Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)

Legacy Department


Committee Member

Dr. Patrick Warren, Committee Chair

Committee Member

Dr. Scott Baier

Committee Member

Dr. F. Andrew Hanssen

Committee Member

Dr. Curtis Simon


This dissertation examines the causal effects of ADHD medication on child welfare, and investigates the effects of a supplemental income program on the diagnoses of learning disabilities. In 2011, 6.4 million children were diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) with nearly 70% of them taking ADHD medication. However, little causal evidence exists on the effectiveness of ADHD medication. The first two chapters of this dissertation utilize an instrumental variable strategy to identify the effects of ADHD pharmaceutical treatment on South Carolina Medicaid children's academic, behavioral, and health outcomes. The first chapter estimates the causal effects of ADHD medication on South Carolina Medicaid students' elementary, middle, and high school test scores as well as grade retention. We find mostly adverse effects. If treated with ADHD medication, male and female students are more likely to repeat a grade and females are less likely to pass middle and high school state standardized tests. This negative effect is most apparent for females diagnosed with combined inattentive and hyperactive/impulsive ADHD. In contrast, ADHD medication improves test performance for males diagnosed with inattentive ADHD in elementary school, but these effects vanish by middle school. The second chapter investigates the effects of ADHD medication on the probability of risky sexual behavior outcomes (STDs and pregnancy), substance abuse disorders, and injuries. Our findings suggest that pharmacological treatment has substantial benefits on behavioral outcomes. It reduces the probability of contracting an STD by 3.6 percentage points (5.8 percentage points if we include STD screening), reduces the probability of having a substance abuse disorder by 7.3 percentage points, reduces the probability of injuries by 2.3 percentage points per year, and associated with them Medicaid costs decrease by $88.4, or 0.054 of a standard deviation. The final chapter estimates the impact of an infant's receipt of Social Security Supplemental Security Income (SSI) disability benefits on future educational achievement and learning disability diagnoses. We exploit program eligibility discontinuities in birth weight to obtain plausibly causal estimates of the long-run impacts of disability benefits on childhood educational achievement. Our findings suggest that individuals who are eligible for SSI disability benefits are less likely to repeat a grade in elementary and middle school, but are more likely to have a reported learning disability.



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