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[Attention deficit/hyperactivity disorders among three-to-six-year-olds treated in medical practices--a national
Dieter Breuer1, Manfred Döpfner
1Klinik und Poliklinik für Psychiatrie und Psychotherapie des Kindes- und Jugendalters, Klinikum der Universität zu Köln, Robert-Koch-Strasse 10, DE-50931 KOLN. heinz-dieter.breuer@uk-koeln.de
Insights
Prevalence of Attention Deficit-/Hyperactivity Disorders (ADHD) in preschoolers is significant, with higher rates in clinical samples. Many children need professional help but do not receive it, highlighting the need for intervention programs.
Area of Science:
- Child and Adolescent Psychiatry
- Developmental Psychology
- Pediatrics
Context:
- Attention Deficit-/Hyperactivity Disorders (ADHD) significantly impact preschoolers.
- Accurate prevalence data is crucial for early intervention and resource allocation.
- Understanding functional impairment and comorbidities aids in comprehensive care.
Purpose:
- To determine the prevalence of ADHD symptoms and diagnoses in preschoolers.
- To assess functional impairment and comorbid symptoms using parent and teacher checklists.
- To compare prevalence rates based on different diagnostic criteria and raters.
Summary:
- A study of 708 preschoolers assessed ADHD prevalence using parent and teacher symptom checklists.
- DSM-IV criteria indicated ADHD in 11.3% based on parental ratings and 6.6% on teacher ratings.
- Higher rates and comorbidities were observed in a clinical sample, with a notable gap in received professional help.
Impact:
- Findings underscore the relevance of prevention and intervention programs for preschool ADHD.
- Highlights the need for increased access to counseling and treatment for affected children.
- Suggests international prevalence rates are applicable, despite study limitations.
Objective:
The aim of the study is to calculate prevalence rates of symptoms and diagnoses of Attention Deficit-/Hyperactivity Disorders (ADHD) in preschoolers, and to assess functional impairment as well as comorbid symptoms by means of parents and teacher symptom checklists.
Method:
N = 708 kindergarten- and preschool-children were recruited nationwide by pediatricians or child and adolescent psychiatrists. The U8/U9 sample (n = 521 children) was assessed during a routine pediatric screening. The clinical sample consisted of n = 187 children who were rated as having ADHD problems by the physician. The children were assessed by age-adapted ADHD Symptom-Checklists (Fremdbeurteilungsbogen für Aufmerksamkeitsdefizit-/Hyperaktivitätsstörungen im Vorschulalter FBB-ADHS-V) rated by parents and teachers. Additionally, the physicians rated ADHD symptoms and comorbid symptoms.
Results:
Based on diagnosis criteria of DSM-IV and the parental ratings in U8/U9, 11.3% of the children fulfilled the criteria for one of the three ADHD diagnoses (ICD 10: 3.8%). The prevalence rate was lower in teacher ratings (6.6%) (ICD 10: 1.5%), and in both the parent and teacher ratings 4.2% of the children fulfilled the DSM-IV criteria for ADHD (ICD 10: 1.2%). Higher prevalence rates and comorbidities were found in the clinical sample. The need for professional help (counseling/treatment) is much higher than the treatment the parents and children actually received.
Conclusion:
International prevalence rates can be applied. Despite methodological restrictions, such as a lack of representativeness and possible pre-selection effects, this study demonstrates the relevance of prevention and intervention programmes.
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