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This is according to a paper by Dr Martin Korn published in the journal Medscape. Korn cites a study by Dr Regina Bussing which targeted 1 615 parents of public school children in kindergarten to fifth grade. A total of 389 high-risk children were identified. About one fourth of the sample was receiving special education services. There were 91 children who met the criteria for ADHD but were not treated for the disorder.

Despite concerns that “something might be wrong” by either parent or teacher, only 57% of boys and 20% of girls had been referred for evaluation. Of the entire sample with ADHD, the rates of ongoing treatment were 35% for boys and 9% for girls.

Why are high-risk children not identified and treated?
According to Bussing, parental decision to seek professional help is the greatest barrier to treatment. Parents may be reluctant to seek treatment for the following reasons:

• Lack of perceived need, thinking that the child has “solved his own problems”.
• System barriers: included were difficulties such as lack of suitable services, inconvenient location, or language barriers.
• Stigma: concerns by the patient or family about what others might think.
• Parents of girls were particularly concerned about stigma.
• Financial problems: concerns about the cost of the treatment.

Korn adds problems such as the clinician’s skill and familiarity with the problem or problems in the therapeutic relationship. Some parents may also be opposed to the use of medications or view treatment as “worthless”.

Both researchers point out that education is needed to improve overall detection and treatment rates. Education should be aimed at parents, teachers and clinicians and particular attention must be paid to gender and cultural differences.

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