VANCOUVER, BRITISH COLUMBIA – When
children struggle with focusing on tasks, staying organized, controlling their
behavior and sitting still, they may be evaluated for attention-deficit/hyperactivity
disorder (ADHD). Clinicians, however, shouldn’t stop there, according to a
study to be presented Tuesday, May 6, at the Pediatric Academic Societies (PAS)
annual meeting in Vancouver, British Columbia, Canada.
Researchers found that many
children with ADHD also face challenges such as poverty, divorce, neighborhood violence
and substance abuse among family members.
“Our findings suggest that children with ADHD
experience significantly higher rates of trauma than those without ADHD,” said
lead author Nicole M. Brown, MD, MPH, MHS, FAAP. “Providers may focus on ADHD
as the primary diagnosis and overlook the possible presence of a trauma
history, which may impact treatment.”
Dr. Brown and her colleagues analyzed data from the
2011 National Survey of Children's Health. They identified 65,680 children ages
whose parents answered questions regarding ADHD diagnosis, severity and
medication use as well as nine adverse childhood experiences (ACEs): poverty,
divorce, death of a parent/guardian, domestic violence, neighborhood violence,
substance abuse, incarceration, familial mental illness and discrimination.
About 12 percent of the children were diagnosed
with ADHD. Their parents reported a higher prevalence of all of the adverse
events than parents of children without ADHD.
Parents of children with ADHD also reported a higher
number of adverse childhood experiences compared to children without ADHD; 17
percent of children with ADHD had four or more ACEs compared to 6 percent
of children without ADHD.
Children dealing with four or more adverse
experiences were almost three times more likely to use ADHD medications
compared to children with three or fewer adverse experiences. Children
with four or more adverse experiences also were more likely to have a parent
rate their ADHD as moderate to severe compared to children with three
or fewer ACEs.
“Knowledge about the prevalence and types of adverse
experiences among children diagnosed with ADHD may guide efforts to address trauma
in this population and improve ADHD screening, diagnostic accuracy and
management,” said Dr. Brown, assistant professor of pediatrics, Division of
General Pediatrics, The Children's Hospital at Montefiore, Albert Einstein
College of Medicine, New York.
“Pediatric providers should consider screening
for adverse childhood experiences in children who they suspect may have ADHD
and/or those who carry the diagnosis, and initiate evidence-based
treatment/intervention plans for children who screen positive for ACEs,” she concluded.
Dr. Brown will present “Associations Between Adverse
Childhood Experiences and ADHD: Analysis of the 2011 National Survey of
Children’s Health” from 1:45-2 p.m. Tuesday, May 6. To view the study abstract,
go to http://www.abstracts2view.com/pas/view.php?nu=PAS14L1_4670.7.
To schedule an interview with Dr. Brown before the PAS
meeting, call the PAS Media Relations Office at 847-434-7877. To schedule an
interview with her during the meeting, call the PAS Press Office at 778-331-7632
No outside funding was received for this research.