School of Medicine (E Nasol), Oregon Health & Science University, Portland; E Nasol is now with the Department of Family Medicine, Harbor-UCLA Medical Center, Harbor City, Calif.
Division of General Pediatrics (OJ Lindly, AE Chavez, and KE Zuckerman), Doernbecher Children's Hospital, Oregon Health & Science University, Portland.; OJ Lindly is now with the Department of Pediatrics, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Acad Pediatr. 2019 Apr;19(3):315-324. doi: 10.1016/j.acap.2018.09.001. Epub 2018 Sep 7.
The 5.1million US children with attention-deficit/hyperactivity disorder (ADHD) have pronounced needs in education, occupational and speech therapy, and medical and behavioral treatments. Given known associations of ADHD diagnosis with race/ethnicity and parent education, this study aimed to assess how measures of socioeconomic status correlate with both adverse family financial impact of ADHD and disparities in unmet treatment need for ADHD.
Secondary analysis of children ages 8 to 17years whose households participated in the 2014 National Survey of the Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder and Tourette Syndrome. Using bivariate testing, we examined associations among measures of socioeconomic status with unmet ADHD treatment need and family financial impact. Logistic regression models estimated the odds of having unmet treatment need, adjusting for demographic factors and family financial impact.
Among US school-aged children with a current ADHD diagnosis, 44.3% experienced an adverse family financial impact from ADHD, and 11.6% had unmet need for ADHD treatment. Children with younger age at first ADHD diagnosis were more likely to experience adverse family financial impact. Children from non-English-speaking households were less likely to report unmet need compared to those from primarily English-speaking households. The adjusted odds of unmet need were twice as great among those who reported adverse family financial impact.
Deeper understanding of the influence of the household language is important in ADHD needs assessments. Considering overall family financial circumstances may also be pertinent, particularly as children age, because earlier diagnosiswas associated with adverse financial outcomes. These findings could shape future clinic policies for targeting community resources.
美国有 510 万患有注意力缺陷多动障碍（ADHD）的儿童在教育、职业和言语治疗以及医疗和行为治疗方面有明显的需求。鉴于 ADHD 诊断与种族/族裔和父母教育程度的已知关联，本研究旨在评估社会经济地位的衡量标准与 ADHD 对家庭的不利经济影响以及 ADHD 治疗需求未得到满足的差异之间的相关性。
对参加 2014 年全国注意力缺陷多动障碍和妥瑞氏综合征诊断和治疗调查的年龄在 8 至 17 岁的儿童家庭进行二次分析。使用双变量检验，我们检查了社会经济地位衡量标准与 ADHD 治疗需求未得到满足和家庭经济影响之间的关联。使用逻辑回归模型，根据人口统计学因素和家庭经济影响调整未满足治疗需求的可能性。
在美国学龄儿童中，目前患有 ADHD 的儿童中，有 44.3%的儿童因 ADHD 而导致家庭经济受到不利影响，有 11.6%的儿童 ADHD 治疗需求未得到满足。首次 ADHD 诊断年龄较小的儿童更有可能经历家庭经济困难。来自非英语家庭的儿童与主要讲英语家庭的儿童相比，报告 ADHD 治疗需求未得到满足的可能性较小。报告家庭经济困难的儿童未满足治疗需求的可能性是其两倍。
深入了解家庭语言的影响对 ADHD 需求评估很重要。考虑到整个家庭的经济状况也可能很重要，特别是随着儿童年龄的增长，因为早期诊断与不利的经济结果有关。这些发现可能会影响未来诊所针对社区资源的目标政策。
