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Journal of Pediatric Psychology Advance Access originally published online on June 7, 2007
Journal of Pediatric Psychology 2007 32(6):695-710; doi:10.1093/jpepsy/jsm023
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Copyright © 2007 by the Ambulatory Pediatric Association, published by Elsevier Inc.

ADHD Service Use Patterns in Youth

Laurel K. Leslie, MD1 and Mark L. Wolraich, MD2

1Child & Adolescent Services Research Center (CASRC), Pediatrics Department at the University of California, San Diego, and Graduate School of Public Health at San Diego State University, San Diego, Calif USA and 2Department of Pediatrics, Oklahoma University Child Study Center, University of Oklahoma Health Sciences Center USA.

All correspondence concerning this article should be addressed to Laurel K. Leslie, MD, Child & Adolescent Services Research Center, Children's Hospital San Diego, 3020 Children's Way MC 5033, San Diego, CA 92123. lleslie{at}casrc.org.


  Abstract

Objective To review what is currently known about service use by youth with attention-deficit/hyperactivity disorder (ADHD) and discuss research and policy implications. Methods Literature review. Results The primary care, mental health, and educational service system sectors all play an essential role in caring for youth with ADHD. Recent studies also suggest increasing use of stimulants and other psychoactive medication for youth with ADHD, decreasing mental health visits for ADHD unassociated with medication use, increased use of other psychotropic medications, and a number of barriers to care coordination across primary care, mental health, and schools. Conclusions Four important services, research, and policy areas that need to be addressed over the next decade include: 1) delving deeper into current service use, 2) paying attention to the context in which service use occurs, 3) operationalizing evidence-based care for real-world settings, and 4) learning what changes clinician and educator behavior.

Key words: ADHD; attention-deficit/hyperactivity disorder; education; primary care; service utilization; specialty mental health; stimulants..

ADHD Special Issue, reprinted by permission from Ambulatory Pediatrics, Vol. 7, Number 2 (Supplement), Jan./Feb. 2007,

Received December 5, 2005; accepted May 14, 2006


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