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Disparities in Receipt of a 504 Plan by Socioeconomic Status among Children Diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) in the United States



We aimed to understand disparities in the receipt of a 504 Plan among US children with Attention-Deficit/Hyperactivity Disorder (ADHD) using the federal poverty level (FPL) as an indicator of socioeconomic status.


We analyzed a subpopulation of the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome (n=2282) children aged 8-17 years. Bivariate and multivariable analyses were used to assess the association of the FPL with receipt of a 504 Plan.


A total of 349 (13.6 %) of children received a 504 Plan. Using the FPL category above 400% as the reference, after controlling for age, sex, race/ethnicity, severity of ADHD, medication status, learning disorders, anxiety and/or mood disorders, overall school performance, and an individualized education plan, children in households at ≤100% of the FPL had the lowest odds of having a 504 Plan (adjusted odds ratio (AOR) 0.33, 95% CI 0.15-0.71), followed by children in households at 101-200% of the FPL (AOR 0.48, 95% CI 0.24-0.94), and children in households at 201-400% of the FPL (AOR 0.57, 95% CI 0.34-0.97).


Children in the lowest FPL category had the lowest odds of having a 504 Plan. Therefore the 504 Plan may be underutilized in children of lower socioeconomic status.

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