Rate of ADHD, autism diagnoses higher among children on Medicaid, study finds

A new study finds that children on Medicaid are more likely to be diagnosed with ADHD and autism spectrum disorder.&nbspPhoto by Debbie Hill/UPI
A new study finds that children on Medicaid are more likely to be diagnosed with ADHD and autism spectrum disorder. Photo by Debbie Hill/UPI | License Photo

Jan. 5 (UPI) -- Children covered under Medicaid are twice as likely to be diagnosed with disorders such as ADHD or autism compared with those who have private insurance, a study published Wednesday by JAMA Psychiatry found.

And regardless of their insurance status, 30% of White children are diagnosed with one of these disorders by age 8, compared with 23% of Black children, 15% of Hispanic children and 9% of Asian children, researchers said.


By that age, 24% of children insured with Medicaid and 11% of those covered by private health insurance are diagnosed with at least one neurodevelopmental disorder, the data showed.

Medicaid is the federal and state program that helps with healthcare costs for some people with limited income and resources.

Although just over 1% of children in both groups are diagnosed with autism spectrum disorder, 15% of those covered under Medicaid are determined to have ADHD, attention-deficit hyperactivity disorder, compared with 6% on private insurance, according to the researchers.


Similarly, 6% of children with Medicaid insurance are diagnosed with a learning disability, compared with just over 1% of those on private insurance, a trend that continues for speech or language disorders and behavioral problems, the researchers said.

"By the age of 8 years, approximately one in four publicly insured and one in nine privately insured children in the United States received a diagnosis of a neurodevelopmental disorder," researchers from Harvard Medical School in Boston wrote.

"The risk of which was considerably higher among boys and White children," they said.

Children diagnosed with neurodevelopmental disorders, which are conditions that affect the growth of the nervous system, often have related health problems that continue to impact them well into adulthood, according to the American Psychiatric Association.

These conditions cause abnormal brain function, leading to problems with control of emotions, learning, self-control and memory, the association says.

As many as 17% of children in the United States have some form of neurodevelopmental disorder, ranging from ADHD and autism spectrum disorders to learning disabilities and behavioral problems, such as aggression, the Centers for Disease Control and Prevention estimates.

That more children covered under Medicaid are diagnosed with these disorders could be the result of several factors, the Harvard researchers said.


For example, children living in poverty in the United States have increased exposure to toxic substances and environmental pollutants, both of which have been linked with an elevated risk for neurodevelopmental disorders, according to the Environmental Protection Agency.

In addition, these children, and their parents may have less access to healthcare services during pregnancy and infancy, which increases their risk for potential health complications, the researchers said.

This may also explain why children covered under private insurance tend to be younger -- typically age 3 to 4 years -- when they are diagnosed with neurodevelopmental disorders compared with those on Medicaid plans, they said.

For this study, the Harvard researchers analyzed data for nearly 3.4 million children in the United States covered either by Medicaid or private insurance.

The data covered diagnoses for various neurodevelopmental disorders within this population reported between 2000 and 2015, the most recent period with information available, the researchers said.

By age 8 years, 31% of boys covered by Medicaid have been diagnosed with at least one neurodevelopmental disorder, compared with 15% of girls, the data showed.

For those covered by private insurance, these figures were 17% for boys and 7% for girls, according to the researchers.


Among children covered by Medicaid, 8% are diagnosed with a speech or language disorder by age 8 years, compared with 5% of those covered by private insurance, the data showed.

In addition, 8% of children with Medicaid coverage are diagnosed with a behavioral disorder, compared with less than 2% of children with private insurance, according to the researchers.

"The high incidence of neurodevelopmental disorders, coupled with racial and socio-demographic disparities, underscores the importance of raising awareness of providing universal and timely access to psychological and educational services," the researchers wrote.

This will "ensure that diagnosis, intervention and support can start as soon as possible for all children," they said.

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