Relationships between teacher-reported ADHD symptom profiles and academic achievement domains in a nonreferred convenience sample of first- to fourth-grade students

OBJECTIVES: Previous studies suggested that inattention was related particularly with reading problems among students. However, most of the former studies had clinically referred samples. A majority of the studies conducted with nonreferred samples have evaluated academic achievement with single or a few parent- or teacher-rated items. Almost none of the studies have investigated reading, writing, and mathematics achievements in a single sample. Data from low- and middle-income countries on the subject are exceedingly scarce. Objectives of the present study were to compare actual measurements of reading fluency, reading comprehension, reading and writing errors, mathematics achievement, and teacher ratings of attention deficit hyperactivity disorder (ADHD) symptoms in a single sample. METHODS: Teachers rated ADHD symptoms in a single, nonreferred, population sample (n = 2493) of first- to fourth-grade students with a SNAP-4 rating scale. Actual measurements of reading fluency, reading comprehension, reading and writing errors, and mathematics achievement were also obtained. Fluid IQ was evaluated with Ravens Progressive Matrices. Students were grouped into Predominantly Inattentive (PI), Hyperactive/Impulsive (HI), Combined (C), or control groups. Univariate and multivariate analyses were conducted. Statistical significance was set at p <.003 after correction for multiple comparisons. RESULTS: We showed that after fluid IQ level and gender were controlled, ADHD-PI and ADHD-C groups (but not ADHD-HI) had significantly lower performance in all academic areas. ADHD-PI increased the risk of being in the lowest performing 10th percentile for reading 3 times, for writing more than 3.9 times, and for mathematics more than 6 times. CONCLUSIONS: We investigated the subtype differences in terms of academic achievement between ADHD-PI, ADHD-HI, and ADHD-C, based on teacher reports. Academic achivement data were not based on teacher or parent reports but on the actual performance of the students using standardized tests. Our results suggested that inattention symptoms must be targeted in primary school students in order to help them have academic achievement similar to their peers.