Disorders of attention and activity level in a referral population

Of 614 children referred for an evaluation of hyperactivity and inattention, the 422 (68.7%) who qualified for a diagnosis of attention deficit disorder (ADD) were compared with the 192 (31.3%) who did not. The children with ADD had significantly higher full-scale IQ scores, verbal scores, and parental educational levels. They also had a significantly higher incidence of specific learning disabilities (73.7%). The absence of hyperactivity in children with ADD further exaggerated the differences in learning disability between the two groups. Cognitive limitation, severe parental psychopathology, and child neglect/abuse were significantly higher in the group without ADD. The two groups did not differ in the incidence of parental or child depressive symptomatology, motor diagnoses, language disorders, conduct disorders, and psychosomatic complaints. That only 29 children in whom ADD was absent (4.7% of all referrals) had been given a trial of stimulant medication does not support the presence of a major abuse of such drugs in the community.