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Attention Problems in Kindergarten Could Spell Long-Term Academic Trouble

They have bigger impact than issues such as depression, anxiety, study finds

TUESDAY, May 26 (HealthDay News) -- Children with attention problems in kindergarten often struggle academically right through high school, a new study suggests.

The study, led by Joshua Breslau of the University of California, Davis, School of Medicine, is among the first to show how attention problems early in a child's life can shape and predict future academic performance, he said.

"The evidence suggests what many educators may already suspect, that kids with attention problems don't learn as much," said Breslau, an anthropologist and epidemiologist. "This starts very early for many children and is cumulative."

The study used data collected by Breslau's mother, Naomi Breslau, an epidemiologist at Michigan State University, for research she had conducted in the 1980s and '90s. In that study, researchers followed more than 800 children from diverse racial and socio-economic backgrounds in the Detroit area, examining the impact of low birth weight on psychological development.

The UC Davis researchers used information collected on 693 of these children, from ages 6 through 17. They zeroed in on three types of behaviors as scored by their teachers -- "internalizing" behaviors such as anxiety and depression; "externalizing" behaviors such as acting out and breaking rules; and attention problems such as restlessness and the inability to focus on one activity.

Compared with other childhood psychiatric problems, including depression, anxiety and disruptive behavior, Breslau and his team found that attention problems -- including symptoms of attention deficit/hyperactivity disorder (ADHD) -- had the strongest impact on a child's future academic success. Signs of ADHD often begin showing up in kindergarten, a child's first school experience that demands a higher level of learning and cognitive skills.

"Ultimately, students who do poorly may lose motivation to invest in academic work, become more open to competing interests, including substance abuse, and more likely to drop out of school," the study authors wrote in the article, published in the June issue of Pediatrics.

As a child progresses through school, the level of failure from ADHD can snowball and lead to emotional problems, substance abuse and academic decline in later grades and difficulties after graduation, said Dr. David W. Goodman, an assistant professor of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine, and director of the Adult Attention-Deficit Disorder Center of Maryland.

"For kids, it's about academic achievement. But later in life, it's about ADHD's impact on family, occupation and social life," he said.

The study stopped short of making specific recommendations, but suggested that school officials need to focus more resources on identifying and helping young children who are struggling with attention problems.

According to Julie Schweitzer, a study author and an associate professor of psychiatry and behavioral sciences at the UC Davis School of Medicine, parents and teachers of young children need to be on lookout for signs of unusual attention problems. While it's normal for 5- and 6-year-olds to be active, those with real attention problems may have unusual difficulty following directions, completing simple projects and controlling impulses, she said.

Treatment at that age usually entails parent training and classroom-based interventions, said Schweitzer, adding that ADHD is a chronic condition for many people and may require years of symptom management, though a percentage of children do outgrow it.

More research is needed to determine how best to help children with ADHD and attention difficulties, said Breslau, who is planning to study the exact relationship between severe attention problems and substance abuse and dropout rates.

"ADHD is underreported and under-appreciated as a source of long-term academic failure," Breslau said. "Studies clearly show that early investment in children pays off big later on."

More information

There's more on ADHD at the U.S. National Institute of Mental Health.

SOURCES: Joshua Breslau, Ph.D., Sc.D., University of California, Davis, School of Medicine; David W. Goodman, M.D., assistant professor, psychiatry and behavioral sciences, Johns Hopkins University School of Medicine, and director, Adult Attention-Deficit Disorder Center, Maryland; June 2009 Pediatrics

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