[CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD): ACCESSIBILITY AND AVAILABILITY OF SERVICES IN ISRAEL].

INTRODUCTION: The prevalence of Attention Deficit Hyperactivity Disorder (ADHD) among children ranges from 8% -12% and is more common in males. Most ADHD children suffer from related disorders such as learning disabilities and behavioral problems. Treatment with stimulants improves the learning and social abilities of most children and the addition of non-pharmaceutical treatments induces further improvement. OBJECTIVES: Our previous study, four years ago, screened 1,129 1st and 2nd grade children in Jerusalem and identified 105 with high risk for ADHD. Currently we evaluated the contribution of the screening and the availability and utilization of services for these children. METHODS: Interviews were conducted with 85 parents of identified children, now in 5th and 6th grades (response rate 81%) and 12 education and health professionals. Research tools consisted of a structured questionnaire for parents completed by phone and semi-structured interviews with professionals. RESULTS: A total of 87% of parents reported that they were aware of the child's attention difficulties before the screening; 68% reported that the screening had encouraged them to pursue diagnosis. Only 49% of the children were diagnosed by the HMO's and 51% privately. Waiting time at HMO's was 3 times that of private services. Only 52% of the ADHD children received pharmacological treatment, most of them also received "supportive treatment". CONCLUSIONS: HMO's do not provide sufficient services to ADHD children and parents have to seek help privately. HMO's should find the way to make better use of the services of psychiatrists and pediatricians permitted to diagnose and treat such children and furthermore, they must improve services and public awareness of ADHD.

Prevalence of ADHD among 7-9-Year-Old Children in Israel. A Comparison between Jewish and Arab Populations.

INTRODUCTION: The world prevalence of ADHD ranges between 5-10%. The prevalence in Israel was generally studied from prescriptions of methylphenidate and not from cohorts of children. METHODS: We assessed the prevalence of ADHD among a cohort of early school age children in the Jewish and Arab populations using DSM-IV criteria and evaluated the difference between teachers' and parental assessment. We also studied in the Jewish population the differences in several social-behavioral parameters between children with and without ADHD. RESULTS: The rate of ADHD among the Jewish children was 9.5% and among the Arab children it was significantly lower - 7.35%. Teachers' evaluation in the Jewish population was 2.3 times higher than parental evaluation but in the Arab population it was closer to that of the parents, being only 12% higher. In addition, there were more regulatory, behavioral and learning problems among the Jewish children with ADHD compared to children without ADHD. CONCLUSIONS: The rates of ADHD in school age children among both Jews and Arabs fall within the average rate in other countries. The high difference between teachers' and parental assessment of ADHD in the Jewish population emphasizes that ADHD diagnosis should rely on the joint behavioral assessment of both. The prevalence of ADHD in Jewish early school age children is slightly higher than in Arab children and the inattentive type is the most common. There is a discrepancy between teachers' and parents' evaluation of children's behavior in the Jewish population, but this discrepancy is less in the Arab population.