Children in special education programs: attention deficit hyperactivity disorder, use of services, and unmet needs.

Abstract

OBJECTIVES: Attention deficit hyperactivity disorder (ADHD), a common psychiatric condition, may impair a child's ability to learn and to form social relationships, tasks critical to healthy development. This study describes the prevalence of the disorder among children in special education programs and identifies the extent and predictors of unmet service needs. METHODS: A 2-stage screening protocol of a countywide population of second- through fourth-grade students in special education was conducted to (1) screen for ADHD, employing standardized parent and teacher questionnaires, and determine health services use (n = 499) and (2) perform diagnostic assessments of ADHD (n = 318). RESULTS: Almost half of the children qualified for a diagnosis of ADHD, yet only half of those were reportedly receiving care for the condition, mainly in the general health care sector. Girls were more than 3 times as likely as boys to have unmet service needs; minority status, low income, and health maintenance organization coverage also emerged as possible risk factors for unmet service needs. CONCLUSIONS: ADHD is a common yet often untreated condition among children in special education. Mental health services for children with this disorder should be integrated with general health care and special education programs.

Do Parent Perceptions Predict Continuity of Publicly Funded Care for Attention-Deficit/Hyperactivity Disorder?

“…78 Parent distress and clinical need were inconsistently predictive of staying in care during the 6-and 12-month followup time intervals, but the direction of these relationships was consistent with earlier studies. 61,68,79,80 Together, the variation in predictors of staying in care over time may reflect the more dynamic decision-making process of parents continually "revisiting decisions about treatment" during the course of ADHD care. 68,81 Attitudes about medication treatment may be more influential during an earlier phase of treatment, whereas parentperceived need for continued care may be more influential during more long-term ADHD care.…”

“…Influential individual-level characteristics for mental health service use include child sociodemographic characteristics, 43,[47][48][49][50] clinical severity, 49,[51][52][53][54] and parental mental health. 51,52,[54][55][56][57][58][59] In addition, parentperceived barriers to care 50,60 and attitudes are hypothesized to affect access to and continuity of care, such as stigma, [61][62][63][64][65] recognition of symptoms or a problem, [66][67][68][69] and receptivity to stimulant medication treatment. 67,70 -72 On the system level, the considerable overlap in mental health and special education service use may increase the likelihood of staying in care through shared problem recognition and monitoring.…”

Special school teachers require more goal-oriented collaboration with psychiatric professionals in Northern Finland

“…School-aged children's problems and needs for care are often manifested as behavioural and emotional disorders and may be related to problematic life situations (1)(2)(3)(4). In western countries, 15-22 % of school-aged children suffer from psychiatric disorders (2,3,(5)(6)(7).…”

“…The need for psychiatric help is most pressing (38-44 %) among special-needs pupils (1,10). Special schools also cater for intellectually disabled pupils, of whom 34-65 % have been shown by different studies to have psychiatric disorders (11)(12)(13)(14).…”

“…Most of the intellectually disabled persons in need of mental health services remain without adequate examinations and treatments (11,15,16). Pupils who are transferred from normal to special schools generally have multiple underlying problems (1) and are hence particularly liable to behavioural and emotional disorders (17).…”