Study finds primary school kids missing out on ADHD treatment and support

Many children with attention deficit hyperactivity disorder (ADHD) are missing out on assessment and treatment according to new research by the Murdoch Children’s Research Institute.

Contrary to popular perceptions, the study of early to mid-primary school aged children across Melbourne found only a small number of kids with ADHD were prescribed medication.

The findings, published in the Journal of Child and Adolescent Psychopharmacology, suggest that many children who meet the criteria for ADHD diagnosis are not referred for assessments and are therefore missing out on treatment and support to help them thrive.

Lead author and MCRI clinician scientist Assoc. Prof Daryl Efron said that while children with the most severe symptoms were more likely to be diagnosed and receive medication, those with less severe but still significant and impairing symptoms appeared to fall through the cracks.

“From a public perception point of view, this provides good evidence against the commonly held idea that too many kids are put on medication,” Dr. Efron said.

“If anything, not enough kids are being assessed and offered medication, so it would appear that some kids are missing out on proven effective treatment.”

The study analysed data from the Children’s Attention Project (CAP), a longitudinal community-based study of grade 1 children recruited through 43 Melbourne primary schools. Children who screened positive by both parent and teacher ratings, and who had the diagnosis formally confirmed, were invited into the study. Children were tracked from age 7 to 10.

Researchers from MCRI, University of Melbourne, Royal Children’s Hospital and Deakin University examined parent reports of medication treatment, clinician diagnosis and psychological service use at ages seven and 10. They looked for patterns of medication use and ADHD symptom severity, other difficulties, academic performance and socioeconomic factors.

Of the 179 children found to meet the criteria for ADHD, about 17 per cent had received a clinical diagnosis at seven years, rising to almost 38 per cent at 10 years. Almost 14 per cent of the group were taking ADHD medication at age seven, increasing to nearly 26 per cent at age 10.

The study concluded that most Australian children who meet ADHD criteria are not being medically diagnosed by age 10. It also found the strongest predictors of medication treatment were symptom severity and socioeconomic disadvantage.

“It’s not about the doctors but rather the fact that kids are not getting to a paediatrician,” Dr. Efron said.

“It really needs to start with the relationship between parents and teachers, where concerns about the child can be raised and discussed and suggestions for further assessments made if people are worried.”

Dr. Efron stressed that an assessment does not automatically lead to a diagnosis or medication.

“A paediatrician will consider the broad range of factors that could be at play and then think about whether anything extra needs to be done within the education or the health sector or both, and that may or may not involve medication,” Dr. Efron said.

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