MSU pediatrician Marsha Rappley reviewed 15 months' worth of medical billing claims and found that 223 children between the ages of one and three were diagnosed with ADHD. Of those children, 127, or nearly 60 percent, were treated with psychotropic medications, including Ritalin, Prozac and Zoloft.
The study, published in the recent Archives of Pediatrics and Adolescent Medicine, was part of a larger project examining diagnosis and treatment patterns for ADHD in the Michigan Medicaid system of health care.
Normally children this young are not diagnosed with ADHD, a malady that affects from three to five percent of the population.
"I don't think you can give a simple diagnosis of ADHD in a child of this age," Rappley said. "My hypothesis about this is that the problems of these children are so severe that the physician and parents feel compelled to do something."
The study also found that nearly half of the children were treated for chronic conditions such as developmental delays, language disorders, and medical problems such as asthma and diabetes.
"In addition," Rappley said, "over 40 percent of these children were treated for injuries during that 15-month period. That is an unusually high number."
Rappley also found that the children in this study averaged 18 health care visits during the 15-month period. Numbers of visits range from as low as one to as high as 91.
"Ninety-one is a high number, but these aren't all visits to a doctor," Rappley said. "Some were for counseling or physical therapy. Still that's a great deal of services rendered for medical diagnoses over that period of time."
The nature of the injuries was not specified in the billing reports, she said. It also is unclear if the injuries were related to ADHD.
"However, some of the symptoms these children might exhibit include highly aggressive behavior and participation in physically dangerous activities," Rappley said.
Some of the study's other findings include:
-- Thirty-four percent of the children in the study received no treatment at all for ADHD.
-- More than 40 percent of the children never received a well-child check-up. Rappley said this might be because the other symptoms were so overwhelming that well-child surveillance was lost in the shuffle.
-- Nearly 30 percent of the children in the study suffered from chronic media otitis, or ear infections.
Rappley's research was supported in part by a grant from the Michigan Applied Public Policy Research Funds, which is designed to promote research in the areas of health, urban concerns and pre-university education.
Media Contact: Marsha Rappley, Pediatrics & Human Development
(517) 355-4715
or Tom Oswald, University Relations
(517) 355-2281 [email protected]
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