ADHD and High School Academics

Assessing the impact of a diagnosis of ADHD on school performance is a research challenge.  Many children and adolescents have a concurrent psychiatric disorder that can also impair learning.  Concurrent mental disorders found at higher rates for children with ADHD include (but are not limited to):

• Oppositional defiant disorder
• Conduct disorder
• Anxiety disorder
• Autism spectrum disorder
• Reading disorder or other learning disorder

So when designing research experiments to examine the academic effect of ADHD specifically, these concurrent disorders need to be controlled for in some manner.

Kristine Kent and colleagues at Florida International University recently published some data related to academic performance in a group of male high school students.  They conducted a follow-up study in the Pittsburgh ADHD Longitudinal Study sample.  These subjects were originally enrolled in an intensive Summer Treatment Program for children with ADHD—typically when they were between 5 and 12 years of age.  Now an average of eight years later a subgroup was re-evaluated during their high school years.  The authors reported on only the male students in this manuscript.

A sample of control adolescents without ADHD were identified from a similar demographic group.  However, the controls did not match the ADHD group on yearly parental average income ($72,300 for control parents versus $61,700 for ADHD parents).  Also the control group sample were more likely to have a parent who completed college or a graduate degree (61% versus 44%).   These differences were controlled for in the key outcome variable analysis.

Although the ADHD had a primary problem with ADHD, they also had some difficulties with oppositional defiant disorder and conduct disorder.  Using a four point severity rating scale at baseline in high school the average scores were ADHD 2.28, oppositional defiant disorder 1.87, conduct disorder .45 (0=not present at all and 3=very much present).  The same ratings were not obtained in the control group, however the effect of oppostional defiant disorder and conduct disorder severity on key outcome variables in the ADHD was examined.

The key findings from the study (ADHD versus control):

• ADHD subjects tested lower on an IQ test (102 versus 111—this difference was also controlled in the analysis)
• ADHD subjects had lower overall grade point average (75.6 versus 81.4)
• ADHD subjects had higher drop-out rates by senior year (14.1% versus 1.4%)

The ADHD group also showed higher course subject failure rates and fewer advanced placement courses.  ADHD students also had increased numbers of school absences and days tardy.  Teachers rated the overall academic performance of those with ADHD on a lower level.  The GPA average means those with ADHD had about a C minus average compared to control with a B minus to C plus average.  Of note, for ADHD adolescents who stayed in school, the GPA gap appeared to narrow as the groups reached the senior year of high school.


The authors noted that their study did not examine for the presence of a specific learning disorder in either the ADHD or the control group and this might have affected their findings.  But the was better designed than many on this topic.

So the take home message for parents with a high school student with ADHD based on this study would seem to be:

• Emphasize the importance of doing well in school
• Monitor your child’s academic performance
• Limit school absences and tardiness
• Consider outside tutoring for academic assessment and support
• Monitor (and reward) homework completion
• Tell your child to stay in school and don’t drop out
• Consider ADHD behavioral therapy or medication use through the high school period
• Understand whether any common concurrent disorders qre present,how they may effect academic performance and what additional treatment assistance may be necessary

For more information of ADHD, visit the CDC website related to the topic in the widget below.


Kent KM, Pelham WE Jr, Molina BS, Sibley MH, Waschbusch DA, Yu J, Gnagy EM, Biswas A, Babinski DE, & Karch KM (2010). The Academic Experience of Male High School Students with ADHD. Journal of abnormal child psychology PMID: 21103923