Associations Between Participation in After-School Activities, Attention-Deficit/Hyperactivity Disorder Severity, and School Functioning.

Objective: To examine the association between after-school activity (ASA) participation, attention-deficit/hyperactivity disorder (ADHD) severity, and school functioning among children with ADHD.

Methods: A cross-sectional study was conducted using data from the 2016 National Survey of Children's Health on ADHD severity, ASAs and 2 domains of school functioning among children with ADHD: missed days from school and calls home from school.

Results: Of 4,049 children with ADHD (weighted N = 5,010,662), 71.8% participated in at least 1 ASA. In multivariable regression analyses, ASA participation was associated with lower odds of moderate-to-severe ADHD [adjusted odds ratio (aOR): 0.62, 95% confidence interval (CI), 0.46-0.85] and lower odds of missed school days (aOR 0.55, 95% CI, 0.41-0.74). We did not find significant associations with calls home from school (aOR 0.79, 95% CI, 0.59-1.07).

Conclusion: After-school activity participation is associated with decreased ADHD severity and reduced school absenteeism. Efforts to optimize ADHD outcomes should consider engaging children and adolescents in ASAs.