Attention Deficit Disorder-Hyperactivity and Academic Failure: Which Comes First and What Should Be Treated?

Abstract

Evidence on the relationship between attention deficit disorder-hyperactivity (ADDH) and learning difficulties is reviewed in the light of: (1) the degree of overlap between the two disorders, (2) possible causal directions between the two, and (3) the appropriate focus of treatment. The evidence suggests a substantial overlap in prevalence between the two types of disorder and that there is no qualitatively distinct pattern of cognitive deficits associated with each disorder. Furthermore, what longitudinal data there are suggest that learning difficulties lead to ADDH rather than the reverse. Finally, the appropriate focus of treatment would seem to be the learning difficulties of the child with ADDH. The authors recommend more longitudinal research on the relationship between ADDH and learning difficulties, particularly in terms of the potential behavioral effects of treating learning difficulties. © 1988, The American Academy of Child and Adolescent Psychiatry. All rights reserved.