Many US Children With ADHD Receive No Medication or Mental Health Care

Most US children with parent-reported attention-deficit/hyperactivity disorder (ADHD) are neither taking ADHD medication nor have ever received outpatient mental health care, suggest results from a cross-sectional study published online in JAMA Network Open.

“It would be naive to assume that all children with parent-reported ADHD need or would benefit from treatment…,” wrote study corresponding author Mark Olfson, MD, MPH, of Columbia University and the New York State Psychiatric Institute, New York, New York, and coauthors. “Nevertheless, the findings provide a sense of the scale and distribution of children with parent-reported ADHD not receiving treatment. As such, they highlight the importance of developing strategies to increase clinical recognition of children with ADHD, especially girls, and increasing access to acceptable treatments.”

Related: When can ADHD symptoms be minimal or absent?

The study included 1206 children with parent-reported ADHD, aged 9 and 10 years, from the first wave of the Adolescent Brain and Cognitive Development Study, which was conducted at 21 sites nationwide from June 1, 2016, to October 15, 2018.

Just 12.9% of children with parent-reported Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for ADHD were currently receiving ADHD medications, according to the study. This included 15.7% of boys compared with 7% of girls; 14.8% of White children compared with 9.4% of Black children; 32.2% of children whose parents did not have a high school education compared with 11.5% of children whose parents had a bachelor’s degree or higher; and 17% of children with the combined subtype of ADHD compared with 9.5% of children with the inattentive subtype.

Meanwhile, only 26.2% of children with parent-reported ADHD had ever received outpatient mental health care. This included 36.2% of children whose parents had a high school education and 31% whose parents had some college education compared with 21.3% of children whose parents had a bachelor’s degree or higher. 

Additionally, researchers found rates of lifetime outpatient mental health care for children with parent-reported ADHD were 36.5% among those with family incomes of less than $25,000 and 27.7% with family incomes between $25,000 and $49,999, compared with 20.1% among those with family incomes of $75,000 or more. Rates were 33.6% among children with the combined subtype of ADHD, compared with 20% among children with the predominantly inattentive subtype of ADHD and 22.4% with the hyperactive-impulsive subtype of ADHD.

Reference

Olfson M, Wall MM, Wang S, Laje G, Blanco C. Treatment of US children with attention-deficit/hyperactivity disorder in the adolescent brain cognitive development study. JAMA Netw Open. 2023;6(4):e2310999. doi:10.1001/jamanetworkopen.2023.10999