Cited by 580Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentDevelopmental and Educational Neuropsychology

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Patterns of Comorbidity, Functioning, and Service Use for US Children With ADHD, 2007

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Larson, Kandyce, Russ, Shirley A., Kahn, Robert S., Halfon, Neal·2011·Pediatrics

DOI 10.1542/peds.2010-0165PMC PMC3065146

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Abstract

OBJECTIVE: To determine patterns of comorbidity, functioning, and service use for US children with attention-deficit/hyperactivity disorder (ADHD). METHODS: Bivariate and multivariable cross-sectional analyses were conducted on data from the 2007 National Survey of Children's Health on 61 779 children ages 6 to 17 years, including 5028 with ADHD. RESULTS: Parent-reported diagnosed prevalence of ADHD was 8.2%. Children with ADHD were more likely to have other mental health and neurodevelopmental conditions. Parents reported that 46% of children with ADHD had a learning disability versus 5% without ADHD, 27% vs 2% had a conduct disorder, 18% vs 2% anxiety, 14% vs 1% depression, and 12% vs 3% speech problems (all P < .05). Most children with ADHD had at least 1 comorbid disorder: 33% had 1, 16% had 2, and 18% had 3 or more. The risk for having 3 or more comorbidities was 3.8 times higher for poor versus affluent children (30% vs 8%). Children with ADHD had higher odds of activity restriction (odds ratio: 4.14 [95% confidence interval: 3.34–5.15]), school problems (odds ratio: 5.18 [95% confidence interval: 4.47–6.01]), grade repetition, and poor parent-child communication, whereas social competence scores were lower and parent aggravation higher. Functioning declined in a stepwise fashion with increasing numbers of comorbidities, and use of health and educational services and need for care coordination increased. CONCLUSIONS: Clinical management of ADHD must address multiple comorbid conditions and manage a range of adverse functional outcomes. Therapeutic approaches should be responsive to each child's neurodevelopmental profile, tailored to their unique social and family circumstances, and integrated with educational, mental health and social support services.

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Authors: Larson, K., Russ, S. A., Kahn, R. S., & Halfon, N.
Affiliations: University of California, Los Angeles (US)
Cedars-Sinai Medical Center (US)
Cincinnati Children's Hospital Medical Center (US)
Corresponding author: Larson, Kandyce
ORCID: Larson, Kandyce
Russ, Shirley A.
Kahn, Robert S.
Halfon, Neal
Venue: Pediatrics
Publisher: American Academy of Pediatrics (AAP)
Published: 2011-03-01
Volume: 127
Issue: 3
Pages: 462-470
ISSN: 0031-4005 (ISSN-L)
1098-4275
DOI: 10.1542/peds.2010-0165
PMC: PMC3065146
OpenAlex: W2133663175
Cited by: 580
References: 74
Citations by year: 2026: 16 · 2025: 30 · 2024: 27 · 2023: 39 · 2022: 42 · 2021: 43 · 2020: 47 · 2019: 51 · 2018: 46 · 2017: 39 · 2016: 45 · 2015: 48 · 2014: 37 · 2013: 34 · 2012: 23
FWCI: 22.98
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: PEDIATRICS (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
Health Resources and Services Administration
U.S. Public Health Service (2T76M600014:11)
Maternal and Child Health Bureau
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords: attention deficit hyperactivity disorder, comorbidities, children, functioning, service utilization, learning disabilities, conduct disorder, anxiety, depression, speaking difficulties, socioeconomic status, school problems, school retention, parent-child communication, social competence, care coordination, National Survey of Children's Health
MeSH terms: Adolescent, Anxiety Disorders, Attention Deficit Disorder with Hyperactivity, Mental Disorders, Child, Cross-Sectional Studies, Humans, Learning Disabilities, Mental Health, Retrospective Studies, United States, Comorbidity, Prevalence, Delivery of Health Care, Integrated

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Patterns of Comorbidity, Functioning, and Service Use for US Children With ADHD, 2007

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