Attention Deficit/Hyperactivity Disorders among three-to-six-year-olds treated in medical practices -: A national survey

Objective: The aim of the study is to calculate prevalence rates of symptoms and diagnoses of Attention Deficit-/Hyperactivity Disorders (ADHD) in preschoolers, and to assess functional impairment as well as comorbid symptoms by means of parents and teacher symptom checklists. Method: N = 708 kindergarten- and preschool-children were recruited nationwide by pediatricians or child and adolescent psychiatrists. The U8/U9 sample (n = 521 children) was assessed during a routine pediatric screening. The clinical sample consisted of n = 187 children who were rated as having ADHD problems by the physician. The children were assessed by age-adapted ADHD Symptom-Checklists (Fremd-beurteilungsbogen fur Aufmerksamkeitsdefizit-/Hyperaktivitatsstorungen im Vorschulalter FBB-ADHS-V) rated by parents and teachers. Additionally, the physicians rated ADHD symptoms and comorbid symptoms. Results: Based on diagnosis criteria of DSM-IV and the parental ratings in U8/U9, 11.3% of the children fulfilled the criteria for one of the three ADHD diagnoses (ICD 10: 3.8%). The prevalence rate was lower in teacher ratings (6.6%) (ICD 10: 1.5%), and in both the parent and teacher ratings 4.2% of the children fulfilled the DSM-IV criteria for ADHD (ICD 10: 1.2%). Higher prevalence rates and comorbidities were found in the clinical sample. The need for professional help (counseling/treatment) is much higher than the treatment the parents and children actually received. Conclusion: International prevalence rates can be applied. Despite methodological restrictions, such as a lack of representativeness and possible pre-selection effects, this study demonstrates the relevance of prevention and intervention progammes.