Treatment Utilization among Children with Autism and Attention-Deficit/Hyperactivity Disorder (ADHD): Exploring the Role of Parental Mental Health

Objective: Despite the availability of effective mental health care, evidence suggests significant variation in treatment among children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in the U.S. Parental mental health is an important predictor of healthcare utilization among children with mental health disorders, but evidence on the effect of parental mental health is lacking among those with these two conditions. This study examines the effect of parents’ mental health status on treatment utilization among children with ASD or ADHD.

Method: We analyzed data from 2016 National Survey of Children’s Health (NSCH). The study cohort included all children (ages 3-17) with ASD and ADHD and with at least one adult parent. The key independent variable is parents’ mental health status. The major outcomes of interest are whether the child is currently receiving treatment for ASD or ADHD, including medication and behavioral therapy. We used an instrumental variable to correct potential endogeneity of parental mental health status. All analyses were weighted.

Findings: Among children with Autism and ADHD, percentages of currently receiving treatment (medication or behavioral therapy) are 77.0 % for ASD and 71.7% for ADHD. Preferred specification shows that parental mental health below “very good” leads to an 18.6% decrease in probability of receiving any treatment for ADHD (p=0.021) among those with both conditions and a 15.5% decrease in probability of receiving any treatment for ASD (p=0.061).

Implication: Lower mental health status of parents is associated with lower likelihood of treatment among children with ADHD and ASD. Addressing parents’ mental health needs is critical in improving treatment utilization for children with ASD and ADHD.