. The transition from middle school to high school may be an especially important period for intervention, as grade trajectories began to diverge at this stage.

5. Classroom accommodations and learning support throughout middle and high school could help teens with ADHD reach their academic potential and access post-secondary opportunities.

Conclusions

• ADHD symptom severity in adolescence is modestly related to later post-secondary enrollment, but is not the sole determining factor.

• Early academic achievement differences between teens with and without ADHD tend to persist through adolescence.

• High school grades and GPA trajectories are most predictive of eventual post-secondary enrollment for teens with ADHD.

• Supporting school performance and study skills in high school may be crucial for improving post-secondary access for students with ADHD.

• Further research on effective interventions and support strategies for teens with ADHD in middle and high school is warranted.