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More kids with mental disorders, Pittsburgh-based study shows

| Monday, Aug. 18, 2014, 12:01 a.m.

The number of children with developmental conditions such as autism and attention deficit hyperactivity disorder jumped by 28 percent for some families, a Pittsburgh-based national study shows.

The two-year project led by Dr. Amy Houtrow at Children's Hospital of Pittsburgh of UPMC found poor homes have the highest known rates of intellectual and physical disabilities in youths, while reports of pediatric mental health and neurodevelopmental issues are climbing faster in families that make at least four times the federal poverty level. For a family of four, that would be $95,400 a year.

Houtrow said her discovery does not necessarily mean impairments are proliferating more rapidly for higher-income families. Instead, she said, it could reflect better awareness, detection and services for those with easier access to health care.

“We need to rise to the challenge to help children be as capable and functional as possible, so they can have the best lives possible,” said Houtrow, chief of pediatric rehabilitation medicine at Children's. She said the findings can become a foundation for more research into root causes of developmental conditions and how to prevent them across socioeconomic groups.

Using federal data from the National Health Interview Survey, Houtrow and a cross-country team of colleagues found 54 of 1,000 children in wealthier households in 2011 had known disabilities related to mental health or neurodevelopmental concerns, including learning disabilities or language disorders. That was up 28.4 percent in 10 years.

Meanwhile, 83 of 1,000 children in poverty had such impairments in 2011, up from 72 per 1,000 in 2001. Doctors generally cite premature birth rates, inadequate access to health care and other struggles in explaining chronic health problems among the poor.

Plus, symptoms of neurodevelopmental conditions can be tough to spot. It took months before early suspicions led to a formal ADHD diagnosis for Elizabeth Strickland's eldest son about 12 years ago, Strickland said.

She said he was smart enough to enroll in a gifted program through the Pittsburgh Public Schools but struggled to stay focused.

“He wasn't a bad kid. Those things were beyond what he could do,” said Strickland, 44, of Windgap, the early intervention coordinator for the city schools.

She credits a pediatrician for drawing attention early to the possibility of ADHD, before her son, now 19, began grade school.

“Kids can be evaluated in a variety of settings now,” including at school, Strickland said. “It used to be that you had to wait months and months to get them into a child development unit” for screening.

It's understandable that lower-income families would have less time, less information and fewer resources to investigate care that might ease or prevent developmental conditions, said Daniel A. Torisky, president of the Autism Society of Pittsburgh.

“If this is true, it's a wake-up call for advocacy organizations — all of us,” he said of Houtrow's study. “We've got to keep getting the word out about possible causes so people can avail themselves of information.”

Houtrow said her work shows a bright spot: a 12 percent decline in health-related physical disabilities in children.

She said that might result from better treatment of physical ailments.

The National Institutes of Health supported her study, findings of which appear in the September issue of the journal Pediatrics.

“There's a lot more we can do as a health care system and as a broader society in ensuring children get the services they need, and the accommodations, in order to be as successful as possible,” Houtrow said.

Adam Smeltz is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or asmeltz@tribweb.com.

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