According to the authors of a large Danish study, increased pharmacological treatment of ADHD accounts for a substantial share of the observed decrease in foster care caseloads in Denmark.
In order to supplement existing literature regarding the effect of children’s behavioural problems on foster care caseloads, this study used Danish registry data (involving all 277 municipalities and 10% of all Danish children [N=157,938]) collected between 1998 and 2010 to examine whether increased pharmacological treatment of ADHD led to a decline in foster care caseloads in Denmark. Data were analysed by examining the relationship between municipal-level ADHD medication rates and foster care caseloads (macro level) followed by an examination of how ADHD medication rates affected the individual risk of being in foster care (micro level).
When taking into account municipality characteristics, year-fixed effects and municipality-fixed effects, 45% of the decrease in foster care caseloads reported in Denmark in 1998–2010 was found to be attributable to increased ADHD medication use. Moreover, a child’s risk of entering foster care was reduced by 0.8 percentage points when the proportion of children receiving medication was increased by 1.0 percentage point.
The results of this analysis of registry data suggest that pharmacological treatment of ADHD has substantial effects on foster care caseloads in Denmark, and that interventions that address children’s acute behavioural problems can have a beneficial impact on foster care. Limitations of this study include the lack of insight into what the optimal level of pharmacological treatment may be; potential confounding of data with municipal-level variation; and lack of individual-level risk data for foster care placement to test how pharmacological treatment for ADHD may alleviate this in individuals.
Fallesen P, Wildeman C. The effect of medical treatment of attention deficit hyperactivity disorder (ADHD) on foster care caseloads: evidence from Danish registry data. J Health Soc Behav 2015; 56: 398-414.