The Estimated Annual Cost of ADHD to the US Education System

The purpose of this study was to examine and monetize the educational outcomes of students with ADHD. Data were examined from the Pittsburgh ADHD Longitudinal Study, a follow-up study of children diagnosed with ADHD in childhood and recontacted for follow-up in adolescence and young adulthood. A comprehensive educational history was obtained for all participants from Kindergarten through 12th grade. Annual economic impact was derived from costs incurred through special education placement, grade retention, and disciplinary incidents. Results indicated that, as compared to students without ADHD, students with ADHD incurred a higher annual cost to the US Education system. Specifically, a student with ADHD incurred an average annual incremental cost to society of $5,007, as compared with $318 for students in the comparison group. These results suggest that prevention and intervention strategies are greatly needed to offset the large financial impact of educating youth with ADHD.

[1]  R. Michels,et al.  Diagnostic and Statistical Manual of Mental Disorders, 3rd ed , 1981 .

[2]  W. Pelham,et al.  Peer relationships in hyperactive children: Description and treatment. , 1982 .

[3]  W. Pelham,et al.  A comparison of objective classroom measures and teacher ratings of attention deficit disorder , 1985, Journal of abnormal child psychology.

[4]  L. Goldman,et al.  Forecasting coronary heart disease incidence, mortality, and cost: the Coronary Heart Disease Policy Model. , 1987, American journal of public health.

[5]  W. Pelham,et al.  The differential validity of teacher ratings of Inattention/Overactivity and Aggression , 1989, Journal of abnormal child psychology.

[6]  A. Robin,et al.  Negotiating Parent-Adolescent Conflict: A Behavioral-Family Systems Approach , 1989 .

[7]  C. Johnston,et al.  Determinants of Parenting Stress: Illustrations from Families of Hyperactive Children and Families of Physically Abused Children , 1990 .

[8]  R. Klein,et al.  Young adult mental status of hyperactive boys and their brothers: a prospective follow-up study. , 1991, Journal of the American Academy of Child and Adolescent Psychiatry.

[9]  W. Pelham,et al.  Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorders. , 1992, Journal of the American Academy of Child and Adolescent Psychiatry.

[10]  S. Hinshaw,et al.  Academic underachievement, attention deficits, and aggression: comorbidity and implications for intervention. , 1992, Journal of consulting and clinical psychology.

[11]  Joseph Biederman,et al.  Intellectual performance and school failure in children with attention deficit hyperactivity disorder and in their siblings. , 1993, Journal of abnormal psychology.

[12]  R. Klein,et al.  Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status. , 1993, Archives of general psychiatry.

[13]  P. Chamberlain,et al.  A Functional Analysis of Resistance During Parent Training Therapy , 1994 .

[14]  R. Barkley,et al.  Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment , 1994 .

[15]  Dc Washington.  Diagnostic and Statistical Manual of Mental Disorders, 4th Ed. , 1994 .

[16]  G. DuPaul,et al.  ADHD in the Schools: Assessment and Intervention Strategies. Second Edition. , 1994 .

[17]  Robert Fabian,et al.  Valuing health for policy : an economic approach , 1995 .

[18]  D. Mennin,et al.  A prospective 4-year follow-up study of attention-deficit hyperactivity and related disorders. , 1996, Archives of general psychiatry.

[19]  M. Gold.  Cost-effectiveness in health and medicine , 2016 .

[20]  M C Weinstein,et al.  Recommendations for reporting cost-effectiveness analyses. Panel on Cost-Effectiveness in Health and Medicine. , 1996, JAMA.

[21]  Milton C. Weinstein,et al.  Recommendations for Reporting Cost-effectiveness Analyses , 1996 .

[22]  S. Faraone,et al.  Diagnostic continuity between child and adolescent ADHD: findings from a longitudinal clinical sample. , 1998, Journal of the American Academy of Child and Adolescent Psychiatry.

[23]  Herbert C. Quay,et al.  Handbook of disruptive behavior disorders , 1999 .

[24]  R. Klein,et al.  Adolescent and Adult Outcomes in Attention-Deficit/Hyperactivity Disorder , 1999 .

[25]  Tom V. Hanley,et al.  Evaluation of learning disorders in children with a psychiatric disorder: An example from the Multimodal Treatment Study for ADHD (MTA Study). , 2000 .

[26]  L. Greenhill.  Learning disabilities : implications for psychiatric treatment , 2000 .

[27]  K. Kavale,et al.  Impact of ADHD on school systems. , 2002 .

[28]  R. Greene,et al.  Are Students with ADHD More Stressful to Teach? , 2002 .

[29]  K. Dodge,et al.  Issues in the Economic Evaluation of Prevention Programs , 2003, Applied developmental science.

[30]  J. Chambers,et al.  Total Expenditures for Students with Disabilities, 1999-2000: Spending Variation by Disability. Report. Special Education Expenditure Project (SEEP). , 2003 .

[31]  Terrance M. Scott,et al.  Using Staff and Student Time Engaged in Disciplinary Procedures to Evaluate the Impact of School-Wide PBS , 2004 .

[32]  R. Kessler,et al.  Costs of attention deficit–hyperactivity disorder (ADHD) in the US: excess costs of persons with ADHD and their family members in 2000 , 2005, Current medical research and opinion.

[33]  J. Swanson,et al.  Cost-effectiveness of ADHD treatments: findings from the multimodal treatment study of children with ADHD. , 2005, The American journal of psychiatry.

[34]  R. Barkley,et al.  Young adult outcome of hyperactive children: adaptive functioning in major life activities. , 2006, Journal of the American Academy of Child and Adolescent Psychiatry.

[35]  Russell A. Barkley,et al.  Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment, 3rd ed. , 2006 .

[36]  R. Barkley,et al.  ADHD in Adults: What the Science Says , 2007 .

[37]  J. Buitelaar,et al.  Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD) , 2007, European Child & Adolescent Psychiatry.

[38]  W. Pelham,et al.  The economic impact of attention-deficit/hyperactivity disorder in children and adolescents. , 2007, Journal of pediatric psychology.

[39]  L Eugene Arnold,et al.  Treatment for ADHD: is more complex treatment cost-effective for more complex cases? , 2007, Health services research.

[40]  H. Feldman,et al.  Academic and educational outcomes of children with ADHD. , 2007, Journal of pediatric psychology.

[41]  W. Barbaresi,et al.  Long-Term School Outcomes for Children with Attention-Deficit/Hyperactivity Disorder: A Population-Based Perspective , 2007, Journal of developmental and behavioral pediatrics : JDBP.

[42]  E. Foster,et al.  Service Use Patterns for Adolescents with ADHD and Comorbid Conduct Disorder , 2009, The Journal of Behavioral Health Services & Research.

[43]  R. Kessler,et al.  The prevalence and workplace costs of adult attention deficit hyperactivity disorder in a large manufacturing firm , 2008, Psychological Medicine.

[44]  J. Swanson,et al.  The MTA at 8 years: prospective follow-up of children treated for combined-type ADHD in a multisite study. , 2009, Journal of the American Academy of Child and Adolescent Psychiatry.

[45]  S. Pliszka,et al.  Attention‐Deficit‐Hyperactivity Disorder: An Update , 2009, Pharmacotherapy.

[46]  N. Kleinman,et al.  Incremental Employee Health Benefit Costs, Absence Days, and Turnover Among Employees With ADHD and Among Employees With Children With ADHD , 2009, Journal of occupational and environmental medicine.

[47]  W. Pelham,et al.  The Academic Experience of Male High School Students with ADHD , 2011, Journal of abnormal child psychology.

[48]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .