There may be some concerning disparities between children with Attention-Deficit/Hyperactivity Disorder (ADHD) and the quality of treatment received, according to a new study published in the peer-reviewed Journal of the American Medical Association.
The study stated that the US and other high-income countries have lately been reporting increasing numbers of children with an ADHD diagnosis.
The percentage of US children who, according to parent reports, received an ADHD diagnosis increased from 5.5% in 1999 to 9.8% in 2018, per the United State Centers for Disease Control and Prevention (CDC).
According to a 2022 report from the CDC, 77% of US children who received a diagnosis of ADHD received treatment and 69% received medications.
However, study authors noted that their cross-sectional analysis of parent-reported ADHD diagnoses in children “suggests that most [children] were not receiving ADHD medications and had never received outpatient mental health care.”
Gender, racial and socioeconomic disparities
Of the 1,206 children (aged 9-10 years) with parent-reported ADHD, 26.2% had ever received outpatient mental health care, 12.9% were currently receiving ADHD medications, and 34.8% had received either treatment.
In this group of children examined in the study, 826 were girls and 380 were boys. 15% of the boys were receiving medication to treat their ADHD, while only 7% of girls were taking medication.
A similar difference was seen along racial lines, with 14% of white children receiving medications compared to 9% of Black children. In particular, Black children were less likely than white children to take stimulant medications. The difference was smaller for non-stimulant medications.
“Because non-stimulant medications tend to yield smaller therapeutic effects than stimulants,” wrote study authors, “all parents should be provided with relevant clinical information to make informed ADHD medication choices. Prescriber implicit bias might be associated with disparities in stimulant prescribing.”
Medication use was also more common among children whose parents did not have a high school education than among those whose parents had received higher education.
What is more, low levels of parental education were also associated with higher rates of children with ADHD receiving outpatient mental health treatment.
Study authors stipulated that families with higher levels of education and high-income levels were more likely to may seek out “nontraditional strategies” for managing a child’s ADHD, such as private tutoring, sports programs and changes in diet, rather than resorting to traditional treatments.
The overall low treatment rates (26.2%) “suggest a need to increase mental health service availability; enhance knowledge of ADHD symptoms among parents, teachers, and primary care clinicians; and develop accessible care pathways,” study authors pointed out.
The authors also clarified that not all children with ADHD need to be treated in order to thrive. Parent-reported data is not a substitute for interviewing children directly and conducting extensive clinical trials.
The study’s results “highlight the importance of developing strategies to increase clinical recognition of children with ADHD, especially girls, and increasing access to acceptable treatments,” concluded its authors.