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Abstract
Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and their parents often face challenges that may lead to contact with child welfare services (CWS). However, there is a lack of studies addressing this issue. This study assessed the rate and association between ADHD and different types of CWS contact compared to the general population. We also examined whether individual and parental characteristics were associated with CWS contact among children and adolescents with ADHD. We employed a longitudinal research design and examined an 18-year age trajectory for a cohort of 8,051 children and adolescents aged 5 to 18 years diagnosed with ADHD between 2009 and 2011, linking several Norwegian nationwide registries. Descriptive statistics and logistic regression analysis assessed rate and association between ADHD and CWS contact. Chi-square tests and t-tests examined associations between individual and parental characteristics and CWS contact among those with ADHD. Children and adolescents with ADHD had considerably higher rate of any CWS contacts (32.7%) compared to the general population (6.1%). ADHD was significantly associated with both out-of-home placement (aOR = 7.3, 95% CI: 5.2-10.2) and supportive interventions (aOR = 6.3, 95% CI: 5.1-7.7). Among those with ADHD, comorbid conduct disorder and a criminal record were significantly associated with CWS contact compared to those without CWS contact. Additionally, they were more likely to have unmarried parents and parents with lower income and educational level. These findings provide novel insight into the relationship between ADHD and contact with CWS. Future research should examine the impact of clinical and behavioral treatment of ADHD on contact with CWS.
Highlights
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental conditions in children and adolescents, characterized by inappropriate levels of inattention and/or hyperactivity and impulsivity [1]
Among children and adolescents diagnosed with ADHD, 32.7% had contact with one or more child welfare services (CWS) at any time, compared to 6.1% of the general population
While most of the previous studies have assessed the rate of ADHD among those living in foster care or institutions, our study examined the rate of broader ranges of CWS outcomes, including any CWS, supporting intervention, and out-of-home placement among children and adolescents diagnosed with ADHD Further, our study provides novel insight into the association between ADHD and the range of CWS outcomes compared with general population, temporality, and age at contact with CWS
Summary
Attention-deficit/hyperactivity disorder (ADHD) is one of the most prevalent neurodevelopmental conditions in children and adolescents, characterized by inappropriate levels of inattention and/or hyperactivity and impulsivity [1]. Children with ADHD have challenges in one or more areas of social, academic, adaptive behavior, and emotional functioning [2–9]. In addition to these challenges, they often have comorbid conditions, such. Parents of children and adolescents with ADHD might have their own difficulties. They often have lower educational attainment, income, and unmarried [1, 6, 12, 13]. Because of behavioral challenges in the child and/or parents deficient in resources or own mental health conditions, children and adolescents with ADHD and their parents may be more likely to have contact with child welfare services (CWS)
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