The transition to middle school is associated with changes in the developmental trajectory of ADHD symptomatology in young adolescents with ADHD

Abstract

The attention deficit hyperactivity disorder (ADHD) symptom presentation of young adolescents with ADHD was examined in association with the transition to middle school. This study used data collected in the Multimodal Treatment Study of ADHD, which included children between 7 and 9 years of age with a diagnosis of ADHD (n = 258) and grade- and sex-matched controls (n = 112). The trajectory of ADHD symptoms before, during, and after the transition to middle school was modeled using hierarchical linear modeling. A clear developmental reduction in ADHD symptomatology was observed for all three ADHD symptom domains. For young adolescents with ADHD, the transition to middle school was associated with a disruption in the developmental decline of inattention, hyperactivity, and impulsivity symptoms as measured by parent ratings. This effect was also observed for teacher ratings of inattention and hyperactivity. These results support the assertion that the environmental changes associated with transitioning to middle school coincide with a transient reversal in ADHD symptom decline among children with ADHD.

Figures

Figure 1

Parent rated symptoms of inattention on the SNAP Rating Scale where timepoint 0 represents the transition to middle school. In order to equate the transition year across participants, the x-axis represents grade with the transition year coded as time 0 and consecutive negative integers for the preceding elementary school years (e.g., −2, −1) and positive integers for the post-ceding middle school years (e.g., 1, 2). The LNCG does not have a timepoint −3 because participants were not recruited until the 24 month MTA timepoint.

Figure 2

Parent rated symptoms of hyperactivity on the SNAP Rating Scale. In order to equate the transition year across participants, the x-axis represents grade with the transition year coded as time 0 and consecutive negative integers for the preceding elementary school years (e.g., −2, −1) and positive integers for the post-ceding middle school years (e.g., 1, 2). The LNCG does not have a timepoint −3 because participants were not recruited until the 24 month MTA timepoint.

Figure 3

Parent rated symptoms of impulsivity on the SNAP Rating Scale where time-point 0 represents the transition to middle school. In order to equate the transition year across participants, the x-axis represents grade with the transition year coded as time 0 and consecutive negative integers for the preceding elementary school years (e.g., −2, −1) and positive integers for the post-ceding middle school years (e.g., 1, 2). The LNCG does not have a timepoint −3 because participants were not recruited until the 24 month MTA timepoint.

Figure 4

Teacher rated symptoms of inattention on the SNAP Rating Scale where timepoint 0 represents the transition to middle school. In order to equate the transition year across participants, the x-axis represents grade with the transition year coded as time 0 and consecutive negative integers for the preceding elementary school years (e.g., −2, −1) and positive integers for the post-ceding middle school years (e.g., 1, 2). The LNCG does not have a timepoint −3 because participants were not recruited until the 24 month MTA timepoint.

Figure 5

Teacher rated symptoms of hyperactivity on the SNAP Rating Scale. In order to equate the transition year across participants, the x-axis represents grade with the transition year coded as time 0 and consecutive negative integers for the preceding elementary school years (e.g., −2, −1) and positive integers for the post-ceding middle school years (e.g., 1, 2). The LNCG does not have a timepoint −3 because participants were not recruited until the 24 month MTA timepoint.

Figure 6

Teacher rated symptoms of impulsivity on the SNAP Rating Scale where time-point 0 represents the transition to middle school. In order to equate the transition year across participants, the x-axis represents grade with the transition year coded as time 0 and consecutive negative integers for the preceding elementary school years (e.g., −2, −1) and positive integers for the post-ceding middle school years (e.g., 1, 2). The LNCG does not have a timepoint −3 because participants were not recruited until the 24 month MTA timepoint.