How effective are drug treatments for children with ADHD at improving on-task behaviour and academic achievement in the school classroom? A systematic review and meta-analysis

2012 ◽  
Vol 22 (4) ◽  
pp. 203-216 ◽  
Author(s):  
Vibhore Prasad ◽  
Ellen Brogan ◽  
Caroline Mulvaney ◽  
Matthew Grainge ◽  
Wendy Stanton ◽  
...  
2017 ◽  
Author(s):  
Lisa G. Smithers ◽  
Alyssa C. P. Sawyer ◽  
Catherine R. Chittleborough ◽  
Neil Davies ◽  
George Davey Smith ◽  
...  

AbstractBackgroundSuccess in school and the labour market is due to more than just high intelligence. Associations between traits such as attention, self-regulation, and perseverance in childhood, and later outcomes have been investigated by psychologists, economists, and epidemiologists. Such traits have been loosely referred to as “non-cognitive” skills. There has been no attempt to systematically assess the relative importance of non-cognitive skills in early life on later outcomes.MethodsThe systematic review protocol was registered with the International Prospective Register for Systematic Reviews (PROSPERO, CRD42013006566) in December 2013. We systematically reviewed electronic databases covering psychology, education, health and economics for articles published from database conception until September 2015. Titles and abstracts were screened for eligibility, and from eligible articles data was extracted on study design, sample type and size, age of participants at exposure and outcome, loss to follow up, measurement of exposure and outcome, type of intervention and comparison group, confounding adjustment and results. Where possible we extracted a standardised effect size. We reviewed all studies and rated their evidence quality as ‘better, weak, or poor’ on the basis of study design and potential for confounding, selection and measurement bias.ResultsWe reviewed 375 studies and provided interpretation of results from 142 (38%) better quality studies comprising randomised controlled trials, quasi-experimental, fixed effects including twin studies, longitudinal and some cross-sectional designs that made reasonable attempts to control confounding. In the academic achievement category outcomes were reported in 78 publications of better quality studies which were consistent with 0.1-0.2 SD effects.Psychosocial outcomes were reported in 65 better quality studies consistent with effects of 0.3-0.4 SD. For the language and cognitive category there were 42 publications reporting better quality studies consistent with effects of 0.3-0.4 SD. For physical health, results across only eight better quality studies were inconsistent but centred around zero. Analysis of funnel plots consistently showed asymmetric distributions, raising the potential of small study bias which may inflate these observed effects.ConclusionsThe evidence under-pinning the importance of non-cognitive skills for life success is diverse and inconsistent. Nevertheless, there is tentative evidence from published studies that non-cognitive skills associate with modest improvements in academic achievement, psychosocial, and language and cognitive outcomes with effects in the range of 0.2-0.4 SD. The quality of evidence under-pinning this field is generally low with more than a third of studies making little or no attempt to control even the most basic confounding (endogeneity) bias. The evidence could be improved by adequately powering studies, and using procedures and tools that improve the conduct and reporting of RCTs and observational studies. Interventions designed to develop children’s non-cognitive skills could potentially improve opportunities, particularly for disadvantaged children. The inter-disciplinary researchers interested in these skills should take a more rigorous approach to determine which interventions are most effective.


2021 ◽  
Author(s):  
Victor Zanetti Drumond ◽  
Gabriela Luíza Nunes Souza ◽  
Mateus José de Carvalho Pereira ◽  
Ricardo Alves Mesquita ◽  
Maryam Amin ◽  
...  

Objectives: To evaluate whether children with attention deficit/hyperactivity disorder (ADHD) are more affected by dental caries than children without ADHD by means of a systematic review and meta-analysis. Design: Electronic searches was performed in four databases (PubMed, Embase, Scopus, and Web of Science) in July 2021. Grey literature search in OpenGrey, a search in Google Scholar, and searches in the reference list of included articles were also conducted. The eligibility criteria were observational studies in which children with ADHD were compared with children without ADHD with respect to the dental caries. Study selection, data extraction, and risk of bias assessment, applying the Joanna Briggs tool were performed by two reviewers independently. Meta-analysis and assessment of heterogeneity among studies were conducted with the meta-package of RStudio using the R programming language (R Core Team, Vienna, Austria). Results of meta-analysis were provided in mean difference (MD), odds ratio (OR), and confidence intervals (CI). For assessment of heterogeneity, Baujat plot and influence analysis plot were obtained. Results: Thirteen studies were included and 10 were incorporated into meta-analyses. The meta-analysis showed that children with ADHD had a higher decayed, missing, and filled teeth (DMFT) index than their peers without ADHD (I²=42%; MD=0.75 [0.38-1.13]). For decayed, missing, and filled surfaces (DMFS) (I²=0; MD=0.39 [-0.02-0.80]) and decayed surfaces (DS/ds) (I²=0%; MD=0.35 [-0.63-1.33]), no difference between groups was observed. In addition, children with ADHD had higher odds of having dental caries than their healthy peers (OR = 3.31 [1.25, 8.73]; I² = 0%). After assessment of heterogeneity among studies, sensitivity analysis was conducted for DMFT. One study was removed and the significant difference between groups remained. Children with ADHD had a significantly higher DMFT index than their peers without ADHD (MD = 0.98 [CI = 0.75, 1.20]; I² = 0%) Risk of bias ranged from low to high. Conclusion: The main shortcoming of the included studies is the high risk of bias regarding the strategies to deal with confounding factors. Within its limitations, this systematic review and meta-analysis demonstrated that children with ADHD were more likely to develop dental caries than their healthy counterparts. Funding: No funding Registration: CRD42021238923


2017 ◽  
Vol 24 (7) ◽  
pp. 947-962 ◽  
Author(s):  
Yvonne C. Y. Chau ◽  
Si-Min Peng ◽  
Colman P. J. McGrath ◽  
Cynthia K. Y. Yiu

Objective: This systematic review investigated the oral health of children with ADHD. Method: A structured search strategy was performed on five electronic databases: SCOPUS, Web of Science, COCHRANE, PubMed, and PsychInfo. Studies were included in the review if they reported clinical oral health outcomes on a population diagnosed with ADHD under the age of 18 years old. Qualitative and quantitative analysis was performed on pooled prevalence and mean/median values for caries, trauma, periodontal problems, and tooth wear. Results: Twenty-seven effective articles were reviewed by two calibrated assessors. Meta-analysis of the results found higher mean number of decayed surfaces, plaque index, and trauma prevalence among children with ADHD. Conclusion: Children with ADHD show increased risk for caries and traumatic dental injuries, and may have poorer oral hygiene compared with children without ADHD. More awareness among clinicians would promote better caries- and trauma-preventive advice and management.


2016 ◽  
Vol 10 (13) ◽  
pp. 257-269
Author(s):  
Conceicao Moura Mirian ◽  
Rita Carvalho Garbi Novaes Maria ◽  
SSP Zago Yuri ◽  
Junio Eduardo Emanoel ◽  
Augusto Casulari Luiz

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hoda Seens ◽  
Shirin Modarresi ◽  
Joy C MacDermid ◽  
David M Walton ◽  
Ruby Grewal

Abstract Background Attention-deficit/hyperactivity disorder (ADHD) is a significant neurodevelopment disorder among children and adolescents, with 5 % prevalence. Bone fractures account for 25 % of accidents and injuries among all children and adolescents. Considering the characteristics of inattention, hyperactivity, and impulsivity in children with ADHD, it is critical to examine bone fractures among these children. The objective of our meta-analysis was to determine the prevalence of bone fractures among children and adolescents with ADHD. Methods We completed a systematic review and meta-analysis using an electronic search of the following databases: CINAHL, EMBASE, PsycINFO, PubMed, and Scopus. The search terms used were: “attention deficit hyperactivity disorder OR attention deficit disorder” and “bone fracture*.” We included studies examining patients 18 years or younger who were diagnosed with ADHD and tracked (prospectively or retrospectively) for five or more years. Effect size (es), using a random effects model, was calculated. We registered the review protocol with PROSPERO (CRD42019119527). Results From 445 records retrieved, 31 full text articles were reviewed and 5 articles met inclusion criteria for meta-analysis. The summary es revealed the prevalence of bone fractures among children and adolescents with ADHD to be 4.83 % (95 % CI: 3.07–6.58 %). The location of bone fractures, using a subset of data, showed a distribution of 69.62 %, 22.85 %, and 7.53 % in the upper limbs, lower limbs, and other anatomical regions, respectively. Another subset of studies revealed a 2.55-fold increase in the prevalence of fractures among the children with ADHD compared to their counterparts. Conclusions Awareness of these findings is critical to physicians, parents, and policy makers to create safe environments and provide supports in order to optimize the health and safety of children and adolescents with ADHD.


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