{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:34:02Z","timestamp":1793727242168,"version":"4.6.1"},"reference-count":38,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T00:00:00Z","timestamp":1790553600000},"content-version":"vor","delay-in-days":27,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["academicpedsjnl.net","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Academic Pediatrics"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.acap.2026.103474","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:25:21Z","timestamp":1790576721000},"page":"103474","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["National Trends in Severe ADHD and Treatment Among U.S. Children, 2016\u20132024"],"prefix":"10.1016","author":[{"given":"Chengke","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qi","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenxi","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Qiang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.acap.2026.103474_bib1","doi-asserted-by":"crossref","DOI":"10.1016\/j.psychres.2025.116746","article-title":"Global, regional, and national trends in the burden of attention deficit hyperactivity disorder among children and adolescents (0-14 years): A 30-year analysis and future projections (1990-2036)","volume":"353","author":"Lin","year":"2025","journal-title":"Psychiatry Res"},{"issue":"2","key":"10.1016\/j.acap.2026.103474_bib2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.su7102a1","article-title":"Mental Health Surveillance Among Children - United States, 2013-2019","volume":"71","author":"Bitsko","year":"2022","journal-title":"MMWR Suppl"},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib3","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.jaac.2013.09.001","article-title":"Trends in the parent-report of health care provider-diagnosed and medicated attention-deficit\/hyperactivity disorder: United States, 2003-2011","volume":"53","author":"Visser","year":"2014","journal-title":"J Am Acad Child Adolesc Psychiatry"},{"issue":"3","key":"10.1016\/j.acap.2026.103474_bib4","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1080\/15374416.2024.2335625","article-title":"ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment","volume":"53","author":"Danielson","year":"2024","journal-title":"J Clin Child Adolesc Psychol."},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib5","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2018.1471","article-title":"Twenty-Year Trends in Diagnosed Attention-Deficit\/Hyperactivity Disorder Among US Children and Adolescents, 1997-2016","volume":"1","author":"Xu","year":"2018","journal-title":"JAMA Netw Open"},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib6","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2026.5784","article-title":"Incidence of ADHD Diagnoses on the Rise\u2014Good or Bad News","volume":"9","author":"Cortese","year":"2026","journal-title":"JAMA Network Open"},{"issue":"7","key":"10.1016\/j.acap.2026.103474_bib7","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1097\/DBP.0000000000001087","article-title":"Primary Care Diagnosis and Treatment of Attention-Deficit\/Hyperactivity Disorder in School-Age Children: Trends and Disparities During the COVID-19 Pandemic","volume":"43","author":"Bannett","year":"2022","journal-title":"Journal of Developmental & Behavioral Pediatrics"},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib8","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1177\/1087054720978549","article-title":"Physical Health, Media Use, and Mental Health in Children and Adolescents With ADHD During the COVID-19 Pandemic in Australia","volume":"26","author":"Sciberras","year":"2022","journal-title":"Journal of Attention Disorders"},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib9","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2021.5335","article-title":"Overdiagnosis of Attention-Deficit\/Hyperactivity Disorder in Children and Adolescents: A Systematic Scoping Review","volume":"4","author":"Kazda","year":"2021","journal-title":"JAMA Network Open"},{"issue":"5","key":"10.1016\/j.acap.2026.103474_bib10","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1016\/j.eurpsy.2012.05.002","article-title":"Is ADHD severity in adults associated with the lifetime prevalence of comorbid depressive episodes and anxiety disorders","volume":"28","author":"Simon","year":"2013","journal-title":"European Psychiatry"},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib11","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.acap.2016.08.013","article-title":"Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity","volume":"17","author":"Brown","year":"2017","journal-title":"Academic Pediatrics"},{"key":"10.1016\/j.acap.2026.103474_bib12","unstructured":"The United States Census Bureau, Associate Director for Demographic Programs, National Survey of Children\u2019s Health. https:\/\/www.census.gov\/programs-surveys\/nsch\/data\/datasets.html"},{"issue":"9","key":"10.1016\/j.acap.2026.103474_bib13","doi-asserted-by":"crossref","first-page":"1916","DOI":"10.1002\/aur.3228","article-title":"Prevalence and treatment of autism spectrum disorder in the United States, 2016-2022","volume":"17","author":"Li","year":"2024","journal-title":"Autism Res."},{"key":"10.1016\/j.acap.2026.103474_bib14","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.puhe.2024.08.027","article-title":"Multiple developmental disabilities among American children: prevalence and secular trends 2016-2022","volume":"237","author":"Lin","year":"2024","journal-title":"Public Health"},{"issue":"10","key":"10.1016\/j.acap.2026.103474_bib15","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1111\/j.1440-1754.2011.02044.x","article-title":"Emotional, developmental and behavioural co-morbidities of children with chronic health conditions","volume":"47","author":"Blackman","year":"2011","journal-title":"Journal of Paediatrics and Child Health"},{"issue":"10","key":"10.1016\/j.acap.2026.103474_bib16","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.36872","article-title":"Prevalence and Trends in Diagnosed ADHD Among US Children and Adolescents, 2017-2022","volume":"6","author":"Li","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib17","doi-asserted-by":"crossref","first-page":"E155","DOI":"10.1097\/PHH.0000000000001223","article-title":"Concordance of Data on Children's Unmet Health Care Needs Between 2 National Surveys","volume":"28","author":"White","year":"2022","journal-title":"Journal of Public Health Management and Practice"},{"issue":"8","key":"10.1016\/j.acap.2026.103474_bib18","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1016\/j.acap.2021.03.009","article-title":"Examining the Relationship Between Adverse Childhood Experiences and ADHD Diagnosis and Severity","volume":"21","author":"Crouch","year":"2021","journal-title":"Academic Pediatrics"},{"issue":"6","key":"10.1016\/j.acap.2026.103474_bib19","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1017\/S2045796014000523","article-title":"Prevalence of severe ADHD: an epidemiological study in the Italian regions of Tuscany and Latium","volume":"24","author":"Donfrancesco","year":"2015","journal-title":"Epidemiol Psychiatr Sci"},{"key":"10.1016\/j.acap.2026.103474_bib20","first-page":"1","article-title":"Trends in Parent-Reported ADHD Diagnosis and Treatment Among U.S. Children, 2016-2023","author":"Katz","year":"2026","journal-title":"J Clin Child Adolesc Psychol"},{"issue":"2","key":"10.1016\/j.acap.2026.103474_bib21","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1177\/10870547221132793","article-title":"Familial Factors Associated With Symptom Severity in Children and Adolescents With ADHD: A Meta-Analysis and Supplemental Review","volume":"27","author":"Jendreizik","year":"2023","journal-title":"Journal of Attention Disorders"},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib22","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1016\/j.acap.2016.08.013","article-title":"Associations Between Adverse Childhood Experiences and ADHD Diagnosis and Severity","volume":"17","author":"Brown","year":"2017","journal-title":"Acad Pediatr. May-"},{"issue":"5","key":"10.1016\/j.acap.2026.103474_bib23","first-page":"467","article-title":"ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis?","volume":"119","author":"Abdelnour","year":"2022","journal-title":"Mo Med. Sep-"},{"key":"10.1016\/j.acap.2026.103474_bib24","volume":"5","author":"American Psychiatric Association D","year":"2013"},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib25","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1089\/cap.2005.15.88","article-title":"Race\/Ethnicity and Insurance Status as Factors Associated with ADHD Treatment Patterns","volume":"15","author":"Stevens","year":"2005","journal-title":"Journal of Child and Adolescent Psychopharmacology"},{"issue":"12","key":"10.1016\/j.acap.2026.103474_bib26","doi-asserted-by":"crossref","first-page":"1338","DOI":"10.1176\/appi.ps.202100578","article-title":"Racial and Ethnic Disparities in Childhood ADHD Treatment Access and Utilization: Results From a National Study","volume":"73","author":"Yang","year":"2022","journal-title":"Psychiatric Services"},{"key":"10.1016\/j.acap.2026.103474_bib27","article-title":"Differences in patterns of attention deficit\/hyperactivity disorder medication use in US children","author":"Ryan","year":"2025","journal-title":"JCPP Advances"},{"key":"10.1016\/j.acap.2026.103474_bib28","doi-asserted-by":"crossref","DOI":"10.3389\/fpsyt.2021.649399","article-title":"Failure of Healthcare Provision for Attention-Deficit\/Hyperactivity Disorder in the United Kingdom: A Consensus Statement","volume":"12","author":"Young","year":"2021","journal-title":"Front Psychiatry"},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib29","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1038\/s41572-024-00495-0","article-title":"Attention-deficit\/hyperactivity disorder","volume":"10","author":"Faraone","year":"2024","journal-title":"Nature Reviews Disease Primers"},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib30","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2020-016824","article-title":"Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey","volume":"146","author":"Patrick","year":"2020","journal-title":"Pediatrics."},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib31","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1186\/s12888-024-05623-4","article-title":"ADHD prescription patterns and medication adherence in children and adolescents during the COVID-19 pandemic in an urban academic setting","volume":"24","author":"Cunniff","year":"2024","journal-title":"BMC Psychiatry"},{"key":"10.1016\/j.acap.2026.103474_bib32","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.euroneuro.2023.04.008","article-title":"The impact of the COVID-19 pandemic on ADHD medicine consumption in 47 countries and regions","volume":"73","author":"Gimbach","year":"2023","journal-title":"European Neuropsychopharmacology"},{"issue":"3","key":"10.1016\/j.acap.2026.103474_bib33","doi-asserted-by":"crossref","DOI":"10.1001\/jamahealthforum.2026.0041","article-title":"Manufacturing Supply Chains and Imports in the ADHD Drug Shortage","volume":"7","author":"Currie","year":"2026","journal-title":"JAMA Health Forum"},{"issue":"4","key":"10.1016\/j.acap.2026.103474_bib34","article-title":"Treatments for ADHD in Children and Adolescents: A Systematic Review","volume":"153","author":"Peterson","year":"2024","journal-title":"Pediatrics"},{"issue":"10","key":"10.1016\/j.acap.2026.103474_bib35","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1001\/jama.2024.0851","article-title":"ADHD Pharmacotherapy and Mortality in Individuals With ADHD","volume":"331","author":"Li","year":"2024","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib36","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/07370016.2018.1404832","article-title":"Barriers to Health Care Access for Low Income Families: A Review of Literature","volume":"35","author":"Lazar","year":"2018","journal-title":"J Community Health Nurs. Jan-"},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib37","doi-asserted-by":"crossref","first-page":"1148","DOI":"10.1186\/s12913-022-08527-9","article-title":"Impact of low health literacy on patients\u2019 health outcomes: a multicenter cohort study","volume":"22","author":"Shahid","year":"2022","journal-title":"BMC health services research"},{"issue":"1","key":"10.1016\/j.acap.2026.103474_bib38","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1186\/1741-7015-10-99","article-title":"A systematic review and analysis of long-term outcomes in attention deficit hyperactivity disorder: effects of treatment and non-treatment","volume":"10","author":"Shaw","year":"2012","journal-title":"BMC medicine"}],"container-title":["Academic Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1876285926002561?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1876285926002561?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T16:58:46Z","timestamp":1793725126000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1876285926002561"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":38,"alternative-id":["S1876285926002561"],"URL":"https:\/\/doi.org\/10.1016\/j.acap.2026.103474","relation":{},"ISSN":["1876-2859"],"issn-type":[{"value":"1876-2859","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"National Trends in Severe ADHD and Treatment Among U.S. Children, 2016\u20132024","name":"articletitle","label":"Article Title"},{"value":"Academic Pediatrics","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.acap.2026.103474","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier, Inc. on behalf of Academic Pediatric Association.","name":"copyright","label":"Copyright"}],"article-number":"103474"}}