Journal of the American Academy of Child & Adolescent Psychiatry
SPECIAL COMMUNICATIONTreatment Services for Children With ADHD: A National Perspective
Section snippets
Research Review
Trends in Prescription Practices. Safer et al. (Safer, 1997; Safer and Krager, 1988, 1994; Safer et al., 1996) studied levels of methylphenidate use over time and found increased levels of prescribing for all ages of children. The rate of medication treatment for elementary school students increased from 1.07% in 1971 to 5.96% in 1987; for middle school students, it increased from 0.59% in 1975 to 2.98% in 1993; and for high school students, it increased from 0.22% in 1983 to 0.70% in 1993.
METHOD
NAMCS, a survey conducted by the NCHS, uses a multistage probability design of samples of medical practices within primary sampling units and patient visits within practices. The basic sampling unit is the visit to medical practices engaged in office-based patient care. For these analyses, a sample was constructed of all children aged 0 to 17 seen by either a pediatrician, family practice physician, or psychiatrist and coded with an ICD-9 diagnosis of ADHD. All analyses of NAMCS data refer to
Trends in Identification of ADHD From 1989 to 1996 (NAMCS)
Analyses from NAMCS indicate that the percentage of visits to physicians where ADHD was identified has risen from less than 1% in 1989 (0.74%) to almost 2% (1.9%) in 1996. The percentage of mental health problem visits where ADHD was specifically identified has risen as well. In 1989, 40.91% of all visits to physicians by children where a mental health problem was identified as the primary reason for the visit included attentional problems. In 1996, the percentage of mental health problem
DISCUSSION
It is clear that patterns of services for children with ADHD have changed. Since 1989, prescriptions of stimulants have risen from about one half of all visits to three fourths of all visits. During the same period, prescriptions of other medications have dropped. Children with ADHD who are seen by physicians now are more likely to receive diagnostic services, mental health counseling, and general health counseling than they were in 1989. These children, however, are less likely to receive
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The opinions and assertions contained in this paper are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of Health and Human Services or the National Institute of Mental Health.