Racial/Ethnic Differences in Treatment of Attention Deficit/Hyperactivity Disorder among Children Open Access
Zhou, Jiani (2016)
Abstract
Objectives
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common disorders among children, while also having low treatment rates. According to the American Academy of Pediatrics (AAP), clinical guidelines for ADHD treatment vary according to the age of the child. Although race/ethnicity has been identified as a key predictor in mental health (MH) services use, few studies have examined its role in ADHD treatment with a national sample. To address this gap, this study examined racial/ethnic differences in ADHD treatment using a nationally representative sample of children that have received an ADHD diagnosis by a health care provider.
Methods
The 2009-2010 National Survey of Children with Special Health Care Needs (NS-CSHCN) was used as the data source to derive a nationally representative sample of 8,799 children aged 4-17 years with current ADHD. Racial/ethnic differences in ADHD treatment were examined using weighted logistic regressions, by age group, adjusted for demographics, socioeconomic characteristics, health status, and contextual factors.
Results
Among children aged 6-11 years, non-Hispanic black children (ME=-0.050 percentage points; SE=0.02) and children from other racial/ethnic groups (ME=-0.070 percentage points; SE=0.02) were less likely than non-Hispanic white children to receive guideline-concordant treatment (i.e., medication or behavioral therapy) for their ADHD, controlling for sociodemographic factors, health status, and contextual factors.
Among children aged 12-17 years, non-Hispanic black children (ME=-0.106; SE=0.03) and children from other racial/ethnic groups (ME=-0.079; SE=0.004) were less likely than non-Hispanic whites to receive guideline-concordant treatment (i.e., medication), controlling for covariates. These differences were partially explained by whether the child had a usual source of care and parent-perceived severity of ADHD.
Conclusion
The findings of this study highlight lower rates of guideline-concordant treatment for ADHD among racial/ethnic minority children compared to non-Hispanic whites. Future studies should seek to use appropriate data and qualitative methods to examine other pathways that account for racial/ethnic differences in the receipt of ADHD treatment.
Table of Contents
INTRODUCTION. 1
LITERATURE REVIEW. 3
ADHD among U.S. children. 3
AAP Guidelines for the Diagnosis, Evaluation, and Treatment of ADHD. 4
Racial/Ethnic Differences in MH Services Use. 6
Gaps in Literature. 8
METHODS. 10
Conceptual Framework. 10
Focal Relationship. 12
Pathways. 12
Confounders. 13
Hypothesis. 15
Construct Measurement. 17
Data Source. 23
Analytical Sample. 24
Analysis 26
RESULTS. 28
Descriptive Statistics: Children aged 6-11 years. 28
Descriptive Statistics: Children aged 12-17 years. 33
Multivariate Results: Children Aged 6-11 Years. 38
Multivariate Results: Children Aged 12-17 Years. 42
DISCUSSION. 45
REFERENCES. 50
APPENDICES. 56
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