JAMA Netw Open

Early ADHD diagnoses in preschoolers often followed by rapid medication use

September 3, 2025

Study details: This retrospective cohort study examined electronic health records of 712,478 children aged 3 to 5 years across 8 U.S. pediatric health systems from 2016 to 2023. Researchers assessed ADHD diagnosis rates and timing of stimulant or nonstimulant medication initiation before age 7, using multivariable Cox models to evaluate demographic and clinical predictors.

Results: ADHD was diagnosed in 1.4% of children, with wide variation across sites (0.5%–3.1%). Among those diagnosed, 68.2% received medication before age 7, and 42.2% were prescribed medication within 30 days. Early prescribing was more common among older children, males, and those with public insurance. Asian, Hispanic, and Black children were less likely to receive early prescriptions than White children.

Clinical impact: These findings reveal a disconnect between clinical guidelines and practice, with many preschoolers receiving pharmacologic treatment soon after diagnosis. The study highlights the need to improve access to behavioral interventions and address racial and socioeconomic disparities in ADHD care.

Source:

Bannett Y, et al. (2025, August 1). JAMA Netw Open. ADHD Diagnosis and Timing of Medication Initiation Among Children Aged 3 to 5 Years. https://pubmed.ncbi.nlm.nih.gov/40880088/