Child/Adolescent Health

Children with ADHD from larger families more likely to use stimulants

Children who have attention-deficit/hyperactivity disorder (ADHD) are typically impulsive, hyperactive, and easily distracted—characteristics that can harm schoolwork, self-esteem, psychological development, and interpersonal relationships. Various stimulant medications are typically prescribed to quiet their behavior and help them focus. A recent study has found differences in stimulant use among these children depending on family structure. Specifically, children from families with additional children are more likely to use stimulants compared with children from a single-child family.

University of Chicago researchers, Atonu Rabbani, Ph.D., and G. Caleb Alexander, M.D., M.S., examined parental educational level, types of stimulants used by children with ADHD, and family size using data from the National Health Interview Survey from 1997 to 2003 and from the Medical Expenditure Panel Survey from 1998 to 2005. Stimulant use was greatest among younger children aged 2 to 6 with ADHD, with 56 percent of them using these medications. Older children aged 12 to 17 years had the least usage, with only 27 percent taking stimulants. Stimulant use was also more likely among children reporting excellent health (45 percent) compared with children reporting fair (27 percent) or poor health (13 percent).

Children were 11 percent less likely to use stimulants if they came from households with a single mother, after adjusting for household income, insurance, and health status. After adjusting for these factors, children with ADHD from families with one other child and two or more other children were 32 percent and 77 percent more likely, respectively, to use stimulants than families with a single child. Children living in the largest families had greater than 2.5-fold odds of using stimulants compared with children who were the only child in the family. The study was supported in part by the Agency for Healthcare Research and Quality (HS15699).

See "Impact of family structure on stimulant use among children with attention-deficit/hyperactivity disorder," by Drs. Rabbani and Alexander, in the December 2009 HSR: Health Services Research 44(6), pp. 2060-2078.

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