1. Relationships between Varying Treatment Approaches & Occupational Performance Among Children with ADHD Shannon M. Cullerton, OTS and Ruth E. Benedict, DrPH, OTR Occupational Therapy Program, Department of Kinesiology University of Wisconsin-Madison RESEARCH DESIGN & METHODS 5.4 million children 4-17 years of age have been diagnosed with ADHD, with a 22% diagnostic increase between 2003-2007 (CDC, 2010). Adolescents with ADHD are at a higher risk for school failure, poor social relationships, delinquency, and poor vocational outcomes than typical adolescents (Warren et al., 2009). Two-thirds of children with ADHD receive pharmacological treatment (Zuvekas and Vitiello, 2011). Little is known about the long term effects of medication on children who continue a medication regimen throughout adolescence and adulthood (Parens and Johnston, 2009). Pharmacotherapy alone has not show to improve long-term outcomes for any domain of functioning (Goldman, Genel, Bezman, & Slanetz, 1998). The majority of the literature examines academic performance among varying ADHD treatments vs. occupational performance measures. Hypothesis: Children receiving both medication and therapy are less likely to report poor school engagement, poor social skills, and problematic behavior compared to those who receive medication only, therapy only, and no intervention. RESULTS CONCLUSIONSINTRODUCTION ACKNOWLEDGEMENTS A huge thank you to Dr. Benedict for her guidance and expertise throughout this project, Dr. Wilbarger for her assistance throughout, as well as my classmates, family, and friends for their ongoing support. IMPLICATIONS FOR PRACTICE Occupational therapists need to establish their role in treating children with ADHD. Occupational therapy interventions for children with ADHD should focus on increasing school engagement. Occupational therapists need to further understand effective strategies for increasing occupational performance in children with ADHD. Future research should examine a specific occupational therapy approach for treating children with ADHD in regards to their occupational performance. Data from the 2007 National Survey of Children’s Health (NSCH) Cross-sectional, random-digit dial telephone survey Representative sample of children diagnosed with ADHD, ages 4-17, from all 50 states N = 5,495 Independent Variable: [Treatment Type] 1.) Medication Only (n = 3004) 2.) Therapy Only (n = 393) 3.) Medication & Therapy (n = 748) 4.) No Intervention (n = 1340) Dependent Variable: [Occupational Performance] 1.) Poor Engagement 2.) Poor Social Skills 3.) Problematic Behavior Children with severe ADHD are more likely than those with mild ADHD to report poor school engagement (adjusted Odds Ratio [aOR]: 2.77; 95% confidence interval [CI]: 1.78-4.13), problematic behavior (aOR:15.99; CI: 6.64-38.51), or poor social skills (aOR: 9.93; CI: 4.81-20.52). Children with ADHD are more likely to receive medication alone followed by no intervention, medication and therapy, and therapy alone. Children receiving medication alone report higher occupational performance than those receiving therapy only, medication and therapy, and no intervention. Children with ADHD are more likely to report poor school engagement than poor social skills or problematic behavior. REFERENCES Goldman, L. S., Genel, M., Bezman, R. J., & Slanetz, P. J. (1998). Diagnosis and treatment of attention-deficit/hyperactivity disorder in children and adolescents. council on scientific affairs, american medical association. JAMA : The Journal of the American Medical Association, 279(14), 1100-1107. Parens, E., & Johnston, J. (2009). Facts, values, and attention-deficit hyperactivity disorder (ADHD): An update on the controversies. Child and Adolescent Psychiatry and Mental Health, 3(1), 1. doi:10.1186/1753-2000-3-1 Warren, A. E., Hamilton, R. M., Belanger, S. A., Gray, C., Gow, R. M., Sanatani, S.,... Schachar, R. (2009). Cardiac risk assessment before the use of stimulant medications in children and youth: A joint position statement by the canadian paediatric society, the canadian cardiovascular society, and the canadian academy of child and adolescent psychiatry. The Canadian Journal of Cardiology, 25(11), 625-630. Zuvekas, S. H., & Vitiello, B. (2011). Stimulant medication use in children: A 12-year perspective. The American Journal of Psychiatry, doi:10.1176/appi.ajp.2011.11030387 Children ages 15-17 are more likely than children ages 2-6 year olds to report poor school engagement. (aOR: 2.47; CI: 1.12-5.41). Children with high socioeconomic status (SES) are more likely to report problematic behavior than those with low SES. (aOR: 4.02; CI: 1.59-10.14). Children who are black are more likely than children who are white to report poor social skills. (aOR: 4.96; CI: 2.62-9.4).