Pathways to care in children at risk of attention-deficit hyperactivity disorder

Abstract

BackgroundThere is underdiagnosis of and low use of specialist services for attention-deficit hyperactivity disorder (ADHD).AimsTo quantify the filters in the help-seeking pathway through primary care and to investigate factors influencing progress for children at risk of ADHD.MethodA total of 127 children (5–11 years old) with pervasive hyperactivity who passed each filter (primary care attendance and general practitioner (GP) recognition of disorder) were compared with those who had not.ResultsPrimary care attendance was only associated with parental perception of the behaviour as problematic (OR 2.11; 95% CI 1.11-4.03). However, GP recognition was related to both parent and child factors – parental request for referral (OR 20.83; 95% CI 3.05-142.08) and conduct problems (OR 1.48; 95% CI 1.04-2.12). GP non-recognition was the main barrier in the pathway to care; following recognition, most children were referred.ConclusionsParents can be regarded as the main gatekeepers for access to specialist services.

Prevalence of attention-deficit/hyperactivity disorder in Northern Cyprus

“…3,4 A significant percentage of children remain undiagnosed or untreated. 5,6 As with other medical conditions epidemiological data may help improve strategies related with early diagnosis and treatment of ADHD, yet a paucity of such data exist, making it crucial to know the actual prevalence of ADHD in diverse populations. 7 Cyprus is the third largest island in the East Mediterranean area and is divided into North and South Cyprus, with a Turkish population living in the northern part since 1974.…”

How Parents Seek Help for Children with Mental Health Problems

“…Progression through these stages is facilitated or derailed by social, cultural, and systemic factors. For example, physician referral increases the likelihood of obtaining specialized mental health care (Sayal, Taylor, Beecham, & Byrne, 2002).…”

Facilitating Pathways

“…They are probably un der-referred. As another example, Sayal et al (2002) followed a group of children (found by screening to have high hyperactivity scores) through their con tacts with a health system. Parents' perception that there was a problem was governed more by whether the family was suffering financial loss than by their ratings of symptoms.…”