25841538

PMC4469986

Objective

Describe the parent-reported prevalence of ADHD treatments among a national sample of children with special health care needs (CSHCN), and assess the alignment of ADHD treatment to current American Academy of Pediatrics (AAP) guidelines.

Methods

Parent-reported data from the 2009–10 National Survey of Children with Special Health Care Needs allowed for weighted national and state-based prevalence estimates of medication, behavioral therapy, and dietary supplement use for ADHD treatment among CSHCN, aged 4–17 years with current ADHD. National estimates were compared across demographic groups, ADHD severity, and comorbidities. Medication treatment by drug class was described.

Results

Of CSHCN with current ADHD, 74.0% had past week medication treatment and 44.0% had past year behavioral therapy. In the past year, 10.2% used dietary supplements for ADHD. Overall, 87.3% had received past week medication treatment or past year behavioral therapy (both=30.7%, neither=12.7%). Among preschool-aged CSHCN with ADHD, 25.4% received medication treatment alone, 31.9% received behavioral therapy alone, 21.2% received both treatments, and 21.4% received neither treatment. Central nervous system stimulants were the most common medication class (84.8%) among CSHCN with ADHD, followed by the selective norepinephrine reuptake inhibitor atomoxetine (8.4%).

Conclusions

These estimates benchmark clinical practice for the period directly preceding the AAP’s 2011 ADHD guidelines. Most children with ADHD received medication treatment or behavioral therapy; just under one-third received both. Multi-modal treatment was most common among CSHCN with severe ADHD and those with comorbidities. About half of preschoolers received behavioral therapy, the recommended first-line treatment for this age group.

CDC Public Access

CC999999/Intramural CDC HHS/United States