No abstract

BACKGROUND The number of school-aged children diagnosed with ADHD in Canada has been on the rise over the past three decades. Evidence suggests that children with ADHD dealing with risk factors, such as poverty and prolonged wait-times are more likely to have poorer outcomes due to challenges in accessing healthcare services. Schools are ideal for the early identification of children with ADHD, as they are often the setting in which attention and behavioural issues come to light. School-Based Health Centres (SBHCs) are embedded within the school system and are an ideal entry point for children with ADHD into the healthcare system. OBJECTIVES To examine the prevalence of ADHD and as well as demographic characteristics and time to assessment of children at two inner-city SBHCs in Toronto. DESIGN/METHODS A retrospective chart review was performed on 869 children from November 2010- March 2016 from two SBHCs. Frequency measures were used to determine the proportion of children that received a new diagnosis of ADHD. Within this population, the patient’s age, gender, ethnicity, parental income, home arrangement, parental education and newcomer status were described. Diagnostic wait-times within the SBHC were calculated using two specific data points – a child’s first clinic visit data and the clinic date they saw a general paediatrician, who would provide the ADHD diagnosis. RESULTS Of the 869 children, 9.6% of children received a new diagnosis of ADHD. The mean age of diagnosis was 7.6 years and 80% of the children were male. 74.6% of children’s families identified them as an ethnicity other than white. 60.2% of the patients’ household income was <$30,000/year. 44.5% of the families were composed of single-parent households. 52.8% of the patients’ mothers and 47.6% of fathers had completed a high school level of education or less. 34% of the children were not born in Canada, and of those, 57% had been in the country for only 0–3 years. The average wait time for a child to see a general paediatrician for a developmental assessment from initial visit date was 62.3 days. CONCLUSION The prevalence of ADHD at 2 SBHCs was higher than that reported in the general population. A number of barriers to health care access were identified in this cohort of children including low income, single parent homes and newcomer status. SBHCs serve as an accessible health care model that can provide timely diagnosis and management to vulnerable children with ADHD which may improve outcomes.