• ADHD in children and young people: Prevalence, care pathways, and service provision

      Sayal, Kapil; Prasad, Vibhore; Daley, David (2017)
      Attention-deficit hyperactivity disorder (ADHD) is a common childhood behavioural disorder. Systematic reviews indicate that the community prevalence globally is between 2% and 7%, with an average of around 5%. At least a further 5% of children have substantial difficulties with overactivity, inattention, and impulsivity that are just under the threshold to meet full diagnostic criteria for ADHD. Estimates of the administrative prevalence (clinically diagnosed or recorded) vary worldwide, and have been increasing over time. However, ADHD is still relatively under-recognised and underdiagnosed in most countries, particularly in girls and older children. ADHD often persists into adulthood and is a risk factor for other mental health disorders and negative outcomes, including educational underachievement, difficulties with employment and relationships, and criminality. The timely recognition and treatment of children with ADHD-type difficulties provides an opportunity to improve long-term outcomes. This Review includes a systematic review of the community and administrative prevalence of ADHD in children and adolescents, an overview of barriers to accessing care, a description of associated costs, and a discussion of evidence-based pathways for the delivery of clinical care, including a focus on key issues for two specific age groups-younger children (aged ≤6 years) and adolescents requiring transition of care from child to adult services. © 2017 Elsevier Ltd.
    • Barriers to medication entitlements after diagnosis of ADHD - Authors' reply

      Sayal, Kapil; Prasad, Vibhore; Daley, David (2018)
      We thank John Hayden and colleagues for their helpful comments on our paper. We are also pleased that a resolution was found in Ireland for the particular problem that had been limiting access to care for those with attention-deficit hyperactivity disorder (ADHD). We agree that it is important to consider and address barriers to care that might exist post-diagnosis and thank them for highlighting this issue. There is considerable variation in the way that reimbursement for medications is handled within different health-care systems as well as disparity in how rules are applied for different disorders.