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Abstracts
Résumé
Les élèves du primaire référés aux services scolaires complémentaires pour des troubles du comportement constituent l’une des clientèles les plus visées par la prescription de stimulants du système nerveux central (SSNC) puisque nombre d’entre eux présentent un TDAH. Il existe cependant très peu d’information permettant d’établir jusqu’à quel point la prise de SSNC est associée au TDAH chez ces élèves ou si d’autres caractéristiques contribuent à accroître la probabilité d’utilisation des SSNC. L’étude a été menée auprès de 341 élèves suivis à l’école primaire pour des troubles du comportent (27,8 % de filles, âge moyen : 9,9 ans). Les symptômes du TDAH et d’autres troubles du comportement ont été évalués à l’aide d’un instrument diagnostique utilisé auprès d’un parent et d’un enseignant. L’étude montre que 39,9 % des élèves prennent des SSNC et que, parmi les élèves qui n’ont pas de TDAH, près du tiers utilisent des stimulants. Les symptômes d’hyperactivité-impulsivité, les symptômes de trouble de l’opposition avec provocation, le groupe d’âge (6-8 ans), le statut socioéconomique (moyen-élevé) et le placement en classe spécial contribuent de manière unique à accroître la probabilité d’utiliser des SSNC. Ces résultats suggèrent donc que plusieurs caractéristiques autres que le TDAH peuvent jouer dans la décision de traiter les difficultés de ces enfants avec des SSNC. Ces résultats appellent à une meilleure évaluation du TDAH chez ces enfants de même qu’à un suivi longitudinal pour connaître les effets à long terme des SSNC sur leur adaptation scolaire.
Mots-clés :
- stimulants du système nerveux central,
- TDAH,
- troubles du comportement,
- trouble de l’opposition avec provocation,
- troubles des conduites,
- enfants d’âge scolaire primaire,
- services scolaires complémentaires
Abstract
Objectives Elementary school-aged children referred to school-based mental health services for conduct problems are commonly also prescribed central nervous system stimulants (CNSS), since many also suffer from comorbid ADHD. Nevertheless, there exists little information in the extant literature to determine to what degree the prescription of CNSS is associated with the presence of ADHD in these students or if other characteristics contribute to increasing the likelihood of CNSS use.
Methods The current study was carried out on a sample of 341 students receiving school-based mental health services for conduct problems (27.8% girls, mean age of 9.9 years). ADHD and conduct problem symptomatology was assessed using a structured diagnostic instrument administered to parents and teachers.
Results Results show that 39.9% of students were medicated using CNSS and that, among those who do not present ADHD symptomatology, approximately a third used CNSS. Age (6-8 years), socio-economic status (medium or high), placement in a special class for children with conduct problems, and symptoms of hyperactivity/impulsivity and oppositional defiant disorder all contributed unique variance in the prediction of utilisation of CNSS in this sample.
Conclusion These results suggest that there may be several characteristics other than the presence of ADHD that can contribute to the medical decision to treat child problems with CNSS. These findings also underscore the importance of more rigorous assessment of ADHD in these children as well as longitudinal follow-up studies to determine the long-term effects of CNSS on their educational performance and eventual educational attainment.
Keywords:
- central nervous system stimulants,
- ADHD,
- conduct problems,
- oppositional defiant disorder,
- elementary school-aged children,
- school-based mental health services
Appendices
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