Effects of Stimulant Treatment for ADHD on Long-term Academic Outcomes in Children

Abstract

Attention-deficit/hyperactivity disorder (ADHD) is the most prevalent mental disorder afflicting American children. While stimulants have become well-established as an effective short-term treatment of ADHD symptoms, there are few conclusive results on the long-term effects of these drugs. Using nationally representative Medicaid data for drug prescription rates and test scores from the National Assessment of Educational Progress (NAEP), this study examines the long-term effects of stimulant treatment on academic performance and human capital formation in children with ADHD. I find that stimulant use in the fourth grade negatively affects fourth and eighth grade reading test scores, but eighth grade stimulant treatment has no effect on test scores. Mathematics scores in the fourth or eighth grades are also not affected at all by stimulant usage. At the same time, I show that higher stimulant usage is associated with lower special needs enrollment, and finally, ADHD children treated with stimulants in the fourth grade experience neither a slower nor quicker increase in test scores between the fourth and eighth grades compared to their healthy counterparts. Taken together, these results provide evidence that stimulants are increasingly used as a substitute for special education resources, which negatively affects academic achievement in the long-run by failing to address the underlying issues, such as providing struggling children with a method of learning that fit their needs. Additionally, ADHD students are less likely to continue stimulant treatment as they grow older due to adverse side effects or other issues, and it is likely that learning is cumulative over a child’s life such that stimulant drugs have a decreased effect on academic performance as children age. Finally, although stimulant treatment effectively alleviates the symptoms of inattention and hyperactivity characteristic of ADHD, the drug ultimately does not reverse the negative effects of the disorder on human capital formation by closing the learning gap between ADHD children and their healthy peers.