ADHD Treatment Types and Their Impact on Mental Health and School Success Outcomes

Background and Purpose: ADHD affects 5-8% of American youth, making it the most prevalent neurodevelopmental disorder among children in the United States. Children with ADHD often experience difficulties in interpersonal relationships, academic settings, and home environments. As they transition to adulthood, they face elevated risks of substance use, academic underachievement, financial struggles, legal issues, and comorbid mental health conditions. While existing research suggests that combining behavioral and pharmaceutical approaches yields optimal outcomes, with school interventions also showing promise, the comparative effectiveness of these treatments remains under-explored. This study aimed to examine the relationship between different ADHD treatment modalities (behavioral, pharmaceutical, and school-based interventions) and their impact on mental health outcomes (anxiety and depression) and school success indicators (grades, attendance, school engagement, and behavioral problems).

Methods: This study analyzed data from the 2022 National Survey of Children's Health (NSCH), which included a nationally representative sample of children under 18 years in the United States (n=54,103). The research explored associations between ADHD treatment modalities, sociodemographic factors, mental health outcomes, and school success indicators. Multivariate logistic regression models were employed, controlling for relevant covariates, to examine the relationship between ADHD interventions and the specified outcome measures among children diagnosed with ADHD.

Results: Contrary to established research suggesting combination treatments provide optimal outcomes, this study found that pharmaceutical treatment alone outperformed combination approaches for both school success and mental health outcomes. Unexpectedly, school-based interventions were associated with poorer academic performance indicators, including lower grades, increased school-related problems, and decreased academic engagement. Consistent with previous findings, girls with ADHD exhibited worse mental health outcomes but fewer school-related difficulties compared to boys with the same diagnosis. The study also identified significant patterns in intervention implementation related to sociodemographic factors, suggesting potential disparities in treatment access and utilization.

Conclusions and Implications: These findings challenge the current consensus on ADHD treatment effectiveness, suggesting potential advantages of pharmaceutical interventions alone for both academic and psychological well-being. Further longitudinal research is needed to better understand these relationships and their mechanisms. For social work practice, these results have multi-level implications: (1) At the micro level, practitioners should address diverse ADHD presentations and discuss medication benefits with families while acknowledging cultural barriers and stigma; (2) At the mezzo level, social workers should foster collaborative relationships between educational staff and families to actively engage students in treatment planning; (3) At the macro level, advocacy for increased school funding and efforts to reduce stigma surrounding ADHD medication can facilitate timely intervention and mitigate long-term challenges associated with untreated ADHD.