ADHD

Attention Deficit Disorder and Learning Disability: 
United States, 1997-98

National Center for Health Statistics Press Release and Tables 21may02

[Complete paper on CDC website PDF 2.9MB]

According to a new report released today by the Centers for Disease Control and Prevention (CDC), approximately 1.6 million elementary school-aged children have been diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD), a condition also known as Attention Deficit Disorder (ADD). In a national survey, the parents of 7 percent of children 6-11 years of age reported ever being told by a doctor or health professional that their child had ADHD.

The report, "Prevalence of Attention Deficit Disorder and Learning Disability," based on 1997-98 data from CDCs National Health Interview Survey, shows that about one-half of children diagnosed with ADHD have also been identified as having a learning disability.

"This report serves as a snapshot of a condition that has important consequences for the development of school-age children," said David Fleming M.D., Acting CDC Director. "However, much more needs to be learned about ADHD and about the spectrum of impairments associated with ADHD."

The report details many of the characteristics of children with ADHD, learning disability, and children with both conditions. Among children with a diagnosis of only ADHD, boys were nearly three times as likely as girls to have this diagnosis. White non-Hispanic children were more than twice as likely as Hispanic and black non-Hispanic children to report a diagnosis of ADHD.

In addition, access to health care plays an important role in the diagnosis and treatment of ADHD. Children with health insurance coverage were more often reported to have a diagnosis of ADHD than children without health insurance coverage.

The study shows that children with ADHD use more health care services than children without this diagnosis. Children with ADHD were more likely to have contact with a mental health professional and to have frequent health care visits.

"There has been concern in some circles that ADHD has been over-diagnosed among those with regular access to health care," said Fleming. "And there is equal concern that the problem may be under-diagnosed among those who have limited or no access to care. It’s clearly important to accurately identify children with ADHD and ensure that they have appropriate health care."

The report "Prevalence of Attention Deficit Disorder and Learning Disability" was prepared by CDCs National Center for Health Statistics and can be found at the CDC/NCHS Web site.

For Immediate Release Tuesday, May 21, 2002 Contact: NCHS Press Office (301) 458-4800 CDC Office of Media Relations (404) 639-3286 E-mail: paoquery@cdc.gov 


Abstract

Objectives

This report presents national estimates of the prevalence of diagnosed Attention Deficit Disorder (ADD) and/or Learning Disability (LD) in U.S. children. Differences in the prevalence of these conditions are examined for children with selected sociodemographic characteristics. The occurrence of other health conditions and use of educational and health care services are contrasted for children with only ADD, those with only LD, those with both diagnoses, and those with neither diagnosis.

Methods

Estimates in this report are based on data from the National Health Interview Survey (NHIS), a national household survey of the civilian noninstitutionalized population of the United States. The analysis focuses on 8,647 children 6–11 years of age in the 1997 and 1998 NHIS.

Results

In 1997–98 over 2.6 million children 6–11 years of age were reported to have ever had a diagnosis of ADD or LD. A diagnosis of only ADD was reported for 3 percent of children, a diagnosis of only LD for 4 percent, and a diagnosis of both conditions for 4 percent. The prevalence of ADD with or without LD was greater for boys than for girls. Having health insurance was associated with a diagnosis of only ADD. Living in a low-income or mother-only family occurred more often among children with a diagnosis of LD.

Children with LD were nearly five times more likely to be in special education than children with a diagnosis of only ADD. Children with ADD, in contrast to children without this diagnosis, more often had contact with a mental health professional, used prescription medication regularly, and had frequent health care visits.

Keywords: children’s health, learning and behavioral disorders,  health care utilization


Highlights

Prevalence

Other Health Conditions

Use of Special Education

Use of Health Care Services


Tables and References from:

Pastor PN, Reuben CA. Attention deficit disorder and learning disability: United States, 1997–98. National Center for Health Statistics. Vital Health Stat 10(206). 2002.

Table A. Number of children 6–11 years of age by diagnosed Attention Deficit Disorder and/or Learning Disability, according to selected characteristics: United States, 1997–98

KEY
A=All children1, B=NEITHER2, C=ADD/noLD3, D=LD/noADD4, E=BOTH5
					(Number in 1,000s)        		Sample size                .
Characteristic			A	B	C	D	E  	A	B	C	D	E  .
Total				24,160 	21,527 	784 	1,010 	839 	8,601 	7,697 	270 	345 	289 
Sex 
Boys				12,311 	10,556 	582 	576 	597 	4,413 	3,806 	202 	197 	208 
Girls				11,850 	10,970 	203 	434 	242 	4,188 	3,891 	68 	148 	81 
Age 
6–8 years			12,195 	11,171 	281 	409 	333 	4,358	3,993 	106 	146 	113 
9–11 years			11,966 	10,355 	503 	601 	506 	4,243 	3,704 	164 	199 	176 
Race/ethnicity6 
White non-Hispanic		15,789 	13,944 	649 	621 	575 	4,629 	4,084 	193 	180 	172 
Black non-Hispanic 		3,735 	3,312 	69 	201 	153 	1,415 	1,264 	34 	62 	55 
Hispanic			3,573 	3,268 	48 	165 	93 	2,237 	2,049 	35 	95 	58 
Birthweight 
Low (less than 2,500 grams)	1,529 	1,254 	65 	134 	75 	608 	509 	21 	45 	33 
Not low (2,500 grams or more)	21,171 	18,975 	680 	819 	697 	7,452 	6,697 	233 	285 	237 
Family structure7 
Mother and father		17,497 	15,848 	525 	609 	514 	5,808 	5,282 	168 	198 	160 
Mother only 			5,308 	4,538 	203 	325 	242 	2,200 	1,901 	80 	117 	102
Family income 
$20,000 or more			18,133 	16,334 	606 	661 	532 	6,128 	5,535 	202 	222 	169 
Less than $20,000		5,021 	4,288 	143 	302 	287 	2,069 	1,791 	59 	105 	114 
Residence in MSA8 
Central city, MSA		6,553 	5,862 	190 	294 	208 	2,694 	2,427 	78 	104 	85 
Not central city, MSA 		12,676 	11,324 	442 	493 	418 	4,334 	3,880 	139 	173 	142 
Not MSA				4,931 	4,341 	153 	223 	214 	1,573 	1,390 	53 	68 	62 
Health insurance coverage 
Uninsured			3,121 	2,847 	58 	142 	75 	1,283 	1,177 	27 	50 	29 
Medicaid9 			3,738 	2,982 	158 	304 	295 	1,434 	1,159 	54 	107 	114 
Private10			17,165	15,576	566	562	461	5,823	5,307	187	186	143 

ADD is Attention Deficit Disorder. 
LD is Learning Disability. 
1  Data do not include children with unknown responses to the questions on ADD and LD. 
2  NEITHER includes children who have never had a diagonsis of either ADD or LD. 
3  ADD/noLD includes children who have ever had a diagnosis of ADD and have never had a diagnosis of LD. 
4  LD/noADD includes children who have ever had a diagnosis of LD and have never had a diagnosis of ADD. 
5  BOTH includes children who have ever had a diagnosis of both ADD and LD. 
6  Data are not shown for non-Hispanic children of other races due to small sample size. 
7  Mother and father refer to biological, adoptive, step, and foster parents. Data are not shown for children 
   in other family types due to small sample size. 
8  MSA is metropolitan statistical area. 
9  Medicaid includes children insured only by Medicaid. 
10 Private includes children covered by private insurance, those with non-Medicaid public insurance, and those 
   with both private and public insurance. 

Table B. Percent of children 6–11 years of age with Attention Deficit Disorder and/or Learning Disability by sex, according to selected characteristics: United States, 1997–98

KEY
A=ADD/noLD1, B=LD/noADD2, C=BOTH3, Percent (standard error)

				All children 		      Boys 			    Girls                       .
Characteristic 			A	  B	    C	      A	  	B	  C	    A	      B	        C
Total				3.3(0.23) 4.2(0.27) 3.5(0.23) 4.7(0.37) 4.7(0.39) 4.9(0.39) 1.7(0.26) 3.7(0.37) 2.0(0.28)
Age 
6–8 years			2.3(0.27) 3.4(0.31) 2.7(0.30) 3.3(0.47) 3.8(0.45) 4.0(0.50) 1.3(0.28) 2.9(0.43) 1.5(0.34) 
9–11 years			4.2(0.40) 5.0(0.43) 4.2(0.37) 6.1(0.64) 5.6(0.60) 5.7(0.60) 2.2(0.44) 4.4(0.61) 2.6(0.43) 
Race/ethnicity4 
White non-Hispanic		4.1(0.33) 3.9(0.33) 3.6(0.30) 6.0(0.53) 4.2(0.45) 5.0(0.50) 2.1(0.37) 3.7(0.46) 2.2(0.38) 
Black non-Hispanic		1.8(0.34) 5.4(0.84) 4.1(0.67) 2.7(0.62) 7.6(1.40) 6.5(1.14) * 	      3.2(0.83) * 
Hispanic			1.4(0.29) 4.6(0.71) 2.6(0.40) 1.8(0.39) 4.8(0.75) 3.1(0.61) * 	      4.5(1.22) 2.0(0.50) 
Birthweight 
Low (Less than 2,500 grams)	4.3(1.04) 8.8(1.37) 4.9(1.06) 6.9(1.95) 8.7(1.90) 6.5(1.56) * 	      8.8(1.99) * 
Not low (2,500 grams or more)	3.2(0.25) 3.9(0.29) 3.3(0.24) 4.7(0.40) 4.6(0.42) 4.6(0.42) 1.7(0.28) 3.1(0.36) 2.0(0.29) 
Family structure5 
Mother and father		3.0(0.27) 3.5(0.28) 2.9(0.26) 4.4(0.45) 4.0(0.41) 3.8(0.42) 1.5(0.27) 3.0(0.36) 2.0(0.34) 
Mother only			3.8(0.55) 6.1(0.76) 4.6(0.55) 5.4(0.85) 6.6(0.94) 7.0(0.95) * 	      5.7(1.15) 2.0(0.52) 
Family income 
$20,000 or more			3.3(0.27) 3.7(0.27) 2.9(0.26) 4.8(0.45) 3.9(0.38) 4.2(0.43) 1.9(0.31) 3.4(0.39) 1.7(0.29) 
Less than $20,000		2.8(0.46) 6.0(0.82) 5.7(0.63) 4.3(0.78) 7.4(1.11) 7.3(0.97) * 	      4.5(1.10) 3.9(0.82) 
Health insurance coverage 
Uninsured			1.9(0.39) 4.6(0.91) 2.4(0.50) 2.9(0.72) 5.1(1.08) 3.6(0.81) * 	      * 	* 
Medicaid6			4.2(0.72) 8.1(0.99) 7.9(0.88) 6.1(1.22) 9.2(1.40) 11.0(1.42)* 	      6.9(1.31) 4.4(1.04) 
Private7			3.3(0.28) 3.3(0.27) 2.7(0.26) 4.8(0.46) 3.6(0.39) 3.6(0.42) 1.8(0.31) 2.9(0.36) 1.7(0.30) 
Residence in MSA8 
Central city, MSA		2.9(0.39) 4.5(0.56) 3.2(0.40) 4.1(0.68) 5.0(0.75) 4.7(0.70) 1.7(0.41) 4.0(0.86) 1.6(0.42) 
Not central city, MSA		3.5(0.36) 3.9(0.33) 3.3(0.33) 5.1(0.59) 4.5(0.49) 4.5(0.53) 1.9(0.40) 3.3(0.44) 2.1(0.40) 
Not MSA				3.1(0.44) 4.5(0.71) 4.3(0.59) 4.7(0.75) 4.8(0.99) 5.9(0.94) * 	      4.2(0.89) 2.5(0.70) 

ADD is Attention Deficit Disorder. 
LD is Learning Disability. 
* Figure does not meet standard of reliability or precision. 
1 ADD/noLD includes children who have ever had a diagnosis of ADD and have never had a diagnosis of LD. 
2 LD/noADD includes children who have ever had a diagnosis of LD and have never had a diagnosis of ADD. 
3 BOTH includes children who have ever had a diagnosis of both ADD and LD. 
4 Data are not shown for non-Hispanic children of other races due to small sample size. 
5 Mother and father refer to biological, adoptive, step, and foster parents. Data are not shown for children 
  in other family types due to small sample size. 
6 Medicaid includes children insured only by Medicaid. 
7 Private includes children covered by private insurance, those with non-Medicaid public insurance, 
  and those with both private and public insurance. 
8 MSA is metropolitan statistical area. 

Table C. Percent of children 6–11 years of age with selected health conditions by diagnosed Attention Deficit Disorder and/or Learning Disability, according to sex: United States, 1997–98

						Percent (standard error)5 
Health conditions 		  NEITHER1      ADD/noLD2 	LD/noADD3 	BOTH4      .
All children 	
Mental retardation/ODD6		  1.3(0.16) 	* 		30.7(2.97) 	34.4(3.38) 
Hearing or vision problems7	  3.0(0.23) 	* 		12.2(2.22) 	9.5(2.07)
Allergies8			  27.3(0.61) 	31.7(3.63) 	35.6(3.05) 	39.3(3.27) 
Asthma9				  12.1(0.44) 	17.4(2.64) 	16.5(2.46) 	16.6(2.63) 
Other chronic health condition10  4.1(0.26)	4.6(1.23)	9.7(1.77)	12.5(2.42) 
Boys 
Mental retardation/ODD6		  2.0(0.30) 	* 		30.4(3.76) 	34.5(3.98) 
Hearing or vision problems7	  2.8(0.32) 	* 		10.6(2.46) 	7.6(2.24) 
Allergies8			  28.4(0.89) 	31.6(4.33) 	36.8(3.76) 	39.0(3.64) 
Asthma9				  15.0(0.73) 	18.7(3.06) 	17.9(3.03) 	19.7(3.32) 
Other chronic health condition10  4.1(0.36) 	* 		8.8(2.04) 	10.8(2.46) 
Girls 
Mental retardation/ODD6		  0.6(0.14) 	* 		31.2(4.80) 	34.2(6.64) 
Hearing or vision problems7	  3.2(0.33) 	* 		14.3(3.85) 	* 
Allergies8			  26.1(0.85) 	31.9(6.63) 	34.0(4.93) 	39.8(6.84) 
Asthma9				  9.2(0.55) 	* 		14.6(4.02) 	* 
Other chronic health condition10  4.2(0.36) 	* 		11.0(3.11) 	* 

ADD is Attention Deficit Disorder. 
LS is Learning Disability. 
*  Figure does not meet standard of reliability or precision. 
1  NEITHER includes children who have never had a diagnosis of either ADD or LD. 
2  ADD/noLD includes children who have ever had a diagnosis of ADD and have never had a diagnosis of LD. 
3  LD/noADD includes children who have ever had a diagnosis of LD and have never had a diagnosis of ADD. 
4  BOTH includes children who have ever had a diagnosis of both ADD and LD. 
5  Unknowns for the variables of interest are not included in denominators used for the calculation of 
   percents and standard errors. 
6  Parental report of diagnosed mental retardation or other developmental delay, autism, or Down syndrome. 
7  Parental report of blindness, deafness, or serious difficulty seeing or hearing. 
8  Parental report of a digestive allergy, skin allergy, hay fever, respiratory allergy, or frequent ear infections 
   (three or more) during the past 12 months. 
9  Parental report of ever having a diagnosis of asthma. 
10 Parental report of diagnosed Cerebral Palsy, Muscular Dystrophy, Cystic Fibrosis, Sickle Cell Anemia, Diabetes, 
   Arthritis, or heart disease; also a parental report of frequent diarrhea or colitis, anemia, or seizures 
   during the past 12 months. 

Table D. Percent of children 6–11 years of age using selected educational and health care services by diagnosed Attention Deficit Disorder and/or Learning Disability according to sex: United States, 1997–98

								Percent (standard error)5 
Educational and health care services 		NEITHER1 	ADD/noLD2 	LD/noADD3 	BOTH4    .
All children 
Enrolled in special education6			2.3(0.20) 	11.7(2.20) 	45.9(3.24) 	64.7(3.18) 
Contacted a mental health professional7		3.4 (0.26) 	33.9(3.43) 	16.5(2.50) 	51.1(3.72) 
Used prescription medication8			5.8 (0.30) 	53.6(3.55) 	13.8(2.12) 	61.4(3.47) 
Contacted a medical specialist9			9.4 (0.41) 	20.3(3.24) 	17.0(2.37) 	28.4(3.17) 
Contacted a therapist10				3.9 (0.27) 	* 		26.2(3.02) 	24.8(2.97) 
Had four or more health care visits11		22.6(0.60)	44.8(3.56) 	34.3(3.13) 	50.6(3.77) 
Boys 
Enrolled in special education6			2.9 (0.33) 	11.8(2.49) 	48.5(4.12) 	63.3(3.83) 
Contacted a mental health professional7		3.9 (0.41) 	35.2(3.92) 	17.9(3.20) 	53.3(4.23) 
Used prescription medication8			6.7 (0.46) 	55.7(4.20) 	16.1(2.87) 	68.2(4.10) 
Contacted a medical specialist9			9.5 (0.57) 	21.3(3.88) 	17.5(3.25) 	28.9(3.81) 
Contacted a therapist10				4.2 (0.39) 	* 		27.2(3.67) 	25.7(3.46) 
Had four or more health care visits11		22.4 (0.84) 	44.5(4.01) 	34.9(4.00) 	52.8(4.27) 
Girls 
Enrolled in special education6			1.7(0.23) 	* 		42.5(5.10) 	68.0(6.45) 
Contacted a mental health professional7		2.9(0.33)	30.0(6.79)	14.7(3.93)	45.7(6.63) 
Used prescription medication8			5.0(0.39) 	47.7(6.99) 	10.7(3.11) 	44.7(6.77) 
Contacted a medical specialist9			9.2 (0.55) 	* 		16.3(3.76) 	27.3(6.24) 
Contacted a therapist10				3.5 (0.38) 	* 		24.8(4.81) 	22.8(5.47) 
Had four or more health care visits11		22.8 (0.81) 	45.9(7.39) 	33.5(4.75) 	45.3(6.83) 

ADD is Attention Deficit Disorder. 
LD is Learning Disability. 
*  Figure does not meet standard of reliability or precision. 
1  NEITHER includes children who have never had a diagnosis of either ADD or LD. 
2  ADD/noLD includes children who have ever had a diagnosis of ADD and have never had a diagnosis of LD. 
3  LD/noADD includes children who have ever had a diagnosis of LD and have never had a diagnosis of ADD. 
4  BOTH includes children who have ever had a diagnosis of both ADD and LD. 
5  Unknowns for the variables of interest are not included in denominators used for the calculation of percents 
   and standard errors. 
6  Receives special education services. 
7  Saw or spoke to a mental health professional such as a psychiatrist, psychologist, psychiatric nurse, or 
   clinical social worker during the past 12 months. 
8  Has a condition for which prescription medication had been taken regularly for at least 3 months. 
9  Saw or spoke to a medical specialist (other than a gynecologist, psychiatrist, or ophthamalogist) during the 
   past 12 months. 
10 Saw or spoke to a physical therapist, speech therapist, respiratory therapist, audiologist, 
   or occupational therapist. 
11 Four or more visits to a doctor or other health professional during the past 12 months; overnight 
   hospitalizations, emergency room visits, home visits, or telephone calls are not included. 

References

1. Blendon RJ, Young JT, McCormick MC, et al. Americans’ views on children’s health. JAMA 280(24):2122–7. 1998.

2. Terman DL, Larner MB, Stevenson CS, Behrman RE. Special education for students with disabilities: Analysis and recommendations. Future Child 6(1):4–24. 1996.

3. Kelleher KJ, McInerny TK, Gardner WP, et al. Increasing identification of psychosocial problems: 1979–1996. Pediatrics 105(6):1320. 2000.

4. Cherlin AJ, ed. The changing American family and public policy. Washington DC: Urban Institute Press. 1988.

5. Zill N, Schoenborn CA. Developmental, learning, and emotional problems: Health of our Nation’s children, United States, 1988. Advance data from vital and health statistics; no. 190. Hyattsville, Maryland: National Center for Health Statistics. 1990.

6. Reschly DJ. Identification and assessment of students with disabilities. Future Child 6(1):40–53. 1996.

7. Lyon GR. Learning disabilities. Future Child 6(1):54–76. 1996.

8. Safer DJ, Zito JM. Psychotropic medication for ADHD. MRDD Research Reviews 5:237–42. 1999.

9. Kelleher KJ, McInerny TK, Gardner WP, et al. Increasing identification of psychosocial problems: 1979–96. Pediatrics 105(6): 1313–21. 2000.

10. U.S. Department of Health and Human Services. Mental health: A report of the Surgeon General. Rockville, Maryland: U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health. 1999.

11. Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and estimation for the National Health Interview Survey, 1995–2004. National Center for Health Statistics. Vital Health Stat 2(130). 2000.

12. Bloom B, Tonthat L. Summary Health Statistics for U.S. Children: National Health Interview Survey, 1997. National Center for Health Statistics. Vital Health Stat 10(203). 2002.

13. Shah BV, Barnwell BG, Bieler GS. SUDAAN User’s Manual, Release 7.5. Research Triangle Park, North Carolina: Research Triangle Institute. 1997.

14. McCracken JT. Attention Deficit Disorders. In: Sadock BJ, Sadock VA, eds. Kaplan and Sadock’s comprehensive textbook of psychiatry. 7th ed. Philadelphia: Lippincott, Williams and Wilkins. 2000.

15. Wagner MM, Blackorby J. Transition from high school to work or college: How special education students fare. Page 10 [ Series 10, No. 206 Future Child 6(1):103–20. 1996.

16. Angold A, Messer SC, Stangl D, et al. Perceived parental burden and service use for child and adolescent psychiatric disorders. Am J Public Health 88(1):75–80. 1998.

17. Green M, Wong M, Atkins D, et al. Diagnosis of Attention-Deficit/ Hyperactivity Disorder. Technical Review No. 3 (Prepared by Technical Resources International, Inc. under Contract No. 290-94-2024.) AHCPR Publication No. 99-0050. Rockville, Maryland: Agency for Health Care Policy and Research. 1999.

18. National Center for Education Statistics. Digest of Education Statistics, 1999. Washington, DC: Department of Education. 2000. Available from URL: http://nces.ed.gov/ pubs2000/digest99/d99t053.html.

19. McNeil J. Americans with disabilities, 1997. Current population reports, series P-70, no 73. Washington DC: U.S. Department of Commerce. 2001.

20. Pless CE, Pless IB. How well they remember: The accuracy of parent reports. Arch Pediatr Adolesc Med 149(5):553–8. 1995.

21. Edwards WS, Winn DM, Kurlantzick V, et al. Evaluation of National Health Interview Survey Diagnostic Reporting. National Center for Health Statistics. Vital Health Stat 2(120). 1994.

22. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 3rd ed. Revised. Washington, DC: American Psychiatric Association. 1987.

23. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Washington, DC: American Psychiatric Association. 1994.

24. Code of Federal Regulations, Title 34, Subtitle B, Chapter III, Section 300.7(b)(10).

25. Semrud-Clikeman M, Biederman J, Sprich-Buckminster S, et al. Comorbidity between ADDH and learning disability: A review and report in a clinically referred sample. J Am Acad Child Adolesc Psychiatry 31(3):439–48. 1992.

26. Wasserman RC, Kelleher KJ, Bocian A, et al. Identification of attentional and hyperactivity problems in primary care: A report from Pediatric Research in Office Settings and the Ambulatory Sentinel Practice Network. Pediatrics 103(3):e38. 1999. Available from: URL: http://www.pediatrics.org/cgi/ content/full/103/3/e38.

27. Kelleher KJ, Childs GE, Wasserman RC, et al. Insurance status and recognition of psychosocial problems: A report from the Pediatric Research in Office Settings and the Ambulatory Sentinel Practice Networks. Arch Pediatr Adolesc Med 151(11):1109–15. 1997.

28. Barkley RA. Attention-Deficit Hyperactivity Disorder: A handbook for diagnosis and treatment. New York: Guilford Press. 1998.

29. Coiro MJ, Zill N, Bloom B. Health of our Nation’s children. National Center for Health Statistics. Vital Health Stat 10(191). 1994.

30. Zuckerman B, Moore KA, Glei D. Association between child behavior problems and frequent physician visits. Arch Pediatr Adolesc Med 150:146–53. 1996.

31. Leibson CL, Katusic SK, Barbaresi WJ, et al. Use and costs of medical care for children and adolescents with and without Attention-Deficit/Hyperactivity Disorder. JAMA 285(1):60–6. 2001.

32. Hoagwood K, Kelleher KJ, Feil M, Comer DM. Treatment services for children with ADHD: A national perspective. J Am Acad Child Adolesc Psychiatry 39(2):198–206. 2000. Series 10, No. 206 [ Page 11


Appendix II
Definition of Terms

Age¡ªchild¡¯s age in years at last birthday.

ADD¡ªfamily report of a diagnosis of Attention Deficit Disorder by a doctor or health professional.

ADD/noLD¡ªfamily report of a diagnosis of Attention Deficit Disorder without a diagnosis of Learning Disability.

BOTH¡ªfamily report of a diagnosis of Attention Deficit Disorder and Learning Disability. Contact with health care provider¡ª visit or conversation with a physician or other health professional about the child¡¯s health.

Developmental delay¡ªsignificant delay in one of several areas: physical development, cognitive (mental) development, social or emotional development, or adaptive development.

DSM¡ªDiagnostic and Statistical Manual of Mental Disorders, the standard manual for diagnosis of mental disorders in the United States.

DSM-III-R¡ªrevised third edition of the Diagnostic and Statistical Manual of Mental Disorders.

DSM-IV¡ªfourth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Family structure¡ªparents(s) present in the household with the child. Mother and father refer to biological, adoptive, step, and foster parents.

Family income¡ªwages, salaries, government payments, child support/alimony, dividends, help from relatives, and other sources of family income during the calendar year prior to the interview. Each member of a family is classified by the total income of the family. Low family income is defined as an annual income of less than $20,000.

Health care visit¡ªvisits to a health care professional; not including overnight hospitalizations, emergency room visits, home visits, or telephone calls.

Health insurance coverage¡ª insurance coverage at the time of interview including the following categories: Medicaid and other related public insurance (e.g., most State-sponsored insurance coverage), private and other types of insurance (e.g., Medicare, military health insurance coverage, or another form of government-sponsored health insurance coverage), and uninsured. Children with only Indian Health Service coverage are considered uninsured. Children classified as having Medicaid coverage include children with only Medicaid coverage.

IDEA—Individuals with Disabilities Education Act, Federal legislation mandating free and appropriate public education for students with disabilities.

LD—family report of a diagnosis of Learning Disability by a representative from a school or a health professional.

LD/noADD—family report of a diagnosis of Learning Disability without a diagnosis of Attention Deficit Disorder.

MSA—metropolitan statistical area, a county or group of counties containing at least one city having a population of 50,000 or more plus adjacent counties that are metropolitan in character and economically and socially integrated with the central city.

Central city—largest city in an MSA.

Not central city—part of an MSA that is not the central city.

Not in MSA—all other places in the country.

NEITHER—family report of a diagnosis of neither Attention Deficit Disorder nor Learning Disability.

NHIS—National Health Interview Survey.

NHIS-CH—1988 Child Health Survey, a supplement to the National Health Interview Survey.

For answers to questions about this report or for a list of reports published in these series, contact:

Data Dissemination Branch

National Center for Health Statistics

Centers for Disease Control and Prevention

6525 Belcrest Road, Room 1064

Hyattsville, MD 20782-2003

(301) 458–4636

E-mail: nchsquery@cdc.gov

Internet: www.cdc.gov/nchs

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