Factors associated with the probability of attention-deficit/hyperactivity (ADHD) diagnosis among third grade US elementary school children were investigated in a nationally representative sample of 9278 children in the 2002 follow-up of the Early Childhood Longitudinal Survey Cohort conducted at University of Texas, Austin, TX. In a total of 5.44% children diagnosed with ADHD, the means of several variables differed in frequency of ADHD diagnosis. Variables associated with a lower risk of ADHD were female gender, black children, and Hispanics; children living with a biological father; the western and southern regions vs midwestern US; having a white teacher, relative to a nonwhite teacher; and attending a Catholic vs public school. ADHD diagnosis was more frequent in children born in summer months; in lower-income families; in children taught by an older teacher; and in schools subject to stricter state-level performance accountability laws. Larger class sizes or state laws that restrict school personnel from discussing ADHD treatment options with parents were not influencing factors. 
COMMENT. The likelihood of ADHD diagnosis is dependent on a child’s gender and race, the presence of a biologic father in the home, the teacher’s color and age, the season and geographic region of birth, the socio-economic status, and school standards and performance accountability.