Variations in ADHD treatment among special education students

Objective: To examine Variation in patient characteristics (case-mix) and treatment patterns for attention-deficit/hyperactivity disorder (ADHD) by provider type. Method: By means of a two-stage study design, 102 children were identified as receiving treatment for ADHD in the past year, among a school district-wide sample of second- through fourth-grade special education students. Parent and child interviews were conducted using standardized measures of need for treatment, service use, and process of care. Results: Nearly three fourths of the children received treatment for ADHD by a primary care provider, and of these, 68% did not have any contact with a mental health specialist. Children treated only by a primary care provider had fewer comorbid conditions, less impairment, and lower levels of family burden than children treated only by a mental health specialist. Treatment of ADHD solely by primary care providers was characterized by fewer sessions, less time with the patient, and less use of multimodal therapies. Conclusion: Future studies examining clinical outcomes for ADHD treatment should take into account variation in case-mix and treatment patterns by provider type.