Kids in Foster Care Have Tripled Rates of ADHD, Study Finds


Recent research has revealed that kids who are in foster care are three times as likely to be diagnosed with ADHD than the general population. There’s a lot of conjecture around what this data means for foster kids. Some experts are interpreting the  data to mean that foster kids are more likely to suffer from the disorder. But others say foster kids are a vulnerable population that are often over-medicated, and the diagnoses may be excessive. Here’s the scoop. 

Much Higher Rates of ADHD Diagnosis in Foster Care Population

The study in question was carried out by the Centers for Disease Control and Prevention. Researchers there sorted through Medicaid claims from across the United States in the year 2011 looking at prescription drug and outpatient records. They found that more than 25% of kids between the ages of 2 and 17 who were in foster homes had been diagnosed with ADHD. Only about 7% of the other children receiving Medicaid had an ADHD diagnosis on record. The kids with ADHD who were in foster homes were also more likely to have another diagnosis as well, such as oppositional defiant disorder, depression, or anxiety than kids with ADHD who were not in foster care. The foster care group was more likely to have received psychological counseling in addition to medication, although both groups were medicated at about the same rate.

Expert Suggests Environmental and Genetic Causes

Some experts aren’t surprised by these numbers and cite a variety of reasons kids in foster care might have much higher rates of ADHD than kids in the general population. Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen Children’s Medical Center of New York, in New Hyde Park, N.Y, has been widely quoted on the issue. “It is likely a combination of many factors — some relating to the child and others relating to the mother,” he said. “Some children are placed in foster care because of prior neglect or abuse by a parent — and we know that children who are hyperactive are at increased risk for abuse because of the parenting challenges that they sometimes pose.” Dr. Adesman also suggests a genetic reason for the higher incidence of the disorder in foster kids: “Children in foster care are also often the product of an unplanned or unwanted pregnancy. Unplanned pregnancies are more common in mothers who themselves have ADHD, and women with an unwanted pregnancy may have also put their pregnancy at risk for later ADHD through drug and alcohol use, or failure to get prenatal care.”

Some Are Concerned About Over-medication

Other experts, however, are concerned that the diagnosis rate is higher because we are more likely to seek  medication when foster kids misbehave. Children are rarely diagnosed with ADHD unless someone brings them into a doctor’s office asking for a medical diagnosis of a behavioral problem. Many agencies and professionals were concerned about this issue before the recent research even surfaced.  The American Psychological Association, for example, is very concerned about this trend. As far back as 2012, the APA stated that “Foster children are up to four-and-a-half times more likely to receive psychotropic drugs than other children covered by Medicaid, according to a Government Accountability Office report last year. The investigation of foster care programs in five states found that hundreds of children were prescribed multiple psychotropic drugs, including antipsychotic drugs at excessive dosages. Infants also were prescribed psychotropic drugs despite no scientific evidence supporting that use. In response to those findings, the GAO recommended the development of federal best-practice guidelines on the use of psychotropic drugs by foster care programs.”

Hopefully future research will tell us more about this vulnerable population and their complicated relationship with learning disorders, behavior issues, and psychotropic drugs.