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Trajectories of Response to Treatments in Children with ADHD and Word Reading Difficulties

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Abstract

This study investigated patterns of response to intervention in children with co-occurring attention-deficit/hyperactivity disorder (ADHD) and reading difficulties (RD), who participated in a randomized clinical trial examining the efficacy of reading intervention, ADHD treatment, or combined treatments. Growth Mixture Modeling (GMM) was used to investigate trajectories of parent and teacher academic impairment ratings and child oral reading fluency, and whether trajectories were predicted by pre-treatment covariates (ADHD severity, reading achievement, phonemic awareness, rapid letter naming, anxiety, oppositional defiant disorder), for 216 children with ADHD/RD in 2nd-5th grade (61.1% male; 72.2% African American; 8.8 ± 1.3 years of age). GMM revealed three trajectories for academic impairment (6.9–24.2% stable, 23.7–78.7% moderately improving, and 14.1–52.1% steeply improving) and oral reading fluency (20.8% low improving, 42.1% moderate improving, and 37.1% high improving). Children in the reading intervention were more likely to be in the stable or moderately improving trajectory than those in the ADHD and combined treatments, who were more likely to be in the steeply improving trajectory for academic impairment. Relative to the ADHD intervention, children in the reading intervention were more likely to be in the high improving trajectory than the moderate or low improving trajectory for oral reading fluency. Children without comorbid anxiety and with better reading skills showed a more positive treatment response for teacher-rated academic progress and oral reading fluency. Results highlight the importance of examining individual differences in response to reading and ADHD interventions. Intervention modality predicted differences in parent/teacher ratings of academic progress as well as reading fluency.

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Data Availability

Data used in the current manuscript is available from the corresponding author, Leanne Tamm, Ph.D., upon request and execution of a data sharing agreement.

Code Availability

Mplus syntax used in the growth mixture modeling analyses is available from the first author, Melissa Dvorsky, upon request.

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Funding

This research was supported by grant R01 HD060617 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). Melissa Dvorsky is supported by grants (K23MH122839 and T32MH018261) from the National Institute of Mental Health (NIMH). The content is solely the responsibility of the authors and does not necessarily represent the official views of NICHD or the National Institutes of Health. ClinicalTrials.gov Identifier: NCT01133847.

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Authors and Affiliations

  1. Children’s National Medical Center, Psychology and Behavioral Health, Washington D.C., USA

    Melissa Dvorsky & Carolyn A. Denton

  2. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, MLC 10006, Cincinnati, OH, USA

    Leanne Tamm & Jeffery N. Epstein

  3. University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Leanne Tamm & Jeffery N. Epstein

  4. Department of Psychology, Florida State University, Tallahassee, FL, USA

    Christopher Schatschneider

Authors
  1. Melissa Dvorsky
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  2. Leanne Tamm
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  3. Carolyn A. Denton
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  4. Jeffery N. Epstein
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  5. Christopher Schatschneider
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Leanne Tamm, Carolyn Denton, and Jeff Epstein. Analyses were performed by Melissa Dvorsky with input from Chris Schatschneider. The first draft of the manuscript was written by Melissa Dvorsky & Leanne Tamm and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Leanne Tamm.

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Research Involving Human Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments and comparable ethical standards.

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Written informed consent was obtained from the parents, and verbal or written (ages 11 and up) was obtained from the children.

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Dvorsky, M., Tamm, L., Denton, C.A. et al. Trajectories of Response to Treatments in Children with ADHD and Word Reading Difficulties. Res Child Adolesc Psychopathol 49, 1015–1030 (2021). https://doi.org/10.1007/s10802-021-00815-y

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  • DOI: https://doi.org/10.1007/s10802-021-00815-y

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