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Barriers to detection, help-seeking, and service use for children with ADHD symptoms

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Abstract

This study describes 4 help-seeking steps among children at high risk for attention deficit hyperactivity disorder (ADHD), and identifies barriers to ADHD symptom detection and treatment. Using a district-wide stratified random sample of 1615 elementary school students screened for ADHD risk, predictors of 4 help-seeking steps among a high-risk group (n=389) and parent-identified barriers to care among children with unmet need for ADHD care (n=91) were assessed. Study findings indicate that although 88% of children were recognized as having a problem, only 39% had been evaluated, 32% received an ADHD diagnosis, and 23% received current treatment. Older children and those with more severe behavior problems were more likely to be perceived by their parents as having a problem. Additionally, gender and ethnic disparities in the subsequent help-seeking process emerged. Boys had over 5 times the odds than girls of receiving an evaluation, an ADHD diagnosis, and treatment. Compared to African American youth, Caucasian children had twice the odds of taking these help-seeking steps. For those children with unmet need for ADHD care, poverty predicted lower treatment rates and was associated with the most pervasive barriers. The gap between parental problem recognition and seeking services suggests that thresholds for parental recognition of a child behavior problem and for seeking ADHD services may be different. Future research examining the help-seeking process for ADHD should include a qualitative component to explore the potential mechanisms for gender and ethnic differences.

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Authors and Affiliations

  1. Division of Child and Adolescent Psychiatry, Departments of Psychiatry, Pediatrics and of Health Policy and Epidemiology, University of Florida, Box 100157 UFHC, 32610-0157, Gainesville, FL

    Regina Bussing MD, MSHS (Associate Professor, Chief)

  2. the Department of Psychiatry and Biobehavioral Sciences at University of California at Los Angeles, USA

    Bonnie T. Zima MD, MPH (Associate Professor)

  3. the College of Nursing at University of Florida, Gainesville, Florida

    Faye A. Gary EdD, RN (Distinguished Service Professor)

  4. Department of Statistics in the College of Medicine at University of Florida, Gainesville, Florida

    Cynthia Wilson Garvan PhD (Assistant Scientist)

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  1. Regina Bussing MD, MSHS
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  2. Bonnie T. Zima MD, MPH
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  3. Faye A. Gary EdD, RN
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  4. Cynthia Wilson Garvan PhD
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Correspondence to Regina Bussing MD, MSHS.

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Bussing, R., Zima, B.T., Gary, F.A. et al. Barriers to detection, help-seeking, and service use for children with ADHD symptoms. The Journal of Behavioral Health Services & Research 30, 176–189 (2003). https://doi.org/10.1007/BF02289806

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