Mental health treatment access among U.S. children according to ASD and ADHD diagnostic status
- 1Department of Psychiatry Rutgers New Jersey Medical School Newark New Jersey USA.
- 2Rowan-Virtua School of Osteopathic Medicine Stratford New Jersey USA.
Abstract
Aim
To compare mental health treatment receipt and difficulty obtaining treatment among U.S. children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) diagnostic status.Methods
We pooled 2023-2024 National Survey of Children's Health data for children aged 3-17 years who received or needed mental health treatment (N = 15,952). Children were classified as neither ASD nor ADHD, ADHD only, ASD only, or ASD + ADHD. The reference group included children without diagnosed ASD/ADHD who nevertheless received or needed treatment. The primary outcome was substantial difficulty obtaining treatment. Survey-weighted models adjusted for sociodemographic factors; same-sample sensitivity analyses additionally adjusted for individual clinical conditions and chronic functional limitation.Results
Substantial difficulty was reported for 22.2%, 23.2%, 28.3%, and 28.2% of the neither, ADHD-only, ASD-only, and ASD + ADHD groups, respectively. ASD + ADHD was associated with higher adjusted odds of difficulty than neither condition (aOR 1.38, 95% CI 1.07-1.78; Bonferroni-adjusted P = 0.04) but not ASD only (aOR 1.10, 95% CI 0.75-1.59). In the same complete-case sample (n = 15,037), the ASD + ADHD estimate was 1.37 (95% CI 1.06-1.78) with sociodemographic adjustment and 0.79 (95% CI 0.59-1.05) after additional adjustment for the individual clinical conditions and chronic functional limitation. Chronic functional limitation was associated with difficulty (aOR 1.89, 95% CI 1.54-2.31).Conclusion
Differences in difficulty obtaining mental health treatment by ASD/ADHD diagnostic status were attenuated after accounting for measured clinical characteristics and chronic functional limitation. This underscores the importance of considering functional and psychiatric complexity when interpreting access differences across diagnostic groups. Evaluating access should include both treatment receipt and caregiver-reported difficulty obtaining treatment.
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BibTeX
@article{alabed2026mental,
title = {{Mental health treatment access among U.S. children according to ASD and ADHD diagnostic status}},
author = {Sedra T Alabed and Mabad Shacker and Diana B Riestra and Juan M Riestra and Najeeb U Hussain},
journal = {PCN reports : psychiatry and clinical neurosciences},
year = {2026},
month = oct,
doi = {10.1002/pcn5.70435},
url = {https://europepmc.org/article/PMC/PMC13717481},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Mental health treatment access among U.S. children according to ASD and ADHD diagnostic status
AU - Sedra T Alabed
AU - Mabad Shacker
AU - Diana B Riestra
AU - Juan M Riestra
AU - Najeeb U Hussain
PY - 2026
DA - 2026/10/29
JO - PCN reports : psychiatry and clinical neurosciences
DO - 10.1002/pcn5.70435
UR - https://europepmc.org/article/PMC/PMC13717481
AB - Aim To compare mental health treatment receipt and difficulty obtaining treatment among U.S. children with autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) diagnostic status.Methods We pooled 2023-2024 National Survey of Children's Health data for children aged 3-17 years who received or needed mental health treatment (N = 15,952). Children were classified as neither ASD nor ADHD, ADHD only, ASD only, or ASD + ADHD. The reference group included children without diagnosed ASD/ADHD who nevertheless received or needed treatment. The primary outcome was substantial difficulty obtaining treatment. Survey-weighted models adjusted for sociodemographic factors; same-sample sensitivity analyses additionally adjusted for individual clinical conditions and chronic functional limitation.Results Substantial difficulty was reported for 22.2%, 23.2%, 28.3%, and 28.2% of the neither, ADHD-only, ASD-only, and ASD + ADHD groups, respectively. ASD + ADHD was associated with higher adjusted odds of difficulty than neither condition (aOR 1.38, 95% CI 1.07-1.78; Bonferroni-adjusted P = 0.04) but not ASD only (aOR 1.10, 95% CI 0.75-1.59). In the same complete-case sample (n = 15,037), the ASD + ADHD estimate was 1.37 (95% CI 1.06-1.78) with sociodemographic adjustment and 0.79 (95% CI 0.59-1.05) after additional adjustment for the individual clinical conditions and chronic functional limitation. Chronic functional limitation was associated with difficulty (aOR 1.89, 95% CI 1.54-2.31).Conclusion Differences in difficulty obtaining mental health treatment by ASD/ADHD diagnostic status were attenuated after accounting for measured clinical characteristics and chronic functional limitation. This underscores the importance of considering functional and psychiatric complexity when interpreting access differences across diagnostic groups. Evaluating access should include both treatment receipt and caregiver-reported difficulty obtaining treatment.
SN - 2769-2558
ER -