According to a recent release from the government’s Agency for Healthcare Research and Quality (AHRQ), mental health disorders were among the five most commonly treated medical conditions in children in 2008. Coming in ahead of mental health treatment were acute bronchitis, asthma, trauma-related disorders, and middle-ear infections. About 40 percent of all children in the U.S. suffered from one of these five conditions in 2008, which accounts for about 60 percent of all children’s ambulatory care visits to a medical office or outpatient hospital.

Although mental disorders were the fifth most commonly treated condition, the average expense per child was the highest, billing out at about $2,480 per child. Five million children in the U.S. were treated for mental disorders in 2008, adding up to a total price tag of $12.2 billion in expenses. While private insurance paid the largest share of treatment costs for bronchitis (at about 55 percent of expenses), Medicaid picked up the largest share of treatment costs for mental disorders, at about 46 percent. Approximately 31 percent of treatment costs for mental disorders were paid for by private insurance, and just fewer than 14 percent of treatment costs were paid out-of-pocket by the family of the patient.
Guidelines from the American Academy of Pediatrics released in October suggest that attention deficit hyperactivity disorder can be diagnosed and treated in children as young as age 4, two years younger than the previous minimum age set by AAP a decade ago.

Mark Wolraich, the lead author of the ADHD clinical practice guidelines and a professor of pediatrics at the University of Oklahoma Health Sciences Center, told the Wall Street Journal recently that ADHD in a preschool-aged child is very different from the typically active behavior seen in most young children (www.online.wsj.com, October 17). A child with ADHD often doesn’t play well with other children, is prone to accidents, and is overactive much of the time. “It's not the environmental things like parties triggering it,” Dr. Wolraich says.

According to the new guidelines, behavior management should be the first approach for treating preschool-aged children. But when behavioral interventions aren’t enough, the guidelines suggest that doctors consider prescribing methylphenidate (commonly known by the brand name Ritalin) for preschool-aged children with moderate to severe symptoms.

Other key recommendations include assessing children for other conditions that might coexist with ADHD, such as oppositional defiant and conduct disorders, anxiety, and depression.

“Treating children at a young age is important,” asserts Dr. Wolraich, “because when we can identify them earlier and provide appropriate treatment, we can increase their chances of succeeding in school.”

For more information, or to request a complete copy of the guidelines, visit www.aap.org.

What do you think about the new ADHD guidelines? Will they affect your practice? Join the conversation—leave a comment now!
PAR is pleased to announce the release of the Social Emotional Assets and Resilience Scales™ (SEARS) by Kenneth W. Merrell, PhD, and the Social Emotional Assets and Resilience Scales™ Scoring Program (SEARS-SP) by Kenneth W. Merrell, PhD and PAR Staff.

The SEARS is a cross-informant system for assess¬ing the social-emotional competencies of children and adolescents from multiple perspectives. Closely tied to the ideas associated with the positive psychology movement, the SEARS focuses on a child’s assets and strengths.

The SEARS system offers separate long and short forms for children, adolescents, teachers, and parents. The forms may be used for any combination of student, parent, and teacher assessment. All forms measure common constructs (e.g., self-regulation, responsibility, social competence, empathy), and also include items designed to capture the unique perspective of the rater.

Click here for more information on the SEARS and SEARS-SP.