Study Tracks How State Education-Related Policies Affect ADHD Diagnoses

Consequential accountability reforms (those that assign consequences to schools who fail to meet standards) initiated by the No Child Left Behind (NCLB) Act were linked to increased diagnoses of attention-deficit/hyperactivity disorder (ADHD) in children from low-income households from 2003 to 2007, according to a study in Psychiatric Services in Advance. In contrast, states with laws prohibiting school personnel from recommending or requiring that a child take a psychotropic medication saw decreases in ADHD diagnoses.

Because children with ADHD often face problems with academic achievement and those diagnosed are often treated with medications that can improve standardized scores, Stephen Hinshaw, Ph.D., a professor of psychology at the University of California, Berkeley, and colleagues sought to investigate whether consequential accountability indirectly results in more ADHD diagnoses. For the study, the team analyzed data from the National Survey of Children’s Health on public school children aged 6 to 13 from 2003 to 2011.

From 2003 to 2007, public school children from low-income households residing in states first experiencing consequential accountability under NCLB showed an increase in adjusted ADHD diagnostic prevalence of 56% compared with an increase of 19% of demographically similar children residing in states that had consequential accountability prior to NCLB. This association did not continue from 2007 to 2011—a factor the authors suggest may be due to a greater short-term initial response to NCLB and the introduction of a different set of education incentives in 2009.

From 2003 to 2011, states with psychotropic drug–monitoring laws saw ADHD diagnostic prevalence decrease by 4% in contrast to the 23% increase in states without such laws.

“Future research should investigate whether children most affected by these policies are receiving appropriate diagnoses or are being overdiagnosed because of NCLB consequential accountability or underdiagnosed because of psychotropic medication laws,” the authors wrote.

For more on treating ADHD, see the Psychiatric News article “Pediatricians Urged to Adhere Better to ADHD Care Practices.”

(Image: hxdbzxy/Shutterstock.com)