Category: ADHD - Child

PS6- #B38 - Measuring the Household Burden of Raising a Child With ADHD

Friday, Nov 17
2:45 PM – 3:45 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: ADHD - Child / Adolescent | Families | Behavioral Economics

Introduction: ADHD is a prevalent and persistent neurodevelopmental disorder, which negatively affects approximately 10% to 12% American children and adolescents (Visser et al., 2014), across different domains of functioning (e.g., social, academic, cognitive) and settings (e.g., home and school) (Barkley, 2014). Thus, over the course of development, ADHD can be burdensome to individuals, family members, and society. Despite emerging literature on individual financial outcomes (Altszuler et al., 2016) and societal costs (Doshi et al., 2012; Pelham, Foster, & Robb, 2007), the incremental economic burden of ADHD to families, is, largely, unknown. The current study aimed to estimate what it costs families to raise a child with ADHD by measuring direct nonmedical, indirect, and intangible costs (e.g., missed pleasurable activities). Method: The current study is based on a subset of a longitudinal sample collected in Pittsburgh, PA (Lahey et al., 1998). ADHD (n = 56; 72% male) and comparison (n=30; 79% male) participants completed initial assessments at age 5 in 1995. The economic variables were generated from the Impact Questionnaire, a measure developed for this study, to retrospectively assess the household burden of ADHD from birth to age 17. Direct costs included expenses incurred due to child behaviors, such as lost/damaged property, fines and tickets, and legal fees. Indirect costs were estimated for parent-reported hours of missed work, lost income, and additional childcare expenditures. Quantities of these inputs were converted and adjusted to monetized value in 2017 USD using national wage estimates (2015) and annual inflation rates (2007 to 2016) from the Bureau of Labor Statistics. Intangible costs were described for lost employment, reduced work responsibilities, and missed activities. Results: The economic burden of raising a child with ADHD (M = $15,036, SD = $38,269) was five times that of raising a typically developing child (M = $2,848, SD = $6,848, p = .02). Parents of ADHD participants were almost seven times as likely as comparisons to report reduced job responsibilities (e.g. switching from full-time to part-time, reducing work hours) (ADHD = 20%; C = 3%), p = .04, and 11 percent of these parents reported losing their jobs or getting fired whereas no parents of comparisons reported these problems, p = .06. Parents of ADHD participants reported missing nearly twice as many working hours, and were late or left work earlier five times more often than parents of comparisons. Discussion: This is one of the first studies to look at household burden, considering indirect costs and intangibles related to ADHD. Given the limitations of retrospective report and the small sample size, these results are likely a significant underestimate of the true costs of raising a child with ADHD. However, the difference in the economic impact between ADHD participants and comparisons is still quite substantial. Incorporating direct treatment costs would possibly widen this gap. Our results emphasize the importance of providing families accessible and effective interventions for ADHD (e.g., behavioral therapy, medication) to not only improve functioning of youth with ADHD and their families, but to reduce the economic burden of the disorder.  

Xin Zhao

Graduate Student
Florida International University

Timothy Page

Associate Professor
Florida International University

Amy Altszuler

Doctoral Student
Florida International University
Miami, Florida

William Pelham

Graduate Student
Arizona State University

Elizabeth Gnagy

Florida International University

Heidi Kipp

University of Pittsburgh

William E. Pelham

Distinguished Professor of Psychology and Psychiatry
Florida International University
Miami, Florida