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Attention Deficit Hyperactivity Disorder in Children With Sickle Cell Disease Referred for an Evaluation

Acquazzino, Melissa A. MD, MS*; Miller, Meghan MA; Myrvik, Matthew PhD; Newby, Robert PhD§; Scott, John Paul MD

Journal of Pediatric Hematology/Oncology: July 2017 - Volume 39 - Issue 5 - p 350–354
doi: 10.1097/MPH.0000000000000847
Original Articles

Neuropsychological deficits, including difficulties with attention, are well described in children with sickle cell disease (SCD). Very little is known about attention deficit hyperactivity disorder (ADHD) in children with SCD. The objective of this study was to determine the proportion of ADHD in children with SCD referred for neuropsychological evaluation. This prospective, cross-sectional study included patients (age, 4 to 18 y) with SCD and completion of a neuropsychological evaluation between December 2013 and March 2016. Patients were referred for neuropsychological evaluation because of concern regarding school performance, development, and/or behavior. The diagnosis of ADHD was made by a neuropsychologist on the basis of the diagnostic criteria in the Diagnostic Statistical Manual—Fourth or Fifth Editions. ADHD medication usage rate was obtained by medical record review. Of the 89 patients with SCD referred for neuropsychological evaluation, 25% (95% confidence interval, 16%-35%) met diagnostic criteria for ADHD. Only 21% of the patients with SCD and ADHD were prescribed an ADHD medication. Our study supports routine ADHD screening in children with SCD who have poor school performance or behavioral concerns. Despite the benefits of pharmacologic treatment, the majority of patients with SCD and ADHD did not receive a medication for management of their ADHD.

*Department of Pediatrics, Section of Hematology/Oncology, University of South Dakota Sanford School of Medicine, Sanford Children’s Hospital, Sioux Falls, SD

Section of Pediatric Hematology

Department of Psychiatry and Behavioral Medicine

§Department of Neurology

Section of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, WI

Supported in part by a grant from the Midwest Athletes Against Childhood Cancer and Blood Disease Fund.

The authors declare no conflict of interest.

Reprints: Melissa A. Acquazzino, MD, MS, Department of Pediatric Hematology/Oncology, Sanford Children’s Hospital and Specialty Clinic, 1600 W 22nd Street, P.O. Box 5039, Sioux Falls, SD 57117-5039 (e-mail:

Received January 11, 2017

Accepted April 17, 2017

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