New research reveals that high school students with attention-deficit / hyperactivity disorder (ADHD) are using an unexpectedly high rate of services for their age group, yet many low achievers with ADHD are not getting the academic supports they need. Scientists from UNC's Frank Porter Graham Child Development Institute (FPG) and several other universities published the findings in School Mental Health after examining data for a large national sample of high school students with ADHD.

Desiree W. Murray, FPG scientist and lead author of the study, said previous studies have demonstrated that children with ADHD often have difficulty completing work and performing at the level of their actual academic ability.

"Prior research has shown that students with ADHD score 10-30 points lower than their peers on achievement tests, and 30 percent repeat a grade," explained Murray. "High school students with ADHD take lower level classes and fail more courses than their peers."

According to Murray, high school students with ADHD also are up to eight times more likely to drop out.

Murray said the clear need for effective educational interventions for adolescent students with ADHD led her and her team to examine outcomes for these students, while looking at the high school services they use.

Her study found additional evidence that students with ADHD function significantly worse than their peers on academic measures. Teachers rated high school students with ADHD as more aggressive and less academically successful, and these students' test scores and grade point averages were lower than their peers'.

Murray's team used survey data provided by school staff on students from the Multi-Modal Treatment Outcome Study for ADHD, a nationally-representative sample of over 500 students who were followed since early childhood. The researchers determined that slightly more than half of the high school students with a history of ADHD received some type of formal school services, six times as much as students without ADHD in the study sample.

Most of the services and accommodations for students with ADHD targeted academic performance through Individualized Educational Plans (IEPs) as part of special education programs. Only half of these students received behavioral supports or were taught learning strategies.

"Although school procedures for identifying academic impairment in this population appear to be working for the most part, our results also suggest that 20 to 30 percent of students with academic impairment and ADHD have fallen through the cracks," Murray said. "There is a need for greater or more effective academic supports for a substantial minority of the students in our sample."

Murray said that only about one-fourth of the interventions reported in the school survey have evidence behind them. "One of the most common supports we found, for instance, was allowing students to have extended time on tests - but there's no clear evidence this helps improve performance among students with ADHD."

The new findings enabled Murray's team to make recommendations for high school support staff serving students with ADHD.

"Using more evidence-based strategies could help reduce the performance gap between students with and without ADHD," she said. "These include teaching self-advocacy, self-management strategies, and specific study and organizational skills."

Murray said that she and her team are generally encouraged by the "unexpectedly high rate of services" for high school students with ADHD in their study's sample. However, if schools focused more on services backed by research, these students would be more likely to benefit.

"Evidence-based practices can help improve long-term outcomes for high school students with ADHD," said Murray. "Providing effective services may contribute to increased graduation rates and successful transitions to adult life."