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Medicaid-covered children in foster care at increased risk for ADHD

WASHINGTON — Children in foster care and enrolled in Medicaid were at more than three times greater risk for attention-deficit/hyperactivity disorder compared with other pediatric Medicaid recipients, according to data presented at the 2015 AAP National Conference and Exhibition.

“This study shows that children in foster care are much more likely to have received an [attention-deficit/hyperactivity disorder (ADHD)] diagnosis than other children in Medicaid,” Melissa Danielson, MSPH, of the National Center on Birth Defects and Developmental Disabilities at the CDC, told Infectious Diseases in Children. “Children with ADHD in foster care had similar rates of medication treatment compared to other children with ADHD, but were more likely to have received psychological services.This finding is promising, given AAP’s recommendation for behavior therapy as the first-line treatment for preschoolers with ADHD.”

Melissa Danielson

The researchers analyzed 2011 Medicaid outpatient and prescription drug data from 11 states. A group of children aged 2 to 17 years enrolled in Medicaid and in foster care (n = 53,118) was compared with children not in foster care (n = 2,676,957). An ADHD diagnosis was considered any child having at least two ADHD-related ICD-9 codes.

Data indicated that 26% of children in foster care had ADHD vs. 7% of those not in foster care. Those children aged 2 to 5 years in foster care, however, were more likely to have received psychological counseling than nonfoster children (70% vs 42%) and equally likely to have been treated with ADHD medications.

“Given the unique diagnosis and treatment patterns of children with ADHD who are in foster care, it is important to consider the special circumstances of this population as part of any effort to improve the quality of behavioral care for children with ADHD,” Danielson said. – by David Costill

Reference:
Danielson M, et al. Abstract 30570. Presented at: AAP National Conference and Exhibition; Oct. 24-27, 2015; Washington, D.C.

Disclosure: The researchers report no relevant financial disclosures.