In reply
I thank Dr Fischer for raising the issue about who provides service for very young children with attention-deficit/hyperactivity disorder. The following information about provider specialty was presented as a poster at the Pediatric Academic Societies Annual Meeting.1
In the first report, 223 children aged 3 years or younger were identified as having a diagnosis of attention-deficit/hyperactivity disorder within the Michigan Medicaid fee-for-service plan from October 1, 1995, to December 30, 1996.2 Of these, 127 received psychotropic medications. The children who received psychotropic medications were more likely to have a pediatrician as their primary care physician; almost half of these children had no contact with psychiatry or neurology specialists.