Unmet Need and Financial Impact Disparities for US Children with ADHD

Elisa Nasol, Olivia J. Lindly, Alison E. Chavez, Katharine E. Zuckerman

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


Objective: 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. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)315-324
Number of pages10
JournalAcademic Pediatrics
Issue number3
StatePublished - Apr 2019
Externally publishedYes


  • attention deficit disorder
  • needs assessment
  • social determinants of health

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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