Masood Ali Shaikh, Irshad Ali Shaikh


Attention Deficit Hyperactive Disorder (ADHD) is
characterized by inattention, hyperactivity and
impulsiveness1. Learning disabilities have been
reported in up to 30% of children with this disorder2.
Annually some $3.3 billions are spent on its
healthcare cost in the United States3. We describe
gender, race, poverty level and educational
attainment in the family associated with ADHD in
under-eighteen year old children in the United States
of America, using data from the National Survey of
Children’s Health, 2003 (NSCH)4.
The NSCH was conducted from January 2003 to July
2004; by the National Center for Health Statistics,
and funded by the Maternal and Child Health Bureau
of the Health Resources and Services Administration.
NSCH was designed to produce national and statespecific estimates, using random-digit-dial sample of
households with under-18 children. The respondent
was either the parent or a family member of the child,
and interviews were conducted using a computerassisted telephone interviewing system. Affirmative
response to the question “Has a doctor or health
professional ever told you that the child has Attention
Deficit or Attention Deficit Hyperactive Disorder that
is ADD or ADHD?” was used to identify ADHD
cases. Design-based analysis with STATA release 9.1
was done using Logistic Regression, and Odds Ratios
(OR) were computed for the association of ADHD,
with various socio-demographic variables; data was
downloaded from the website of National Center For
Health Statistics4.
The overall prevalence of ADHD was 6.8% with
95% Confidence Interval (CI) 6.5% - 7.1% (n =
90226). In males prevalence was 9.6% (95% CI 9.1%
- 10.1%), while in females it was 4.0% (95% CI 3.6%
- 4.2%). Compared to males, females were much less
likely to be diagnosed with ADHD (OR 0.36, 95% CI
0.33 – 0.40). Race was assessed in the categories of
White, Black, Multiple and Other. Compared to
Whites, Black children were less likely to be
diagnosed with ADHD (OR 0.79, 95% CI 0.68 –
0.92) as well as children in the Other racial group
(OR 0.45, 95% CI 0.32 – 0.64), while no statistically
significant association found with Multiple race.
Highest level of education attained by anyone in a
house of the child was assessed in terms of less than
high school, high school, and more than high school
educational attainment. No statistically significant
association was found with educational attainment
and a child in the family diagnosed with ADHD.
Poverty level of the household was assessed in three
categories; less than 150%, 150% to less than 300%,
and 300% plus, based on Department of Health and
Human Services guidelines. Compared to children in
households with the base category of less than 150%
poverty level, children in the 150% to less than 300%
and 300% plus category were less to be diagnosed
with ADHD; i.e. (OR 0.79, 95% CI 0.69 – 0.90) and
(OR 0.65, 95% CI 0.57 – 0.74), respectively.
In conclusion, male children were more likely, while
children in families living in 150% or above poverty
levels were less likely to have been told by a doctor
or health professional that they have Attention Deficit
or Attention Deficit Hyperactive Disorder.

Full Text:



American Psychiatric Association: Diagnostic

and Statistical Manual of Mental Disorders,

Fourth Edition, Text Revision. Washington,

DC, American Psychiatric Association, 2000.

Wender PH. ADHD: Attention-Deficit

Hyperactivity Disorder in Children and Adults.

Oxford University Press, 2002.

Birnbaum HG, Kessler RC, Lowe SW, et al.

Costs of attention deficit-hyperactivity

disorder (ADHD) in the US: excess costs of

persons with ADHD and their family members

in 2000. Curr Med Res Opin 2005;21:195--

National Survey of Children’s Health.

ch.htm. (Assessed July 14, 2005)


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