Publication year
2014
Citation Title
Attention deficit hyperactivity disorder and medication use by children during parental military deployments.
Journal Name
Military Medicine
Journal Volume
179
Issue Number
5
Page Numbers
573-578
DOI
10.7205/MILMED-D-13-00334
Summary
Children of Service members often experience added stress and disruption during deployment, which can be especially difficult for youth with attention deficit hyperactivity disorder (ADHD). The relationship between parent deployment and youth ADHD interventions (e.g., medication, healthcare utilization) was examined. Parent deployment was associated with significantly greater healthcare utilization, and pre-school children had significantly more changes (e.g., dose, number of prescriptions) in medications.
Key Findings
Parental deployment was associated with a significant increase in outpatient overall medical visits and behavioral health care visits in children with ADHD.
Children on medication for ADHD had a 13% increased mental health appointment rate during parent deployment.
School-aged children with ADHD had a decreased rate of changes in medication regimens during deployment.
Pre-school-aged children had an increased rate of changes in medication regimens during deployment.
Implications for Program Leaders
Offer classes for military parents to educate them about the potential emotional and behavioral responses young children can display during deployment
Offer skill-building classes for parents to teach strategies to assist their children in coping with ADHD symptoms across the deployment cycle
Collaborate with local civilian pediatricians to provide information about the impact of military deployments on families
Implications for Policy Makers
Recommend professional development for health care providers about the unique stressors faced by military children
Continue to support the training of teachers about the unique stressors faced by military children
Recommend professional development for school personnel about helpful strategies to use with students in military families who have ADHD
Methods
Retrospective data of military dependents, who were ages 4-8 years and enrolled in the Military Health Care System in 2006-2007, were analyzed.
Children in the ADHD group had two or more visits during the study period and a recorded diagnosis of ADHD; perscription data was obtained from pharmacy records.
The association between parent deployment and child ADHD intervention (e.g., mental or behavioral healthcare utilization, outpatient medical care utilization, medication changes) was examined.
Participants
Participants included 413,665 military dependents with an average age of 12.1 years (SD = 1.4).
Of the children who met criteria for a diagnosis of ADHD (8% of the sample), 56% were perscribed ADHD medication.
Males accounted for 73% of children with ADHD and 49% of children without; no race or ethnicity data were provided.
Parent service members were 90% male, 91% enlisted, and 90% married, with an average age of 35 years.
Limitations
Other variables (e.g., duration and frequency of deployment, socio-economic status, parent and child co-morbid mental health diagnoses) may have impacted findings.
Analyses did not differentiate between medication increases of decreases, so no conclusions can be drawn regarding medication amounts as they relate to parent deployment.
Families with two military parents were not identified, which may have confounded results related to parent deployment.
Avenues for Future Research
Replicate this study with children of National Guard or Reserve personnel to better understand how these youth react to parental deployment
Examine how length of parental deployment and number of parental deployments impact service seeking and medication use for children with ADHD
Examine how pre- and post-deployment periods impact ADHD intervention use among military dependents
Focus
Multiple Branches
Target Population
Population Focus
Military Branch
Military Component
Abstract
Objective: Parental deployment is associated with children's increased mental health needs. Attention Deficit Hyperactivity Disorder (ADHD) is the most common pediatric mental health diagnosis. We hypothesize children with ADHD will have increased mental health and medication needs during parental deployment. Methods: Retrospective cohort study of children with ADHD aged 4-8 years in the Military Health System. Results: Of 413,665 children aged 4-8 years, 34,205 (8.3%) had ADHD and 19,123 (55.9%) of these were prescribed ADHD medications. During parental deployments, children with ADHD had a 13% increased rate of mental and behavioral health care visits (IRR 1.13 [95% CI 1.12-1.14; p < 0.00001]) and a decreased rate of medication changes (IRR 0.94 [95% CI 0.91-0.96; p < 0.00001]) compared to when parents were at home. Medication changes related to deployment varied by age; school-aged children had decreased medication events (IRR 0.88 [95% CI 0.86-0.91; p < 0.00001]) and preschool-aged children had increased medication events (IRR 1.05 [95% CI 1.02-1.10; p =.006]) during parental deployment. Conclusions: During parental deployment, children with ADHD aged 4-8 years have increased mental health visits and decreased ADHD medication changes. Younger children have increased medication changes, whereas older children have decreased changes during a parent's deployment.
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