http://archpedi.jamanetwork.com/ en-us Sat, 01 Dec 2012 00:00:00 GMT Tue, 01 Jan 2013 00:49:06 GMT Silverchair editor@archpedi.jamanetwork.com webmaster@archpedi.jamanetwork.com http://archpedi.jamanetwork.com/article.aspx?articleID=383218 Sat, 01 May 2010 00:00:00 GMT Sayal K, Owen V, White K, et al. <span class="paragraphSection"><div class="boxTitle">Objectives</div>To investigate the impact of early school-based screening and educational interventions on longer-term outcomes for children at risk for attention-deficit/hyperactivity disorder (ADHD) and the predictive utility of teacher ratings.<div class="boxTitle">Design</div>A population-based 5-year follow-up of a randomized, school-based intervention.<div class="boxTitle">Setting</div>Schools in England.<div class="boxTitle">Participants</div>Children between 4 and 5 years of age with high teacher-rated hyperactivity/inattention scores. Follow-up data were collected on 487 children in 308 schools.<div class="boxTitle">Interventions</div>Following screening, using a 2 × 2 factorial design, schools randomly received an educational intervention (books about ADHD for teachers), the names of children with high hyperactivity/inattention scores between ages 4 and 5 years (identification), both educational intervention and identification, or no intervention.<div class="boxTitle">Outcome Measures</div>Parent-rated hyperactivity/inattention, impairment in classroom learning, and access to specialist health services for mental health or behavioral problems.<div class="boxTitle">Results</div>None of the interventions were associated with improved outcomes. However, children receiving the identification-only intervention were twice as likely as children in the no-intervention group to have high hyperactivity/inattention scores at follow-up (adjusted odds ratio, 2.11; 95% confidence interval, 1.12-4.00). Regardless of intervention, high baseline hyperactivity/inattention scores were associated with high hyperactivity/inattention and specialist health service use at follow-up.<div class="boxTitle">Conclusions</div>We did not find evidence of long-term, generalizable benefits following a school-based universal screening program for ADHD. There may be adverse effects associated with labeling children at a young age.</span> 164 5 462 469 10.1001/archpediatrics.2010.40 http://archpedi.jamanetwork.com/article.aspx?articleID=383218