Attention-Deficit/Hyperactivity Disorder in Looked-After Children: a Systematic Review of the Literature

Abstract

Purpose of review To systematically review the literature on the prevalence and pharmacological treatment of ADHD in looked-after children (LAC). Recent findings LAC are a very challenging population from a clinical and psychosocial standpoint, with higher mental health needs compared to non LAC. To date, no systematic review on the prevalence of ADHD, and its treatment, in LAC is available. Summary We searched Pubmed, PsycInfo EMBASE + EMBASE CLASSIC, OVID Medline and Web of Science up to November 9 th, 2016. We found 24 papers meeting our criteria. The vast majority of the retained studies are from the USA and show rates of ADHD and of its pharmacological treatment substantially higher in LAC than those reported in national estimates. Future studies from countries other than the USA, aiming to understand the most cost-effective strategies, in the short as well as long term, to manage symptoms of ADHD in LAC are needed.

ADHD and social work with children and adolescents

“…in lower SES groups and in child welfare populations) and, on the other, why there also seem to be variations in prevalence rates in child welfare populations across national, regional and local contexts. A systematic review of ADHD among looked after children (Willis, Dhakras, & Cortese, 2017) suggests a quite dramatic difference in the prevalence estimates across countries. France stands out as a country with comparably low rates of ADHD diagnoses in looked after children, with an estimated 3.8 per cent prevalence of ADHD diagnosis.…”

“…France stands out as a country with comparably low rates of ADHD diagnoses in looked after children, with an estimated 3.8 per cent prevalence of ADHD diagnosis. According to Willis et al (2017), the low prevalence rates in France could thus be due to the traditionally strong influence of psychodynamic views in the child psychiatry profession compared to countries with other dominant views.…”

“…Studies from the United States and Canada report prescription rates exceeding 50 per cent for ADHD and other types of psychoactive drugs for children in residential care (Breland-Noble et al, 2004;Brenner, Southerland, Burns, Wagner, & Farmer, 2014;Klein et al, 2015;Leslie et al, 2011;Rubin et al, 2012). However, the prevalence rates of ADHD diagnosis and medication in looked after children vary appreciably across studies, and it should be noted that most data are from the United States (Willis et al, 2017). Table 1 presents prevalence rates of ADHD diagnosis and medication for Swedish children between the ages of 13 and 17 who have been placed in residential or foster care, including also the general population in the same age group.…”

A systematic review protocol to explore the prevalence and impacts of neurodevelopmental disorders in the care experienced by the looked after population

“…Nevertheless, with increased awareness of the diversity of how these disorders manifest in the child increasing in the psychiatric field and diagnostic accuracy 5 improving; research into these neurodevelopmental disorders has much improved [34][35][36]. Willis et al (2017) recently conducted a systematic review and found that the prevalence of Attention Deficit Hyperactivity Disorder (ADHD) was suggested to be higher in in the LAC population compared to NoN-LAC [42]. Although, a significant finding, this review differs as the inclusion criteria includes two further 'looked after' groups; children who have been adopted or children who have been placed in a kinship care setting.…”

“…Although, a significant finding, this review differs as the inclusion criteria includes two further 'looked after' groups; children who have been adopted or children who have been placed in a kinship care setting. Additionally, this review will screen both published and unpublished articles to alleviate anticipated publication bias due to the nature of the outcomes of interest [42,43].…”