Date of Award


Document Type

Campus Access Dissertation


Health Services and Policy Management

First Advisor

Janice C Probst


Attention deficit hyperactivity disorder (ADHD) is a heterogeneous neurobiological condition characterized by significant impairment related to inattention, impulsivity, or both. According to the The Diagnostic and Statistical Manual of the American Psychiatric Association, 4th edition, ADHD (DSM-IV) affects between 3 and 7 percent of school-aged youths in the United States (American Psychiatric Association, 2000). A study by Sibley and associates found that children who have ADHD are at an increased risk of some form of delinquency (Sibley et al., 2010). Furthermore, research suggests that ADHD continues to be a strong predictor of violent behavior for adolescents from ages 14 and 16 years old (Herrenkohl et al., 2000).

The research clearly indicates that there is a link between adolescents with ADHD and their increased risk for delinquency, incarceration and recidivism. However, there seems to be a gap in the literature as to the types of treatment received and the access to providers by these children and their subsequent risk for incarceration.

This study will explore factors affecting the risk for incarceration within a cohort of Medicaid-insured youth with ADHD in South Carolina. Being able to identify the risk factors for ADHD and its coexisting behaviors is crucial in developing health care intervention strategies to prevent violent offending behavior (Wasserman et al., 2000). Specifically, I will determine what demographic differences exist between those juveniles with an ADHD diagnosis, involved in criminal activity and subsequently incarcerated at the South Carolina Department of Juvenile Justice (SCDJJ), as opposed to juveniles with the same diagnosis who do not end up incarcerated at the SCDJJ. Second, among youth diagnosed with ADHD, I will analyze whether the provider type or facility type where the youth was diagnosed and/or type of therapy the youth received (if any) affects the odds that the individual will be incarcerated at DJJ.

Early recognition of ADHD and its coexisting behaviors, along with adequate management, are able to redirect the educational and psychosocial development of these children (Ponde et al., 2007). Thus, early diagnosis and treatment of ADHD is crucial in identifying and implementing intervention strategies and preventing these youth from being incarcerated.