"Your Child Should Not Return": Preschool Expulsion Among Children With Attention-Deficit/Hyperactivity Disorder as an Early Indicator of Later Risks.
Angelika H Claussen, Sara Beth Wolicki, Melissa L Danielson and 1 others
PMID 38896562WHAT IT FOUND
Children with ADHD who had been expelled from preschool had more severe symptoms, other mental or behavioral disorders, and later school and family difficulties than children with ADHD who had not been expelled.
Key findings
014.4% of children ever diagnosed with ADHD were reported to have been expelled from preschool.
02Children with preschool expulsion had earlier first concerns about behavior, attention, or performance, and a higher prevalence of severe ADHD symptoms and other mental, behavioral, or developmental disorders.
03Children with preschool expulsion had higher prevalence of later problems with school performance, writing, handwriting, organized activities, and parent-child relationships, but not sibling or peer relationships.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The data were parent report, so recall about preschool expulsion and early symptoms may be imperfect. Children ranged from 5 to 17 years, and parents of older children may have difficulty recalling preschool events. The survey did not know whether children without preschool expulsion had attended preschool, so non-expelled children may not have been exposed to preschool settings. Many outcomes were measured at the time of the survey, not during preschool, so they may not describe preschool functioning. Some demographic estimates had small cell sizes and unstable prevalence, including non-Hispanic Black children. The sample included only children ever diagnosed with ADHD, so it cannot compare expelled children with children who never had ADHD. Data were collected in 2014 and may not reflect current populations.
Declared interests
The CDC conducted the survey with support from CDC's National Center on Birth Defects and Developmental Disabilities. The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that preschool expulsion causes more severe ADHD or other disorders. The study compared children with ADHD who were expelled with children with ADHD who were not expelled, and it did not include children without ADHD, so it cannot show that expulsion caused these outcomes.