Genetic basis of ADHD and autism spectrum disorder impacts on children's school performance

Attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are neurodevelopmental disorders that appear during childhood and often interfere with school performance.

A study coordinated by the Institut de Recerca Sant Joan de Déu (IRSJD), the Vall d'Hebron Research Institute (VHIR), within the SJD MIND Schools program, and the CIBER of Mental Health (CIBERSAM) has analyzed the impact of the genetic basis of these disorders on the mental health and academic outcomes of children and adolescents from 43 schools and high schools in Catalonia. The results have been published in the journal Molecular Psychiatry.

To understand the relationship between these neurodevelopmental disorders and school performance, the genome of 4,278 children of different ages and socioeconomic backgrounds was analyzed and the impact of genetic variants associated with ADHD and ASD on the mental health and academic performance in mathematics, language and English of the participants was investigated.

The results of the work show a strong relationship between genetic risk factors for ADHD and ASD and school performance. "We have seen that the genetic basis underlying these disorders is associated with the characteristic clinical symptomatology and, partly through these symptoms, contributes to school performance", explains Dr. Judit Cabana-Domínguez, researcher in the Psychiatry, Mental Health and Addictions group at VHIR and CIBERSAM. "This genetic component that negatively impacts academic achievement is not only associated with the characteristic symptoms of these disorders but also with emotional and behavioral problems. Expanding the knowledge about the risk factors that negatively impact school performance and their relationship with neurodevelopmental disorders can contribute to define preventive strategies for the benefit of the most vulnerable students", details Dr. Marta Ribasés, principal investigator of the Psychiatry, Mental Health and Addictions group of VHIR and CIBERSAM.

It is observed that the genetic basis of ADHD also influences multiple behavioral and emotional problems, such as depression and anxiety, which in turn are related to poorer school performance. In addition, poor academic performance may also aggravate these mental health problems, creating a vicious cycle. Furthermore, the results in ASD indicate that one part of the genetic load underlying the disorder is associated with poor school performance, but another is related to better achievement in different subjects.

"Identifying the genetic factors and associated symptoms that correlate with better or worse school performance helps to understand diversity in the classroom, explains, in part, why some children have difficulty learning and may be useful for early detection of future school performance problems", says Dr. Rosa Bosch, coordinator of the SJD MIND Schools program at the IRSJD and SJD Barcelona Children’s Hospital, and CIBERSAM.

Understanding biology for better support of children in schools

Understanding the genetic factors and biological mechanisms underlying neurodevelopmental disorders and their relationship with school performance helps to understand how these may impact educational outcomes. On this regard, the research team highlights that, despite the genetic relationship, it is not deterministic and family and educational support play a key role.

"Identifying the most affecting symptoms, even before the diagnosis of the disorder, is necessary to address educational needs from an early stage", highlights Dr. Miquel Casas, director of the SJD MIND Schools program. "It is essential to provide more individualized attention and support for students, especially those with the highest needs, in order to improve motivation and academic results", he concludes.

The study was possible thanks to funding received from the 3Cat Marató Foundation, Health Research Funds and FEDER funds.

SJD MIND Schools team (left to right): Maria Andreu Pascual, Laura Martínez Fernández, Lorena Gómez Villarroya, Yolanda Santaella Andrés, Rosa Bosch Munsó, Júlia Puigbó Vivas, Clara del Castillo París, Raquel Prat Farràs, Mireia Pagerols Teixidó, Èlia Pagespetit Feliu and Miquel Casas Brugué.

Reference paper

Cabana-Domínguez J, Bosch R, Soler Artigas M, Alemany S, Llonga N, Vilar-Ribó L, Carabí-Gassol P, Arribas L, Macias-Chimborazo V, Español-Martín G, Del Castillo C, Martínez L, Pagerols M, Pagespetit È, Prat R, Puigbó J, Ramos-Quiroga JA, Casas M, Ribasés M. Dissecting the polygenic contribution of attention-deficit/hyperactivity disorder and autism spectrum disorder on school performance by their relationship with educational attainment. Mol Psychiatry. 2024 May 23. doi: 10.1038/s41380-024-02582-w. Epub ahead of print. PMID: 38783053.

These results reinforce the need for more individualized attention to address educational needs from an early stage.