title: Treatment of Attention Deficit/Hyperactivity Disorder among Children with Special Health Care Needs.
abstract: OBJECTIVE
  To describe the parent-reported prevalence of treatments for attention deficit/hyperactivity disorder (ADHD) among a national sample of children with special health care needs (CSHCN), and assess the alignment of ADHD treatment with current American Academy of Pediatrics guidelines.
  
  
  METHODS
  Parent-reported data from the 2009-2010 National Survey of Children with Special Health Care Needs allowed for weighted national and state-based prevalence estimates of medication, behavioral therapy, and dietary supplement use for ADHD treatment among CSHCN aged 4-17 years with current ADHD. National estimates were compared across demographic groups, ADHD severity, and comorbidities. Medication treatment by drug class was described.
  
  
  RESULTS
  Of CSHCN with current ADHD, 74.0% had received medication treatment in the past week, 44.0% had received behavioral therapy in the past year, and 10.2% used dietary supplements for ADHD in the past year. Overall, 87.3% had received past week medication treatment or past year behavioral therapy (both, 30.7%; neither, 12.7%). Among preschool-aged CSHCN with ADHD, 25.4% received medication treatment alone, 31.9% received behavioral therapy alone, 21.2% received both treatments, and 21.4% received neither treatment. Central nervous system stimulants were the most common medication class (84.8%) among CSHCN with ADHD, followed by the selective norepinephrine reuptake inhibitor atomoxetine (8.4%).
  
  
  CONCLUSIONS
  These estimates provide a benchmark of clinical practice for the period directly preceding issuance of the American Academy of Pediatrics' 2011 ADHD guidelines. Most children with ADHD received medication treatment or behavioral therapy; just under one-third received both. Multimodal treatment was most common for CSHCN with severe ADHD and those with comorbidities. Approximately one-half of preschoolers received behavioral therapy, the recommended first-line treatment for this age group.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: svisser@cdc.gov.
authors.forename: Susanna N
authors.initials: SN
authors.lastname: Visser
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Bitsko
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Danielson
authors.affiliation: Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD.
authors.forename: Reem M
authors.initials: RM
authors.lastname: Ghandour
authors.affiliation: National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Blumberg
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Schieve
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Holbrook
authors.affiliation: Oklahoma University Child Study Center, Oklahoma City, OK.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Wolraich
authors.affiliation: Department of Psychiatry, University of Florida College of Medicine-Jacksonville, Jacksonville, FL.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Cuffe
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000628:therapy*; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male
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