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What Differentiates Children with ADHD Symptoms Who Do and Do Not Receive a Formal Diagnosis? Results from a Prospective Longitudinal Cohort Study

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Abstract

ADHD diagnoses are increasing worldwide, in patterns involving both overdiagnosis of some groups and underdiagnosis of others. The current study uses data from a national longitudinal study of Irish children (N = 8568) to examine the sociodemographic, clinical and psychological variables that differentiate children with high hyperactivity/inattention symptoms, who had and had not received a diagnosis of ADHD. Analysis identified no significant differences in the demographic characteristics or socio-emotional wellbeing of 9-year-olds with hyperactivity/inattention who had and who had not received a diagnosis of ADHD. However, by age 13, those who had held a diagnosis at 9 years showed more emotional and peer relationship problems, worse prosocial behaviour, and poorer self-concept. Further research is required to clarify the developmental pathways responsible for these effects.

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Notes

  1. Such a scenario may also occur in research contexts in double-blinded clinical trials, which further confounds the extent to which research on treatment outcomes can be generalised to draw conclusions about the outcomes of ADHD diagnosis.

  2. Johnson et al.’s [49] study of children born preterm found that the more conservative procedure of requiring above-threshold scores in both (rather than either) teacher and parent reports reduced positive ADHD screens in a sample of from 34.2 to 9.6%. Similarly for this study, requiring a score of ≥ 9 in both teacher and parent SDQ reports would have reduced the sample of Undiagnosed ADHD to 81 (.9%) children. This would likely represent an overly conservative estimate of undiagnosed ADHD, given that the accepted prevalence of ADHD in the population is 5% [4] and the rate of existing clinical diagnosis in this sample was .8%.

  3. They were not added to the Diagnosed ADHD group due to ambiguities caused by a change in question wording in GUI Wave 2, which queried the presence of “Emotional or behavioural disorders (e.g. ADHD/ADD)” instead of ADHD alone. This wording makes it impossible to establish whether these children held an ADHD diagnosis or another emotional or behavioural diagnosis. To preserve the clarity of the analysis, these ambiguous cases were dropped from any analysis involving Wave 2 data.

  4. Unfortunately, since questions about medication were not asked of parents who did not report a mental health condition or disability, equivalent information is not available for the Undiagnosed ADHD group.

  5. GUI did not ask those without a diagnosis whether their child was taking psychotropic medication, so it is not possible to determine whether some undiagnosed children were nevertheless undergoing pharmaceutical intervention. The lack of this data for the undiagnosed group also means it was not possible to include pharmaceutical treatment as a covariate in the analysis.

References

  1. Schneider H, Eisenberg D (2006) Who receives a diagnosis of attention-deficit/hyperactivity disorder in the United States elementary school population? Pediatrics 117:e601–e609. https://doi.org/10.1542/peds.2005-1308

    Article  PubMed  Google Scholar 

  2. Taylor E (2017) Attention deficit hyperactivity disorder: overdiagnosed or diagnoses missed? Arch Dis Child 102:376–379. https://doi.org/10.1136/archdischild-2016-310487

    Article  PubMed  Google Scholar 

  3. Visser SN, Danielson ML, Bitsko RH et al (2014) Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit/hyperactivity disorder: United States, 2003-2011. J Am Acad Child Adolesc Psychiatry 53:34–46.e2. https://doi.org/10.1016/j.jaac.2013.09.001

    Article  PubMed  Google Scholar 

  4. Polanczyk GV, Willcutt EG, Salum GA et al (2014) ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. Int J Epidemiol. https://doi.org/10.1093/ije/dyt261

    Article  PubMed  PubMed Central  Google Scholar 

  5. Ginsberg Y, Quintero J, Anand E et al (2014) Underdiagnosis of attention-deficit/hyperactivity disorder in adult patients: a review of the literature. Prim Care Companion CNS Disord. https://doi.org/10.4088/PCC.13r01600

    Article  PubMed  PubMed Central  Google Scholar 

  6. Hamed AM, Kauer AJ, Stevens HE (2015) Why the diagnosis of attention deficit hyperactivity disorder matters. Front Psychiatry. https://doi.org/10.3389/fpsyt.2015.00168

    Article  PubMed  PubMed Central  Google Scholar 

  7. Sayal K, Prasad V, Daley D et al (2018) ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry 5:175–186. https://doi.org/10.1016/S2215-0366(17)30167-0

    Article  PubMed  Google Scholar 

  8. Batstra L, Frances A (2012) Holding the line against diagnostic inflation in psychiatry. PPS 81:5–10. https://doi.org/10.1159/000331565

    Article  Google Scholar 

  9. Thomas R, Mitchell GK, Batstra L (2013) Attention-deficit/hyperactivity disorder: are we helping or harming? BMJ 347:f6172. https://doi.org/10.1136/bmj.f6172

    Article  PubMed  Google Scholar 

  10. Akinbami LJ, Liu X, Pastor PN, Reuben CA (2011) Attention deficit hyperactivity disorder among children aged 5–17 years in the United States, 1998–2009. National Center for Health Statistics, Hyattsville, MD

    Google Scholar 

  11. Boyle CA, Boulet S, Schieve LA et al (2011) Trends in the prevalence of developmental disabilities in US children, 1997-2008. Pediatrics 127:1034–1042. https://doi.org/10.1542/peds.2010-2989

    Article  PubMed  Google Scholar 

  12. Danielson ML, Bitsko RH, Ghandour RM et al (2018) Prevalence of parent-reported ADHD diagnosis and associated treatment among U.S. children and adolescents, 2016. J Clin Child Adolesc Psychol 47:199–212. https://doi.org/10.1080/15374416.2017.1417860

    Article  PubMed  PubMed Central  Google Scholar 

  13. Conrad P, Bergey MR (2014) The impending globalization of ADHD: notes on the expansion and growth of a medicalized disorder. Soc Sci Med 122:31–43. https://doi.org/10.1016/j.socscimed.2014.10.019

    Article  PubMed  Google Scholar 

  14. Scheffler RM, Hinshaw SP, Modrek S, Levine P (2007) The global market for ADHD medications. Health Aff (Millwood) 26:450–457. https://doi.org/10.1377/hlthaff.26.2.450

    Article  Google Scholar 

  15. Bruchmüller K, Margraf J, Schneider S (2012) Is ADHD diagnosed in accord with diagnostic criteria? Overdiagnosis and influence of client gender on diagnosis. J Consult Clin Psychol 80:128–138. https://doi.org/10.1037/a0026582

    Article  PubMed  Google Scholar 

  16. Quinn PO, Madhoo M (2014) A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. Prim Care Companion CNS Disord. https://doi.org/10.4088/PCC.13r01596

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chen M-H, Lan W-H, Bai Y-M et al (2016) Influence of relative age on diagnosis and treatment of attention-deficit hyperactivity disorder in Taiwanese children. J Pediatr 172:162–167.e1. https://doi.org/10.1016/j.jpeds.2016.02.012

    Article  PubMed  Google Scholar 

  18. Elder TE (2010) The importance of relative standards in ADHD diagnoses: evidence based on exact birth dates. J Health Econ 29:641–656. https://doi.org/10.1016/j.jhealeco.2010.06.003

    Article  PubMed  PubMed Central  Google Scholar 

  19. Evans WN, Morrill MS, Parente ST (2010) Measuring inappropriate medical diagnosis and treatment in survey data: the case of ADHD among school-age children. J Health Econ 29:657–673. https://doi.org/10.1016/j.jhealeco.2010.07.005

    Article  PubMed  Google Scholar 

  20. Halldner L, Tillander A, Lundholm C et al (2014) Relative immaturity and ADHD: findings from nationwide registers, parent- and self-reports. J Child Psychol Psychiatry 55:897–904. https://doi.org/10.1111/jcpp.12229

    Article  PubMed  Google Scholar 

  21. Hoshen MB, Benis A, Keyes KM, Zoëga H (2016) Stimulant use for ADHD and relative age in class among children in Israel. Pharmacoepidemiol Drug Saf 25:652–660. https://doi.org/10.1002/pds.3962

    Article  PubMed  PubMed Central  Google Scholar 

  22. Morrow RL, Garland EJ, Wright JM et al (2012) Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children. CMAJ 184:755–762. https://doi.org/10.1503/cmaj.111619

    Article  PubMed  PubMed Central  Google Scholar 

  23. Sayal K, Chudal R, Hinkka-Yli-Salomäki S et al (2017) Relative age within the school year and diagnosis of attention-deficit hyperactivity disorder: a nationwide population-based study. The Lancet Psychiatry 4:868–875. https://doi.org/10.1016/S2215-0366(17)30394-2

    Article  PubMed  Google Scholar 

  24. Whitely M, Lester L, Phillimore J, Robinson S (2017) Influence of birth month on the probability of Western Australian children being treated for ADHD. Med J Aust 206:85. https://doi.org/10.5694/mja16.00398

    Article  PubMed  Google Scholar 

  25. Zoëga H, Valdimarsdóttir UA, Hernández-Díaz S (2012) Age, academic performance, and stimulant prescribing for ADHD: a nationwide cohort study. Pediatrics 130:1012–1018. https://doi.org/10.1542/peds.2012-0689

    Article  PubMed  PubMed Central  Google Scholar 

  26. Health Service Exeecutive (2014) Fifth annual child & adolescent mental health service report. Health Service Exeecutive, Dublin

    Google Scholar 

  27. Adamis D, Tatlow-Golden M, Gavin B, McNicholas F (2018) General practitioners’ (GP) attitudes and knowledge about attention deficit hyperactivity disorder (ADHD) in Ireland. Ir J Med Sci. https://doi.org/10.1007/s11845-018-1804-3

    Article  PubMed  Google Scholar 

  28. O’Connor C, Kadianaki I, Maunder K, McNicholas F (2018) How does psychiatric diagnosis affect young people’s sense of self and social identity? A systematic review and synthesis of the qualitative literature. Soc Sci Med 212:94–119. https://doi.org/10.1016/j.socscimed.2018.07.011

    Article  PubMed  Google Scholar 

  29. Cheung KKW, Wong ICK, Ip P et al (2015) Experiences of adolescents and young adults with ADHD in Hong Kong: treatment services and clinical management. BMC Psychiatry. https://doi.org/10.1186/s12888-015-0478-x

    Article  PubMed  PubMed Central  Google Scholar 

  30. Cooper P, Shea T (1998) Pupils’ perceptions of AD/HD. Emot Behav Diffic 3:36–48. https://doi.org/10.1080/1363275980030306

    Article  Google Scholar 

  31. Honkasilta J, Vehmas S, Vehkakoski T (2016) Self-pathologizing, self-condemning, self-liberating: youths’ accounts of their ADHD-related behavior. Soc Sci Med 150:248–255. https://doi.org/10.1016/j.socscimed.2015.12.030

    Article  PubMed  Google Scholar 

  32. Kendall J, Hatton D, Beckett A, Leo M (2003) Children’s accounts of attention-deficit/hyperactivity disorder. Adv Nurs Sci 26:114–130

    Article  Google Scholar 

  33. Singh I (2011) A disorder of anger and aggression: children’s perspectives on attention deficit/hyperactivity disorder in the UK. Soc Sci Med 73:889–896. https://doi.org/10.1016/j.socscimed.2011.03.049

    Article  PubMed  PubMed Central  Google Scholar 

  34. Travell C, Visser J (2006) ‘ADHD does bad stuff to you’: young people’s and parents’ experiences and perceptions of attention deficit hyperactivity disorder (ADHD). Emot Behav Diffic 11:205–216. https://doi.org/10.1080/13632750600833924

    Article  Google Scholar 

  35. Krueger M, Kendall J (2001) Descriptions of self: an exploratory study of adolescents with ADHD. J Child Adolesc Psychiatr Nurs 14:61–72. https://doi.org/10.1111/j.1744-6171.2001.tb00294.x

    Article  PubMed  Google Scholar 

  36. Hallberg U, Klingberg G, Setsaa W, Moller A (2010) Hiding parts of one’s self from others—a grounded theory study on teenagers diagnosed with ADHD. Scand J Disabil Res 12:211–220. https://doi.org/10.1080/15017410903478964

    Article  Google Scholar 

  37. MTA Cooperative Group (2004) National Institute of Mental Health Multimodal Treatment Study of ADHD follow-up: changes in effectiveness and growth after the end of treatment. Pediatrics 113:762–769

    Article  Google Scholar 

  38. Shaw M, Hodgkins P, Caci H et al (2012) A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment. BMC Med 10:99. https://doi.org/10.1186/1741-7015-10-99

    Article  PubMed  PubMed Central  Google Scholar 

  39. Storebø OJ, Ramstad E, Krogh HB et al (2015) Methylphenidate for children and adolescents with attention deficit hyperactivity disorder (ADHD). Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD009885.pub2

    Article  PubMed  Google Scholar 

  40. Sonuga-Barke EJS, Brandeis D, Cortese S et al (2013) Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. Am J Psychiatry 170:275–289. https://doi.org/10.1176/appi.ajp.2012.12070991

    Article  PubMed  Google Scholar 

  41. Zwi M, Jones H, Thorgaard C et al (2011) Parent training interventions for attention deficit hyperactivity disorder (ADHD) in children aged 5 to 18 years. Cochrane Database Syst Rev. https://doi.org/10.1002/14651858.CD003018.pub3

    Article  PubMed  PubMed Central  Google Scholar 

  42. Arnold LE, Hodgkins P, Caci H et al (2015) Effect of treatment modality on long-term outcomes in attention-deficit/hyperactivity disorder: a systematic review. PLoS ONE 10:e0116407. https://doi.org/10.1371/journal.pone.0116407

    Article  PubMed  PubMed Central  Google Scholar 

  43. Harpin V, Mazzone L, Raynaud JP et al (2016) Long-term outcomes of ADHD: a systematic review of self-esteem and social function. J Atten Disord 20:295–305. https://doi.org/10.1177/1087054713486516

    Article  PubMed  Google Scholar 

  44. Fischer M, Barkley RA, Fletcher KE, Smallish L (1993) The adolescent outcome of hyperactive children: predictors of psychiatric, academic, social, and emotional adjustment. J Am Acad Child Adolesc Psychiatry 32:324–332. https://doi.org/10.1097/00004583-199303000-00013

    Article  PubMed  Google Scholar 

  45. Sayal K, Goodman R, Ford T (2006) Barriers to the identification of children with attention deficit/hyperactivity disorder. J Child Psychol Psychiatry 47:744–750. https://doi.org/10.1111/j.1469-7610.2005.01553.x

    Article  PubMed  Google Scholar 

  46. Rey JM, Sawyer MG (2003) Are psychostimulant drugs being used appropriately to treat child and adolescent disorders? Br J Psychiatry 182:284–286. https://doi.org/10.1192/bjp.182.4.284

    Article  PubMed  Google Scholar 

  47. Able SL, Johnston JA, Adler LA, Swindle RW (2007) Functional and psychosocial impairment in adults with undiagnosed ADHD. Psychol Med 37:97–107. https://doi.org/10.1017/S0033291706008713

    Article  PubMed  Google Scholar 

  48. Thornton M, Williams J, McCrory C et al (2016) Growing up in Ireland National Longitudinal Study of children: design, instrumentation and procedures for the child cohort at wave two (13 years). Department of Children and Youth Affairs, Dublin

    Google Scholar 

  49. Johnson S, Hollis C, Marlow N et al (2014) Screening for childhood mental health disorders using the strengths and difficulties questionnaire: the validity of multi-informant reports. Dev Med Child Neurol 56:453–459. https://doi.org/10.1111/dmcn.12360

    Article  PubMed  Google Scholar 

  50. Goodman R, Ford T, Simmons H et al (2000) Using the strengths and difficulties questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry 177:534–539

    Article  Google Scholar 

  51. Goodman R, Renfrew D, Mullick M (2000) Predicting type of psychiatric disorder from strengths and difficulties questionnaire (SDQ) scores in child mental health clinics in London and Dhaka. Eur Child Adolesc Psychiatry 9:129–134. https://doi.org/10.1007/s007870050008

    Article  PubMed  Google Scholar 

  52. Russell G, Rodgers LR, Ford T (2013) The strengths and difficulties questionnaire as a predictor of parent-reported diagnosis of autism spectrum disorder and attention deficit hyperactivity disorder. PLoS ONE 8:e80247. https://doi.org/10.1371/journal.pone.0080247

    Article  PubMed  PubMed Central  Google Scholar 

  53. van Dulmen MHM, Egeland B (2011) Analyzing multiple informant data on child and adolescent behavior problems: predictive validity and comparison of aggregation procedures. Int J Behav Dev 35:84–92. https://doi.org/10.1177/0165025410392112

    Article  Google Scholar 

  54. Silva TBF, Osório FL, Loureiro SR (2015) SDQ: discriminative validity and diagnostic potential. Front Psychol. https://doi.org/10.3389/fpsyg.2015.00811

    Article  PubMed  PubMed Central  Google Scholar 

  55. Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39:175–191

    Article  Google Scholar 

  56. Goodman R (1997) The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 38:581–586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.x

    Article  PubMed  Google Scholar 

  57. Piers EV, Herzberg DS (2007) Piers-Harris children’s self-concept scale–manual, 2nd edn. Western Psychological Services, Los Angeles, CA

    Google Scholar 

  58. Angold A, Costello EJ, Messer SC, Pickles A (1995) Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. Int J Methods Psychiatr Res 5:237–249

    Google Scholar 

  59. Batzle CS, Weyandt LL, Janusis GM, DeVietti TL (2010) Potential impact of ADHD with stimulant medication label on teacher expectations. J Atten Disord 14:157–166. https://doi.org/10.1177/1087054709347178

    Article  PubMed  Google Scholar 

  60. Canu WH, Newman ML, Morrow TL, Pope DLW (2008) Social appraisal of adult ADHD stigma and influences of the beholder’s big five personality traits. J Atten Disord 11:700–710. https://doi.org/10.1177/1087054707305090

    Article  PubMed  Google Scholar 

  61. Chew BL, Jensen SA, Rosén LA (2009) College students’ attitudes toward their ADHD peers. J Atten Disord 13:271–276. https://doi.org/10.1177/1087054709333347

    Article  PubMed  Google Scholar 

  62. Harris MJ, Milich R, Corbitt EM et al (1992) Self-fulfilling effects of stigmatizing information on children’s social interactions. J Pers Soc Psychol 63:41–50. https://doi.org/10.1037/0022-3514.63.1.41

    Article  PubMed  Google Scholar 

  63. O’Driscoll C, Heary C, Hennessy E, McKeague L (2012) Explicit and implicit stigma towards peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 53:1054–1062. https://doi.org/10.1111/j.1469-7610.2012.02580.x

    Article  PubMed  Google Scholar 

  64. Ohan JL, Visser TAW, Moss RG, Allen NB (2013) Parents’ stigmatizing attitudes toward psychiatric labels for ADHD and depression. Psychiatr Serv 64:1270–1273. https://doi.org/10.1176/appi.ps.201200578

    Article  PubMed  Google Scholar 

  65. Walker JS, Coleman D, Lee J et al (2008) Children’s stigmatization of childhood depression and ADHD: magnitude and demographic variation in a national sample. J Am Acad Child Adolesc Psychiatry 47:912–920. https://doi.org/10.1097/CHI.0b013e318179961a

    Article  PubMed  Google Scholar 

  66. Ohan JL, Visser TAW, Strain MC, Allen L (2011) Teachers’ and education students’ perceptions of and reactions to children with and without the diagnostic label “ADHD”. J Sch Psychol 49:81–105. https://doi.org/10.1016/j.jsp.2010.10.001

    Article  PubMed  Google Scholar 

  67. Ford T, Goodman R, Meltzer H (2003) The British child and adolescent mental health survey 1999: the prevalence of DSM-IV disorders. J Am Acad Child Adolesc Psychiatry 42:1203–1211. https://doi.org/10.1097/00004583-200310000-00011

    Article  PubMed  Google Scholar 

  68. Kvist AP, Nielsen HS, Simonsen M (2013) The importance of children’s ADHD for parents’ relationship stability and labor supply. Soc Sci Med 88:30–38. https://doi.org/10.1016/j.socscimed.2013.04.001

    Article  PubMed  Google Scholar 

  69. Meltzer H, Gatward R, Goodman R, Ford T (2000) Mental health of children and adolescents in Great Britain. The Stationery Office, London

    Book  Google Scholar 

  70. Bagwell CL, Molina BSG, Pelham WE, Hoza B (2001) Attention-deficit hyperactivity disorder and problems in peer relations: predictions from childhood to adolescence. J Am Acad Child Adolesc Psychiatry 40:1285–1292. https://doi.org/10.1097/00004583-200111000-00008

    Article  PubMed  Google Scholar 

  71. Barkley RA, Fischer M, Smallish L, Fletcher K (2006) Young adult outcome of hyperactive children: adaptive functioning in major life activities. J Am Acad Child Adolesc Psychiatry 45:192–202. https://doi.org/10.1097/01.chi.0000189134.97436.e2

    Article  PubMed  Google Scholar 

  72. Young S, Chadwick O, Heptinstall E et al (2005) The adolescent outcome of hyperactive girls. Eur Child Adolesc Psychiatry 14:245–253. https://doi.org/10.1007/s00787-005-0461-z

    Article  PubMed  Google Scholar 

  73. Mikami AY, Hinshaw SP, Lee SS, Mullin BC (2008) Relationships between social information processing and aggression among adolescent girls with and without ADHD. J Youth Adolesc 37:761–771. https://doi.org/10.1007/s10964-007-9237-8

    Article  PubMed  PubMed Central  Google Scholar 

  74. Mehta N, Clement S, Marcus E et al (2015) Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. Br J Psychiatry 207:377–384. https://doi.org/10.1192/bjp.bp.114.151944

    Article  PubMed  PubMed Central  Google Scholar 

  75. Thornicroft G, Mehta N, Clement S et al (2016) Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet 387:123–1132

    Article  Google Scholar 

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Funding

This research has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no. 702970.

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Authors and Affiliations

  1. School of Psychology, University College Dublin, Dublin, Ireland

    Cliodhna O’Connor

  2. School of Medicine, University College Dublin, Dublin, Ireland

    Cliodhna O’Connor & Fiona McNicholas

  3. Our Lady’s Children’s Hospital Crumlin, Dublin, Ireland

    Fiona McNicholas

  4. Lucena Clinic, Dublin, Ireland

    Fiona McNicholas

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Correspondence to Cliodhna O’Connor.

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The GUI study was conducted in accordance with the 1964 Helsinki Declaration and its later amendments and received ethical approval from the Irish Health Research Board’s Research Ethics Committee. Informed consent was obtained from all participants.

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O’Connor, C., McNicholas, F. What Differentiates Children with ADHD Symptoms Who Do and Do Not Receive a Formal Diagnosis? Results from a Prospective Longitudinal Cohort Study. Child Psychiatry Hum Dev 51, 138–150 (2020). https://doi.org/10.1007/s10578-019-00917-1

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