Young smiling girl, Delhi IndiaRelatively few children with attention deficit hyperactivity disorder (ADHD) who receive medication also participate in some kind of behavioral or talk therapy. The findings, from a RAND Corporation study, indicate that whether a child receives talk therapy in addition to medication is strongly connected to where the child lives. The researchers found a large variance in the rate of additional therapy for children with ADHD based on which United States county the children lived in.

The researchers based their work on a large commercial claims database, selecting records for more than 300,000 children aged 17 and younger who had received a prescription for ADHD medication. The children resided in 1,516 counties in the US. The researchers excluded sparsely populated counties. They tallied how many children received some form of talk therapy in addition to ADHD medication. The researchers also examined how many licensed psychologists were available in the counties they reviewed.

The majority of children who received a prescription for ADHD medication did not receive any talk therapy in the same year that they received the prescription. Only one-quarter of children who were prescribed medication went to talk therapy in the same year. Thirteen percent of the children had at least four therapy sessions. Seven percent of the children had eight or more sessions. In 200 of the counties surveyed, less than one in ten children received any therapy. In general, counties with a smaller supply of licensed psychologists were the counties in which fewer children received talk therapy. However, there were exceptions to this trend.

This study is the first to document the local variations in ADHD treatment methods in the United States. Other research demonstrates that some children benefit from receiving therapy and medication. The findings indicate that there is room for improvement in making a variety of services available for families and children with ADHD.

This research is published in JAMA Pediatrics.

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