Lifetime Contacts with Child Welfare Services among Children and Adolescents with ADHD: A Population-Based Registry Study.

Abstract

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) and their parents often face challenges that may lead to contact with child welfare services (CWS). However, there is a lack of studies addressing this issue. This study assessed the rate and association between ADHD and different types of CWS contact compared to the general population. We also examined whether individual and parental characteristics were associated with CWS contact among children and adolescents with ADHD. We employed a longitudinal research design and examined an 18-year age trajectory for a cohort of 8,051 children and adolescents aged 5 to 18 years diagnosed with ADHD between 2009 and 2011, linking several Norwegian nationwide registries. Descriptive statistics and logistic regression analysis assessed rate and association between ADHD and CWS contact. Chi-square tests and t-tests examined associations between individual and parental characteristics and CWS contact among those with ADHD. Children and adolescents with ADHD had considerably higher rate of any CWS contacts (32.7%) compared to the general population (6.1%). ADHD was significantly associated with both out-of-home placement (aOR = 7.3, 95% CI: 5.2-10.2) and supportive interventions (aOR = 6.3, 95% CI: 5.1-7.7). Among those with ADHD, comorbid conduct disorder and a criminal record were significantly associated with CWS contact compared to those without CWS contact. Additionally, they were more likely to have unmarried parents and parents with lower income and educational level. These findings provide novel insight into the relationship between ADHD and contact with CWS. Future research should examine the impact of clinical and behavioral treatment of ADHD on contact with CWS.