Risk For Poor School Performance Research Articles

Attention deficit disorders in adults

Among the disorders that are most extensively investigated in medicine, especially in pediatrics, ADHD is considered a neuro-psychiatric disorder with multifactorial development, based on genetic predisposition and neurobiological disruptions. Epidemiological data indicate a global prevalence of 5.29% among individuals under 18 years of age, and recent analysis documents a prevalence of 2.5% in adults.1 Although previously it was considered that it remits in childhood or during adolescence, long-term studies on the term of children and prospective studies on adults with ADHD have shown that the disorder persists even into adulthood.2 In general, problems related to ADHD include, for children, a higher risk of poor school performance, lower academic achievements, lower grades, school suspensions, and extracurricular difficulties. In the case of adolescents, they may experience strained relationships with family, school dropout, aggression, conduct problems, and substance experimentation and abuse. In the case of adults, there may be accidents related to driving and violations of traffic rules, social difficulties in relationships, marriage, and employment.2 ADHD and comorbid depression are frequently reported, with prevalence rates in individuals with ADHD ranging from 18.6% to 53.3%.3 Similarly, studies have documented comorbidity between ADHD and depressive disorders with rates ranging from 9% to 16%, with a median rate of 7.8%.4

Association between small-for-gestational age and poor school performance in 2 500 000 children born 1973-2002.

To examine the association between infant weight for gestational age and school performance when leaving school at 16 years of age. Out of 2 525 571 infants born near- or at term, between 1 January 1973 and 31 December 2002, identified from the Swedish Medical Birth Register, 65 912 (2.6%) were born small-for-gestational age (SGA). Outcomes studied were the risk for the need for education in special school, and the final average grades. Modified Poisson regression analyses and weighted linear regression analyses were performed. An association between SGA and the need for a special school was found, irrespective of restrictions or adjustments (RR between 2.47 and 2.25). SGA was associated with final grades below the 10th and 25th percentile (RR 1.49 and 1.18, respectively). A linear relationship between maternal height and the RR for education in special school (p = 0.005), suggested that SGA is a stronger risk factor among children of tall than of shorter women. SGA increased the risk for poor school performance, and for the need for a special school. We found an association between maternal height and school performance in relation to birthweight, suggesting that maternal height should be considered when estimating the impact of SGA on later outcomes.

Abstract 13952: Neurodevelopmental Outcomes in Early Adolescence: The Pediatric Heart Network’s Single Ventricle Reconstruction Trial

Introduction: Neurodevelopmental (ND) and functional impairments for survivors of palliated hypoplastic left heart syndrome (HLHS) are among the most consequential morbidities, resulting in an increased risk of poor school performance and lower reported quality of life. Longitudinal follow-up of those enrolled in the Single Ventricle Reconstruction (SVR) III study provides opportunity to measure important outcomes such as ND, and understand associated risk factors. Goals/Aims: Describe and identify predictors of ND outcomes at 10-12 years of age in participants enrolled in SVR. Methods: Transplant-free survivors from the SVR III trial were invited to complete in-person ND assessments, including the Wechsler Intelligence Scale for Children-V, Wechsler Individual Achievement Test-III, and the Behavior Rating Inventory of Executive Function (BRIEF). Descriptive and regression analyses were performed. Results: Of the 237 enrolled in SVR III, 200 (84%) received a ND assessment. Participants who did vs did not undergo assessment were more likely to be male (63% vs 51%), white (87% vs 76%) and have a higher Child Opportunity Index (61 ±26 vs 46 ±39). Mean Full Scale IQ for the cohort was almost 1 standard deviation (SD) below the normative mean (88 ±18), with 39% >1 and 15% >2 SD below the normative mean. Similar patterns were seen for Reading (38% >1 SD and 16% > 2SD) and Math Composites (38% >1 SD, 19% > 2SD). Executive functions measured with the BRIEF were similarly affected, with 25% to 45% of individuals showing clinically significant (T score >65) Plan/Organization problems on parent and teacher forms, respectively. Measures of socioeconomic status, number of complications, and requirement for a gastrostomy-tube were all independent predictors for multiple ND outcomes. Conclusions: In early adolescence, transplant-free survivors of surgical palliation for HLHS show clinically significant ND concerns across multiple domains of functioning. The distribution of outcomes is broad. Our findings support the American Heart Association recommendations for screening and evaluation in middle school to inform interventions that promote academic success and quality of life.

Long-term effects of medication for opioid use disorder in children.

Opioid maintenance therapy in pregnant patients can result in children born with neonatal abstinence syndrome (NAS). These infants are at high risk for poor school performance, unemployment, and criminal activity because they never reach the neurocognitive levels of their peers. This article discusses the neurocognitive development consequences of medicated opioid use disorder on infants and children and methods to help them reach their potential into adulthood.

Development and Implementation of a Function-Based Clinical Interview to Evaluate Childhood Behavior Problems

The most common reason that children are referred to mental health providers relates to behavior and emotional problems. Without intervention, children with maladaptive behaviors are at risk for poor school performance, interpersonal difficulties, and significant conduct problems later in life. Previous research on the assessment of these problems has focused primarily on caregiver self-report questionnaires, observational coding, and/or diagnostic classification. The behavior literature has far fewer examples of best-practice interview strategies to solicit meaningful clinical information from primary stakeholders. Since caregiver report is essential during initial interviews to better understand his or her child’s presenting issues and given the primary role of assessment is to integrate information into the design of an evidence-based intervention (Barlow et al., 2005), additional published guidance on the content of these clinical interactions is warranted. The following paper outlines an approach to gathering pertinent information from caregivers about their children’s behavior in a way that is germane to treatment planning. In addition, the authors include validity and reliability data to substantiate the interview’s continued use in the clinical setting.

Stability and Change in Early Social Skills Development in Relation to Early School Performance: A Longitudinal Study of A Swedish Cohort

ABSTRACT Research Findings: This study aimed to investigate the developmental path of social skills in early childhood, the associated predictors, and its impact on later school performance. This prospective longitudinal study included 2,121 children, ages 3–5 at baseline, from the general population in a mid-sized Swedish municipality. Results show both stability and change in social skills. Stable low social skills increased the risk for poor school performance, while stable high social skills increased the chance for good school performance in primary school. With some notable gender differences, both individual and family factors were significant predictors of stable low and stable high paths of social skills during early childhood. Practice or Policy: Whether the goal is to improve children’s social skills or their performance in school, this study provides important clues for prevention. We identified several potential targets for interventions to promote early social skills development, which may in turn promote positive school performance. It is also notable that there seem to be gender differences in which factors are important, indicating the need for gender-differentiated interventions.

Cognitive and Learning Outcomes in Late Preterm Infants at School Age: A Systematic Review.

Late preterm children born between 340/7 and 366/7 weeks’ gestation account for ≈70% of prematurely born infants. There is growing concern about this population at risk of mild neurodevelopmental problems, learning disabilities and lower academic performance. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement, this paper analyzes recent published evidence from 16selected studies involving late preterm children and control group assessments at preschool and/or school age, mainly focusing on cognitive functioning, language learning and academic achievement. The review identifies the assessment tools used in these studies (standardized tests, parental questionnaires and laboratory tasks) and the areas being evaluated from preschool (age 3 years) to primary school levels. Results reveal the presence of mild difficulties, pointing to suboptimal outcomes in areas such as executive function, short term verbal memory, literacy skills, attention and processing speed. Some difficulties are transient, but others persist, possibly compromising academic achievement, as suggested by the few studies reporting on higher risk for poor school performance. Given the increasing number of late preterm children in our society the review highlights the need to implement screening strategies to facilitate early risk detection and minimize the negative effects of this morbidity in childhood.

Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication.

Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for poor school performance, and pharmacological treatment of ADHD may have beneficial effects on school performance. Conclusions from previous research have been limited by small sample sizes, outcome measures, and treatment follow-up. The current study analyzed school performance in students with ADHD compared to students without ADHD, and the association between pharmacological treatment of ADHD and school performance. A linkage of Swedish national registers covering 657,720 students graduating from year 9 of compulsory school provided measures of school performance, electronically recorded dispensations of ADHD medication, and potentially confounding background factors such as parental socioeconomic status. Primary measures of school performance included student eligibility to upper secondary school and grade point sum. ADHD was associated with substantially lower school performance independent of socioeconomic background factors. Treatment with ADHD medication for 3 months was positively associated with all primary outcomes, including a decreased risk of no eligibility to upper secondary school, odds ratio= 0.80, 95% confidence interval (CI)= 0.76-0.84, and a higher grade point sum (range, 0.0-320.0) of 9.35 points, 95% CI= 7.88-10.82; standardized coefficient= 0.20. ADHD has a substantial negative impact on school performance, whereas pharmacological treatment for ADHD is associated with higher levels in several measures of school performance. Our findings emphasize the importance of detection and treatment of ADHD at an early stage to reduce the negative impact on school performance.

The Link Between School Attendance and Good Health.

More than 6.5 million children in the United States, approximately 13% of all students, miss 15 or more days of school each year. The rates of chronic absenteeism vary between states, communities, and schools, with significant disparities based on income, race, and ethnicity. Chronic school absenteeism, starting as early as preschool and kindergarten, puts students at risk for poor school performance and school dropout, which in turn, put them at risk for unhealthy behaviors as adolescents and young adults as well as poor long-term health outcomes. Pediatricians and their colleagues caring for children in the medical setting have opportunities at the individual patient and/or family, practice, and population levels to promote school attendance and reduce chronic absenteeism and resulting health disparities. Although this policy statement is primarily focused on absenteeism related to students' physical and mental health, pediatricians may play a role in addressing absenteeism attributable to a wide range of factors through individual interactions with patients and their parents and through community-, state-, and federal-level advocacy.

Born Small for Gestational Age and Poor School Performance – How Small Is Too Small?

Aim: To assess the relationship between severity of small for gestational age (SGA) and the risk of poor school performance, and to investigate whether adult stature modifies this risk. Methods: 1,088,980 Swedish children born at term between 1973 and 1988 were categorized into severe SGA (less than –3 standard deviations (SD) of expected birth weight), moderate SGA (–2.01 to –3 SD), mild SGA (–1.01 to –2 SD), and appropriate for gestational age (–1 to 0.99 SD). The risk of poor school performance at the time of graduation from compulsory school (grades <10th percentile) was calculated using unconditional logistic regression models and adjusted for socio-economic factors. In a sub-analysis, we stratified boys by adult stature, and adjusted for maternal but not paternal height. Results: All SGA groups were significantly associated with an increased risk of poor school performance, with adjusted odds ratios and 95% confidence intervals ranging from 1.85 (1.65–2.07) for severe SGA to 1.25 (1.22–1.28) for mild SGA. In the sub-analysis, all birth weight groups were associated with an increased risk of poor school performance among boys with short stature compared to those with non-short stature. Conclusion: Mild SGA is associated with a significantly increased risk of poor school performance, and the risk increases with severity of SGA. Further, this risk diminishes after adequate catch-up growth.

Nutritional Status and Food Behavior among Primary School Students in Duhok City

Background: The assessment of nutritional status as a part of school health component, can serve as a screening tool to identify children who need nutritional intervention and to prevent further deterioration in their nutritional status with reducing the risk of poor school performance. Objective: Evaluate the primary school students' nutritional status in Duhok City and find out the relationship between students' nutritional status with their food behavior. Methodology: A cross sectional study was conducted throughout the period 25th November 2014 to 25th November 2015. Cluster stratified simple random sampling of (700) primary school students who aged 6-12 years were selected of 41 primary schools in Duhok city. Food behavior and socio- demographic data were obtained by direct interview. In addition, height and weight measured in order to calculate body mass index of primary school age children. A questionnaire was modified as a tool of data collection and utilized the height and weight scales for measuring student`s height and weight for the purpose of the present study. Data were analyzed through the use of descriptive and inferential statistical analysis approaches. Results: the present study showed highest percent (57.1%) of primary school student's nutritional status was healthy weight and more than two third of them were at somewhat healthy food behavior (71.3%). In addition to highly significant relationship between such nutritional status of primary school students and their food behavior with P. value (0.001). Conclusion: The present study revealed that the primary school students' nutritional status is influenced by their food behavior. Recommendations: The researchers recommended that schools of Duhok City, health care system and parent should involve in establishing nutritional educational program steps, guidelines, inclusion of health related nutritional topics in school curriculum with yearly screening children including: checking height, weight and BMI according to age.

Translating Assessment into Effective School Services for Students with Epilepsy

Children and adolescents with epilepsy are at increased risk of academic underachievement compared with siblings and healthy peers. Studies suggest that approximately 17 to 30% of children with epilepsy have intellectual disabilities; however, the heightened risk for academic difficulties has been shown in multiple samples of children with epilepsy, including those without intellectual disabilities, and also in children whose epilepsy is well controlled. Notably, learning problems are often identified before the first presenting seizure and are thought to reflect the underlying brain condition. Academic underachievement is most likely multifactorial, resulting from the impact of neurological, seizure, neuropsychological, medication, consistency of school attendance, and psychosocial variables. Several federal statutes ensure that all children in the United States have access to a free and appropriate public education. Despite the knowledge that children and adolescents with epilepsy are at high risk for poor school performance, many do not receive services. Neuropsychological evaluation can help inform appropriate direct services, educational goals, modifications, and accommodations within the school setting. Translation of evaluation findings into recommendations for effective educational programming and helping school personnel understand the unique needs of the children and adolescents with epilepsy will allow for informed school team decisions regarding how to promote academic success.

Sleep and academic performance in later adolescence: results from a large population-based study.

The aim of the current study was to assess the association between sleep duration and sleep patterns and academic performance in 16-19 year-old adolescents using registry-based academic grades. A large population-based study from Norway conducted in 2012, the youth@hordaland-survey, surveyed 7798 adolescents aged 16-19years (53.5% girls). The survey was linked with objective outcome data on school performance. Self-reported sleep measures provided information on sleep duration, sleep efficiency, sleep deficit and bedtime differences between weekday and weekend. School performance [grade point average (GPA)] was obtained from official administrative registries. Most sleep parameters were associated with increased risk for poor school performance. After adjusting for sociodemographic information, short sleep duration and sleep deficit were the sleep measures with the highest odds of poor GPA (lowest quartile). Weekday bedtime was associated significantly with GPA, with adolescents going to bed between 22:00 and 23:00hours having the best GPA. Also, delayed sleep schedule during weekends was associated with poor academic performance. The associations were somewhat reduced after additional adjustment for non-attendance at school, but remained significant in the fully adjusted models. In conclusion, the demonstrated relationship between sleep problems and poor academic performance suggests that careful assessment of sleep is warranted when adolescents are underperforming at school. Future studies are needed on the association between impaired sleep in adolescence and later functioning in adulthood.

&lt;em&gt;Overcoming Obstacles: African American Students with Disabilities Achieving Academic Success&lt;/em&gt;

The purpose of this study was to investigate African American high school students with high incidence disabilities who academically successful. This article tells their story, how they overcame obstacles to reach their academic potential. It includes a discussion of* the overrepresentation of minorities in special education,* African Americans and special education,* teacher beliefs and expectations,* parent and family involvement,* student perceptions, and* a description of the study and its findings.THE OVERREPRESENTATION OFMINORITIES IN SPECIAL EDUCATIONDigging the educational graves of many racially and/or economically disadvantaged children . . . (Dunn, 1968, p. 9) the words used by Lloyd Dunn to express his concern that far too many children from minority and underprivileged backgrounds were being labeled as mentally retarded or emotionally disturbed on the basis of cursory identification procedures and inappropriate use of intelligence testing. Concerns about the overrepresentation of minority groups, mainly African Americans, in special education date back many years and the topic has gained significant attention more recently (e.g., Harry & Klingner, 2006). While some argue that identification of disabilities is important to the acquisition of assistance and accommodations, there is often a stigma, lowered expectations, and inadequate education associated with special education (Harry & Klingner, 2006; Shifrer, 2013).African Americans and students with disabilities (SWDs) both recognized as groups explicitly and historically denied opportunity for education (Blanchett, 2009). Many believed neither group had the right nor the capacity to participate in formal education. The two have run what some would see as a parallel course in the fight for integration and equality, while others argue their movements for equality have not run a parallel course, but instead have converged and collided, resulting in the segregation of many African American students in special education programs (Harry & Klingner, 2006). Critical race theorists in education contend African American schoolchildren are systematically marginalized and miseducated in an educational system that seeks only to highlight what they lack and disregards the cultural wealth they bring to bear (Lynn et al., 2010, p. 291). Critical disability theory argues that traditionally, the response to persons with disabilities is one of either pity or welfarism (Devlin & Pothier, 2006) and that people with disabilities often experience a system of deep structural, economic, social, political, legal, and cultural inequality. Therefore, African Americans with disabilities members of not just one, but two groups that have historically been oppressed and discriminated against.Currently, practices such as culturally responsive teaching and response to intervention (RtI) have been implemented to address the issue of minority overrepresentation in special education (Klingner & Edwards, 2006). Reasons for these practices include an attempt to decrease erroneous placement of students in special education, and to increase learning gains using evidence-based interventions and regular progress monitoring in general education settings (Gersten et al., 2008; Individuals with Disabilities Education Act, IDEA, 2004). However, an important focus that remains is the academic progress and postsecondary outcomes for African American SWDs in special education. Individuals with disabilities from minority groups continue to be at high risk for poor school performance, high unemployment, low wages, limited access to postsecondary education and training, and fewer opportunities for living independently and participating fully in their communities (Simon, 2001). Although there African American SWDs who have been able to demonstrate academic success, the special education literature is fraught with negativity regarding this particular group (e. …

Predicting poor school performance in children suspected for sleep-disordered breathing

ObjectiveHabitually snoring children are at a greater risk of poor school performance (PSP). We investigated the ability of conventional sleep-disordered breathing (SDB) measures for predicting PSP in habitually snoring children. MethodsThe dataset of Hannover Study on Sleep Apnea in Childhood (HASSAC), a large community-based study in primary school children, was retrospectively analyzed. All habitual snorers were included. Based on their grades, children were grouped into good and poor school performers. SDB measures obtained by a parental questionnaire, a home pulse oximetry, and a home polysomnography were evaluated for their accuracy in predicting poor school performance by calculating receiver operating characteristic curves and area under this curve (AUC). The most predictive single factors were identified and entered into a prediction model. ResultsOf 114 habitual snorers (mean age 9.6 years, 51 boys), 59 had PSP. All investigated SDB measures showed low accuracy (ie, AUC <0.8). The highest AUC observed was 0.686 for a questionnaire score, 0.565 for an oximetry factor, and 0.624 for a polysomnography factor. Of 20 single significant predictors for PSP, five were selected for inclusion into a prediction model. The model reached an unadjusted AUC of 0.826 and an adjusted AUC of 0.851. ConclusionsConventional SDB measures obtained with questionnaire, oximetry, or polysomnography may not be sufficiently predictive of PSP in children suspected for SDB. However, combining factors in a clinical prediction model may improve prediction. Results of such a model may be used to assess the risk of developing neurocognitive impairment and to decide whether a child suspected for SDB might benefit from treatment.

School performance after preterm birth.

An increased risk of poor school performance for children born preterm has been shown in many studies, but whether this increase is attributable to preterm birth per se or to other factors associated with preterm birth has not been resolved. We used data from the Swedish Medical Birth Register, the Longitudinal Integration Database for Sickness Insurance and Labor Market Study, the Swedish Multigeneration Register, and the National School Register to link records comprising the Swedish birth cohorts from 1974 through 1991. Linear regression was used to assess the association between gestational duration and school performance, both with and without controlling for parental and socioeconomic factors. In a restricted analysis, we compared siblings only with each other. Preterm birth was strongly and negatively correlated with school performance. The distribution of school grades for children born at 31-33 weeks was on average 3.85 (95% confidence interval = -4.36 to -3.35) centiles lower than for children born at 40 weeks. For births at 22-24 weeks, the corresponding figure was -23.15 (-30.32 to -15.97). When taking confounders into account, the association remained. When restricting the analysis to siblings, however, the association between school performance and preterm birth after week 30 vanished completely, whereas it remained, less pronounced, for preterm birth before 30 weeks of gestation. Our study suggests that the association between school performance and preterm birth after 30 gestational weeks is attributable to factors other than preterm birth per se.

Increasing Latino Parents’ Verbal Interactions with Their Preschool-Aged Children

The rapidly growing Hispanic American population is experiencing an academic achievement gap that seems to be rooted in disparities in early childhood education and literacy development. Children of non-English-speaking immigrant parents are at greatest risk of poor school performance, but there is potential to capitalize on immigrants’ drive by encouraging them to engage with their children in dialog while reading native-language storybooks. This paper reports on a community-based randomized controlled trial () delivered to mostly Mexican immigrant parents of preschool-age children. Intervention group parents attended three monthly 60-minute sessions based on the Dialogic Reading Model—C.A.R. (Comment and Wait, Ask Questions and Wait, and Respond by Adding More), which teaches parents to have a conversation about pictures in books, with the goal of enhancing verbal exchanges with the child in the parent’s native language. After the 3-month intervention, parents in the bilingual early language development intervention reported placing greater value on children’s active verbal participation in reading compared to control group parents who participated in a healthy lifestyle intervention. These results suggest that Hispanics’ educational outcomes may be improved by educating parents on the value of playful conversations with young children while reading books in one’s native language.

The Impact of Perceived Discrimination and Social Support on the School Performance of Multiethnic Sexual Minority Youth

Sexual minority youth are known to face increased risk of poor school performance; however, little research has focused on the educational experiences of multiethnic sexual minority youth (MSMY) in particular. Using venue-based sampling approaches, this study surveyed 255 MSMY at 15 urban high schools. The majority of participants identified as female (65%), Latina (58%), and bisexual (41%), with a mean age of 16. The use of structural equation modeling techniques found that 23% of the variance of school performance was explained by the multivariate model. Examination of the model path coefficients revealed that experiences of perceived discrimination had a powerfully negative influence on the school performance of MSMY. Whereas increased family support was associated with better school performance, neither peer nor school support had similar impact. In addition, levels of support did not significantly moderate the effect of perceived discrimination on MSMY.

Computerized Behavioral Health Screening in the Emergency Department

&lt;P&gt;The rate of untreated mental health problems among children and adolescents has increased over the past decade, and it is estimated that 70% of children in need do not receive mental health services. Untreated, mental health problems place children at risk for poor school performance and social isolation, and in some cases can lead to adult psychopathology and suicide. Routine screening in medical settings has been recommended as a mechanism for identifying adolescents with unmet mental health needs. The American Academy of Pediatrics (AAP) has acknowledged the role of the emergency department (ED) as a safety net for children and adolescents with unmet mental health needs and recommended the development of accurate mental health screening tools and best practices for follow-up programs for pediatric patients.&lt;/P&gt; &lt;H4&gt;ABOUT THE AUTHORS&lt;/H4&gt; &lt;P&gt;Megan E. Pailler, PhD, is with the Division of Emergency Medicine, Department of Pediatrics, Children’s Hospital of Philadelphia. Joel A.Fein, MD, MPH, is with the University of Pennsylvania School of Medicine, Philadelphia. &lt;/P&gt;&lt;P&gt;Address correspondence to Megan E. Pailler, PhD, Department of Psychology, Roswell Park Cancer Institute, Elm &amp; Carlton Streets, Buffalo, NY 14263; fax: 716-845-4528. &lt;/P&gt; &lt;P&gt;Dr. Pailler and Dr. Fein have disclosed no relevant financial relationships. &lt;/P&gt; &lt;H4&gt;EDUCATIONAL OBJECTIVES&lt;/H4&gt;&lt;P&gt; &lt;OL&gt;&lt;P&gt;&lt;LI&gt;Discuss the impact of unrecognized psychiatric illness on child and adolescent health. &lt;/P&gt;&lt;/LI&gt; &lt;P&gt;&lt;LI&gt;Identify the best methods of implementing an “extra” but important screening process in the emergency department setting. &lt;/P&gt;&lt;/LI&gt; &lt;P&gt;&lt;LI&gt;Understand the challenges of translating research results for clinical settings. &lt;/P&gt;&lt;/LI&gt;

School performance of international adoptees better than expected from cognitive test results

To investigate school performance of international adoptees in relation to their cognitive competence. From the population of all male Swedish residents born 1973-1976, registered in the census 1985 and with complete test scores from military conscription, the following study groups were identified: Korean adoptees (n = 320), non-Korean adoptees (n = 1,125), siblings (children born by adoptive parents, n = 190) and Swedish majority comparisons (n = 142,024). Global scores from intelligence tests at conscription were compared with grade points from the last compulsory school year (year 9). Linear and logistic regression was applied in statistical analyses. The mean grade points in theoretical subjects were lower in non-Korean adoptees than in the majority population, but when global test scores from military conscription were adjusted for, outcomes were significantly better, equal for physics, than in the majority population. The grade points of Korean adoptees were higher than in the majority population and the same held true after adjusting for global test scores. When SES was taken into account, the risk of poor school performance (only completed lower subject levels) increased in non-Korean adoptees compared to models only adjusted for age and sex. Male international adoptees generally perform better in school than expected by their cognitive competence. A cognitive evaluation is important in the assessment of adoptees with learning difficulties.