School-Based Services for Children with ADHD
This research update focuses on an overarching question: what predicts school-based services received by children with ADHD? The first study examined specific factors related to receiving school-based services for children with ADHD, and the second study investigated school service use for children specifically with the inattentive presentation of ADHD.
School-based interventions have been shown to be helpful for children with ADHD. These studies help us to understand which students may be more likely to get the services they need and which students may be at greater risk for missing out on school-based services.
Do specific factors predict whether students receive services?
This study examined school-based service use from a nationally drawn sample of 2,495 youths with ADHD in the United States. Parents of students aged 4 to 17 completed questionnaires about what types of services their children were receiving from their schools, such as whether they were on an IEP or 504 plan and whether they were getting extra support for academics or behavior in the classroom. They also answered questions about whether their children had learning, developmental, or social-emotional issues in addition to ADHD. Results showed that about 62% of students with ADHD received educational support, 32% of students received classroom behavior management support, 43% had an IEP, and 14% of students had a 504 plan.
In general, children who had more problems in academics were more likely to receive school-based educational support and classroom management services compared to children with problems in social functioning. For both services of academic and behavioral support, students with a learning or developmental disorder and younger students were more likely to receive such services. Students who received support for classroom behavior were more likely to be male or have the hyperactive-impulsive presentation of ADHD. Students with an IEP were more likely to have more severe ADHD, have hyperactive-impulsive presentations of ADHD, have a younger age of ADHD diagnosis, have academic or social difficulties, and have a co-occurring learning or developmental disorder. Students with a 504 plan were more likely to have English as the primary language used at home, have private insurance, and have both academic and social impairments.
Overall, these results demonstrate that academics, social challenges, age, co-occurring disorders, sex, ADHD presentation, primary language, and insurance type are factors that predict whether students receive specific school-based services. These results point to an important need to address gaps in school services for particular students.
DuPaul GJ, Chronis-Tuscano A, Danielson ML, & Visser SN. (2019). Predictors of receipt of school services in a national sample of youth with ADHD. Journal of Attention Disorders, 23, 1303-1319.
What about students with the inattentive presentation of ADHD?
Although research has looked at use of services for children with ADHD, less research exists on service use of children with the inattentive presentation of ADHD (ADHD-I). This study serves to fill that gap.
In a sample of 199 children with ADHD-I between grades 2 to 5, parents and teachers answered questions about the severity of ADHD symptoms and functional impairment. Parents also reported on the use of services within the past year, and their children completed a test of academic achievement to assess for academic performance. School-based services used in this sample included classroom accommodations, special education classes, occupational/physical therapy, speech/language therapy, in-school tutoring, school counselling, and/or having an IEP or 504 plan.
The results showed that about 79% of children received school services, although only 14% had an IEP. The severity of ADHD symptoms did not predict school service use, but children with more functional impairment and lower academics were more likely to use school services.
These results indicate that for children diagnosed with ADHD-I, those with more functional and academic problems are more likely to receive school-based services whereas school-based services were not dependent on ADHD symptoms per se. Also, although many of the students received school services, fewer had IEPs, which suggests a need for more IEPs among children with ADHD-I.