How Does ADHD Affect Australian Children and Their Families?

What you need to know

• The censusADHD Study is a large-scale Australian study of children with ADHD, providing insights into diagnosis, treatment, and family impacts.
• Boys were typically diagnosed with ADHD earlier than girls and were more likely to have the combined or hyperactive subtypes.
• Most children with ADHD had at least one other mental health condition, with those having the combined subtype at highest risk.
• ADHD diagnosis led to increased healthcare costs for families and the government healthcare system.

Understanding ADHD in Australian Children

Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental condition that affects how children focus, control impulses, and manage activity levels. The censusADHD Study aimed to better understand how ADHD impacts Australian children and their families by looking at diagnosis patterns, medication use, other health conditions, and costs.

Who participated in the study?

The researchers recruited 1,574 families with children aged 6-11 who had been prescribed ADHD medication. They collected information from parents through online surveys and, with permission, accessed children’s health records.

How is ADHD diagnosed in Australia?

The study found that most children (about 85%) were diagnosed with ADHD by age 7. On average, boys were diagnosed about 5 months earlier than girls. Pediatricians diagnosed about two-thirds of the children, followed by psychologists and psychiatrists.

There are three main types of ADHD:

1. Combined type - problems with both attention and hyperactivity/impulsivity
2. Predominantly inattentive type - mainly struggles with focus and attention
3. Predominantly hyperactive-impulsive type - mainly struggles with hyperactivity and impulse control

Most children in the study (70.8%) had the combined type. Boys were more likely to have the combined or hyperactive types, while girls were more likely to have the inattentive type.

ADHD medications and side effects

About 95% of children in the study were taking ADHD medication when their parents completed the survey. The most common medications were different forms of methylphenidate (like Ritalin).

While many parents reported that medication was helpful, side effects were common:

• Most children experienced at least 5-7 side effects from their medication
• The most frequent side effects included changes in appetite, sleep problems, and irritability
• Some families had to stop certain medications due to side effects or because they weren’t effective

Other health conditions

Many children with ADHD also have other mental health or developmental conditions. In this study:

• 91.4% of children screened positive for at least one other condition
• 59% had two or more additional conditions
• Common co-occurring conditions included oppositional defiant disorder, anxiety, depression, and autism spectrum disorder

Children with the combined type of ADHD were at highest risk for having other mental health conditions.

Impact on education

The study found that ADHD often affects children’s experiences at school:

• About half of the children had a personalized learning plan
• 27.4% had been in special education classes at least part-time
• 9.2% had repeated a grade
• 20% had been suspended from school
• 6% had been expelled from school

Boys, children with the combined or hyperactive types of ADHD, and those with additional behavioral disorders were more likely to face suspension or expulsion.

Family history and ADHD severity

The study found that ADHD often runs in families:

• About 1 in 4 children had at least one parent who reported having ADHD or attention problems in childhood
• In families with multiple children, about 25% reported having more than one child with ADHD
• Children who had a parent with ADHD tended to have more severe ADHD symptoms themselves

Costs associated with ADHD

The researchers looked at healthcare costs in the year before and after children were diagnosed with ADHD. They found significant increases after diagnosis:

• Families paid an average of $78.44 more in out-of-pocket medication costs
• Government spending on medication subsidies increased by an average of $233.48 per child
• Children had more prescriptions filled and saw more doctors in the year after diagnosis

These findings highlight that an ADHD diagnosis often leads to increased healthcare use and costs for both families and the healthcare system.

Stress on caregivers

The study used a special questionnaire to measure how much stress parents experienced related to their child’s ADHD. They found:

• Parents of children with the combined type of ADHD reported the highest stress levels
• Mothers reported significantly higher stress levels than fathers
• Parents of children with more than one mental health condition tended to report higher stress

This suggests that supporting parents and caregivers is an important part of helping families manage ADHD.

Conclusions

• ADHD affects children and families in many ways, including mental health, school experiences, and healthcare needs.
• Boys and girls may experience ADHD differently, with boys typically diagnosed earlier and more likely to have hyperactive symptoms.
• Most children with ADHD have at least one other mental health condition, highlighting the need for comprehensive care.
• ADHD often runs in families and can lead to increased stress for parents and caregivers.
• An ADHD diagnosis typically results in increased healthcare use and costs for both families and the healthcare system.

This large Australian study provides valuable insights into how ADHD impacts children and families. The findings can help guide efforts to improve diagnosis, treatment, and support for those affected by ADHD.