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Journal of Pediatric Psychology Advance Access published online on November 20, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn112
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Profiles of Service Utilization and the Resultant Economic Impact in Preschoolers With Attention Deficit/Hyperactivity Disorder

David J. Marks, PhD1, Agnieszka Mlodnicka, BS, BA2, Melissa Bernstein, BA3, Anil Chacko, PhD1,2, Scott Rose, BA4 and Jeffrey M. Halperin, PhD1,2,4

1Department of Psychiatry, Mount Sinai School of Medicine, 2Neuropsychology Doctoral Program, Graduate Center of the City University of New York, 3Department of Psychology, University of Maine, and 4Department of Psychology, Queens College of the City University of New York

All correspondence concerning this article should be addressed to David J. Marks, Department of Psychiatry, Box 1230, Mount Sinai School of Medicine, New York, NY, 10029. E-mail: david.marks{at}mssm.edu


  Abstract

Objective To examine whether preschool children with Attention deficit/hyperactivity disorder (ADHD) utilize more speech and language therapy (ST), occupational therapy (OT), and physical therapy (PT) services and are more likely to be placed in special education (SPED) classrooms as compared to their peers. Corresponding financial consequences were also examined. Methods The amount of ST, OT, and PT, as well as SPED placements, was examined in 3- and 4-year-old children with and without ADHD (n = 109 and n = 97, respectively) during the baseline portion of an ongoing, 5-year longitudinal study. Costs for individual services and aggregate cost were determined per child and compared across groups. Results Preschool children with ADHD were more likely to receive individual and multiple services. Higher rates of service utilization translated into increased costs for each individual service with the exception of PT. Conclusions A comprehensive understanding of service utilization in the early years of development is important in addressing the increased service use in the preschool years and assist in guiding allocation of resources.

Key words: attention deficit hyperactivity disorder; economic impact; preschool children; service utilization.

Received May 14, 2008; revision received August 28, 2008; accepted October 3, 2008


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