A psychometric measure of learning disability predicts educational failure four years later in boys with Attention-Deficit/Hyperactivity Disorder

Objective: Although most children with ADHD experience school problems, only a subset of these youth meet psychometric criteria for learning disabilities (LD) in reading or mathematics. Considering the well-documented adverse impact of both ADHD and LD on school performance, the presence of both conditions in a given child may herald a particularly poor educational outcome for affected youth. This issue has not been adequately addressed in previous follow-up studies of ADHD. Design: In a four-year follow-up study of ADHD children, the educational, psychiatric, and psychosocial outcomes in ADHD youth with and without LD were examined. Results: Among children with ADHD, LD at baseline selectively predicted poorer educational functioning at follow-up, as manifested by higher rates of grade retention, in-school tutoring, and placement in special classes. In contrast, psychiatric comorbidity and psychosocial outcomes were comparable in ADHD youth with and without LD. Conclusions: Results suggest that LD predicts impaired academic outcomes among ADHD children. It does not, however, predict impaired social or psychiatric outcomes. These results stress the importance of including an evaluation of LD in the assessment of ADHD youth.