Does Long-Term Medication Use Improve the Academic Outcomes of Youth with Attention-Deficit/Hyperactivity Disorder?

Youth with Attention-Deficit/Hyperactivity Disorder (ADHD) frequently experience academic impairment, including lower grades
than their peers and elevated risk for grade retention and school dropout. Medication is the most commonly used treatment
for youth with ADHD, and it is therefore essential to understand the extent to which medication use improves long-term academic
functioning. This paper reviews the literature on the relation between long-term medication use and the academic outcomes
of youth with ADHD. A systematic literature search was conducted to identify pertinent studies published since 2000 that followed
youth with ADHD for 3 or more years. Academic outcomes of interest included school grades, achievement test scores, and grade
retention. Nine studies were identified reporting on eight distinct longitudinal samples (N across studies = 8,721). These studies demonstrate that long-term medication use is associated with improvements in standardized
achievement scores. However, the magnitude of these improvements is small and the clinical or educational significance is
questionable. Evidence for long-term improvements in school grades and grade retention is less compelling. This review highlights
methodological considerations in providing directions for future research. The importance of using multiple sources to gather
information about medication adherence is discussed, including use of methodologies such as electronic monitors, rather than
relying solely on parent report or chart review. Future research should also examine a range of medication adherence definitions
in order to determine whether age of onset, duration of use, dose, and/or consistency of use moderates the relation between
long-term medication use and academic outcomes.