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. [1]

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.