Article Text
Abstract
Background Socio-economic factors are known to influence the prevalence of chronic childhood disabling conditions including emotional and behavioural disorders. Referrals of school-age children for assessment of difficult or challenging behaviour constitute a major case load of neurodevelopmental paediatricians (designated as community paediatricians in the UK).
Aims We aimed to evaluate the characteristics of school-age children screened for ADHD following referral for behaviour problems to the local community paediatric unit of a large healthcare NHS Foundation Trust in the North West of England over an 18-month period. We compared the characteristics of children diagnosed with ADHD with those not diagnosed following standard comprehensive assessments.
Results A total of 61 children were assessed for possible ADHD using the Swanson, Nolan, and Pelham –IV Questionnaire (SNAP-IV) (26-item freely available resource online at myadhd.com) between April 2014 and Sept 2015. The characteristics of children fulfilling the clinical criteria for a diagnosis of ADHD was compared with those who were not diagnosed. Using the residential postcodes,the socio-economic status of each child was determined using the Index of Multiple Deprivation (IMD) 2010 scores and ranking order out of all the 34378 LSOAs in England. The ranked LSOAs were analysed as groups of 5 (Quintiles), groups of ten (Deciles). Spearman’s rank correlation coefficient was used to determine the relationship between the prevalence of ADHD in different socioeconomic groups. Table 1 displays the main characteristics of the two groups (ADHD and non-ADHD) compared with the whole group of children.
Conclusion There was no statistically significant difference between the distribution of the socio-economic deprivation of both groups. The highest prevalence for the ADHD and non-ADHD children was highest in the most deprived areas.
These findings have important clinical implications for identifying individuals at highest risk of developing ADHD and other challenging behaviours, and in planning effective management strategies.