Elsevier

Psychiatry Research

Volume 219, Issue 3, 30 November 2014, Pages 707-709
Psychiatry Research

Brief report
The developmental course of childhood inattention symptoms uniquely predicts educational attainment: A 16-year longitudinal study

https://doi.org/10.1016/j.psychres.2014.06.022Get rights and content

Highlights

  • In a 16-year longitudinal study, the developmental course of childhood inattention was examined.

  • Rising inattention predicted functional impairment as indicated by graduation failure.

  • Rising inattention is an important prognostic indicator.

Abstract

In this 16-year longitudinal study, a new trajectory estimation approach was used to verify whether the developmental course of childhood inattention significantly predicted functional impairment. A rising childhood inattention trajectory significantly predicted graduation failure (OR: 1.76 [1.32–2.34]) independently of averaged inattention levels. Rising inattention is, in itself, important for prognosis.

Introduction

Childhood attention deficit hyperactivity disorder (ADHD) predicts a number of functional impairments, including long-term low educational attainment through its inattentive dimension (Pingault et al., 2011). Moreover, ADHD symptoms follow different developmental patterns: inattention symptoms remain stable or increase with age, while hyperactivity symptoms tend to decrease (Larsson et al., 2011, Willcutt et al., 2012).

One limitation in the literature is the lack of studies combining these two lines of research to test if developmental patterns of symptoms are accompanied by changes in functional impairment (Willoughby, 2003). In particular, design issues, such as the lack of regularly repeated assessments in follow-up studies (Willoughby, 2003, Langberg et al., 2008), have led to a lack of knowledge concerning the association between developmental patterns of inattention and low educational attainment. In one exception, Breslau et al. (2010) demonstrated that changes in inattention levels between two assessments at ages 6 and 11 were followed by changes in educational achievement between ages 11 and 17.

Developmental trajectories have been used to examine the heterogeneous developmental patterns of inattention symptoms (Willoughby, 2003, Larsson et al., 2011). However, developmental trajectory estimation combines information concerning the level (e.g. high) and the functional form (e.g. rising). As such, we do not know whether children in a high rising inattention trajectory had lower educational attainment because they were in a rising trajectory or simply because they had high mean levels of inattention across childhood. We aimed to test whether averaged levels of inattention across childhood and/or the functional form of childhood trajectories of inattention made a significant contribution to early adulthood low educational attainment. We used a new trajectory estimation approach to reanalyze previously published data (Pingault et al., 2011). Understanding the developmental course of inattention and the associated impairments is a neglected area of study despite potential benefits in terms of basic research – e.g. understanding underlying mechanisms – as well as clinical research – e.g. informing the prognosis (Willoughby, 2003).

Section snippets

Participants

The study sample included 2000 participants belonging to the Quebec Longitudinal Study of Kindergarten Children and selected to be representative of the children attending kindergarten in French-speaking state schools in the province of Quebec in the 1986–87 and 1987–88 school years (Pingault et al., 2011).

Outcome variable

Information about high school graduation was obtained through the Quebec Ministry of Education at age 22 and 23. The measure differentiated between participants who had a high school diploma

Inattention trajectories

Three adjusted trajectories resulted from the analysis: a stable trajectory, a fluctuating trajectory and a rising trajectory (see Fig. 1 and online supplement for details and a rationale regarding the number of trajectories).

Results

The final model included averaged levels of inattention (mean=2.26, S.D.=1.88), trajectory membership, adversity and sex. The averaged levels of inattention across years significantly predicted graduation failure (odds ratio [OR]: 1.78; 95% Confidence Interval [CI]:

Discussion

We aimed to verify whether mean levels of inattention across childhood and/or the form of inattention trajectories made significant contributions to high school graduation failure. Average levels of inattention strongly predicted graduation failure and, independent of these average levels, boys in the rising trajectory were still 46% more likely to fail than boys in the stable trajectory (56% for girls).

The fact that we detected a subgroup of children with rising inattention is coherent with

Funding/support

This study was supported by grants from the Fonds québecois de la recherche sur la Société et la Culture; grants from the Social Sciences and Humanities Research Council, Canada; grants from the Canadian Institutes of Health Research (National Health Research and Development Program/Canadian Institutes of Health Research); grant SES-9911370 from the US National Science Foundation; grant RO1 MH65611-01A2 from the US National Institute of Mental Health; and a grant from the National Consortium on

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