How Is Early-Childhood Intervention Like Compound Interest?

Jason Fletcher, who teaches public health at Yale, has written earlier on the connection between ADHD and crime. (The gist: “children who experience ADHD symptoms face a substantially increased likelihood of engaging in many types of criminal activities.”) He now has a new working paper called “The Effects of Childhood ADHD on Adult Labor Market Outcomes” (abstract, PDF):

While several types of mental illness, including substance abuse disorders, have been linked with poor labor market outcomes, no current research has been able to examine the effects of childhood ADHD.  As ADHD has become one of the most prevalent childhood mental conditions, it is useful to understand the full set of consequences of the illness.  This paper uses a longitudinal national sample, including sibling pairs, to show important labor market outcome consequences of ADHD.  The employment reduction is between 10-14 percentage points, the earnings reduction is approximately 33%, and the increase in social assistance is 15 points, which are larger than many estimates of the black-white earnings gap and the gender earnings gap.  A small share of the link is explained by education attainments and co-morbid health conditions and behaviors.  The results also show important differences in labor market consequences by family background and age of onset. These findings, along with similar research showing that ADHD is linked with poor education outcomes and adult crime, suggest that treating childhood ADHD can substantially increase the acquisition of human capital.

The more research of this sort that we see, the easier it is to believe the following: compound interest may indeed be the eighth wonder of the world, but early-childhood investment and intervention is probably Wonder 7.5.

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  1. Brad says:

    It would be helpful if there were a corollary study that showed improved adult labor market outcomes for children diagnosed with ADHD that were subsequently put on a dopamine reuptake inhibitor and/or given consistent cognitive behavioral therapy. If the data suggested those interventions led to reduced crime rates and better marketplace productivity in adulthood, then educators and health officials could begin to fund-raise and coordinate publicly administered intervention programs. This all given that the cost/benefit passes analysis based on the above mentioned corollary study.

    There would still be concerns over long term use of DRIs by children with still-developing brains, but research suggests that there’s a mere lag in prefrontal cortex development and proper function which leads to these ADHD cases, and any medicinal intervention would only be necessary for a short time, likely less than < 3 years, and determined by individual brain imaging every 6-12 months to monitor PFC development. http://www.pnas.org/content/104/49/19649.full

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  2. Paul says:

    “… early-childhood investment and intervention is probably Wonder 7.5.”

    This title and tagline for this article implies that early-childhood investment and intervention decreases ADHD symptoms…. but where is the data supporting this?

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    • Lemmy Caution says:

      step 1) assume a cure
      step 2) use the cure to fix ADHD
      step 3) substantially increase the acquisition of human capital

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  3. pawnman says:

    Man, I dodged that bullet. I was diagnosed with ADHD as a child, and now I’m a fully-functional member of society. My brother, who was not diagnosed with ADHD, is now dependent on government assistance.

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  4. Alan Gunn says:

    My feelings on this are mixed. I’ve worked with neglected and abused children, and I’ve seen teachers pushing for ADHD meds for a kid who was plainly not ADHD. He just never learned to read, got promoted anyway, and ended up seriously bored in school because he couldn’t do the work. Furthermore, there’s a lot of work suggesting that many grade school teachers just don’t like boys much because they won’t sit still all day long. Grade school is a seriously boring place for bright kids, and some degree of rebellion is natural, even healthy. Overdiagnosis of ADHD is a serious risk.

    I loved grade school myself. My teachers mostly left me alone and I read books all day, while the other kids were doing whatever they did. Boredom didn’t set in until high school. Most schools aren’t as understanding as mine, though.

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    • James says:

      I agree: too many of these things – ADHD, Asperger’s, etc, are treated as disorders when they are really just part of the normal range of human variability. The “disorder” is that these differences are an inconvenience to some in the educational system.

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  5. Love says:

    Concentrating on stuff like crime or unemployment when researching ADHD is really counter-productive. Also that s only a small spectrum of the implications of the disorder and to focus on these creates an image close to that of a sociopath – well done.

    ADHD people are often more innovative, more creative, more questioning, more intuitive, more open, more honest, more focused and they hate lying. The list goes on and on. There pretty sure is a reason that there are still a lot of people with this kind of brain around. To label them criminals is pretty much counter-productive. No one will benefit from that.

    Crime and breaking rules, also under-archivement ARE ADHD issues, thats certainly true. But there is also tremendous value coming from these people, value that no society can do without.

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  6. Mcra99 says:

    I have six to eight kids each year who are deemed AD or ADHD all are boys with the occasional girl included in that mix. The number of children who I have each year that receive that diagnosis has increased over the years.

    The pediatrician who certifies the condition uses a checklist of AD/HD characteristics or markers that is completed by the parent and teacher; the doctor also relies on his interview of the child to make that diagnosis, usually one. Unlike a broken arm, one is not really sure if there is medically something different about the AD/HD child; the diagnosis is based on the opinion of adults whose views vary about normal childhood behavior and school work habits.

    Comparing my checklist results to other female teachers’ checklists is always interesting. I seem to tolerate the behaviors of boys more than female teachers. I don’t condone the behavior that other teachers dislike – I just know that I can’t change everything about the boy’s behavior in 180 days, but I am relentless in my quest to get the boy to see his errant ways with regard to behavior and school work habits. In fact, in my classroom boys are more quiet and careful about what they say and do. Once out of my room, all bets are off, so to speak. Female teachers notice it. I attribute it to lack of respect for females – boys know what they can get away with and with whom.

    Many of the boys designated AD/HD come from homes of single moms where boys rule the roost. If there is a two parent home, the father is away a lot because of work or the parents are divorced and the child rarely sees the father.

    I do see more parents insisting on a AD/HD label with medication to overcome poor school work habits…not completing notes in class, not turning in assignments, not completing homework, or just not caring for school, and the parent just doesn’t have the time to follow up at home. I think most of the affective and academic behaviors these boys exhibit are learned from home where these boys have figured out how to circumvent parents and stoke their frustrations – parents give up because they are working a lot or don’t have the resolve to squash unwanted behaviors. For example, when my 7 year-old son doesn’t follow through, one month of no electronics resonates. My son has learned that I mean what I say. Parents to whom I suggest long term consequences are in order can only manage one or two days of no XBox. Don’t turn in a project…a couple of days of no XBox is doable for the boy who has avoided two weeks of research. I have only had three or four boys in my 21 years of teaching who needed to be medicated, because they were a danger to the physical well-being of others.

    Finally, many of the children in my classroom who have AD/HD are too young to understand what habits are required to be a productive citizen or employee; sometimes, age and maturity kicks in and changes are made later in life – or they pursue careers where they call the shots. But those students never had a AD/HD in the first place ….just tired or absent parents.

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