Critical but costly ADHD treatments cause many parents unexpected financial strain

As a parent of three children with Attention Deficit Hyperactivity Disorder, Shannon Low knows her psychological, emotional and financial toll.

“They are overwhelmed every day,” says the Calgary pharmacist, whose children are between 16 and 21 years old. Although they are gifted learners, the neurodevelopmental disorder means they struggle with an inability to concentrate, difficulty with planning and organizing, and hyperactivity.

Like most parents, Ms. Low has worked hard to provide her children with the help they need. She spent $1,800 on each child’s psychoeducational assessment, which is conducted by psychologists to determine if a child has attention deficit disorder, ADHD or learning disabilities.

She pays $120 a month for a drug plan that covers her ADHD medications, and spent $230 an hour on a psychologist, paid for tutoring, and enrolled a daughter in a private school that costs $20. $000 per year.

When a child is diagnosed with ADHD, most parents are unaware of the total financial outlay that may ensue. In addition to diagnosis and medication, a treatment plan may include out-of-pocket expenses such as psychological therapies, executive functioning coaching, tutors, or specialized training. Some treatments are covered by provincial health care, but many are not, which erodes family budgets and leads to financial hardship.

Shannon Lee Simmons, a certified financial planner at the New School of Finance in Toronto, says the budgetary pressure on households can be severe if parents do not have health benefits to cover the additional costs and the diagnosis of ADHD n is not serious enough to qualify for tax credits.

“What I typically see with clients who struggle to afford the extra support is that other financial goals, like retirement, fall by the wayside. Many will use their lines of credit to cover these costs,” she says.

A common neurodevelopmental disorder, ADHD affects 5-9% of all children in Canada. The shift to online learning during the pandemic, which has resulted in less activity and more screen time, has led to increased awareness of ADHD among both adults and children. A U.S. survey by ADDitude Magazine found an increase in diagnosis since the start of the pandemic as parents saw firsthand the attention and educational challenges their children were facing during remote schooling.

ADHD treatment costs begin even before a child is officially diagnosed. Although psychoeducational assessments by licensed psychiatrists are covered by provincial health care, waiting lists can last for months or years, says Heidi Bernhardt, founder of the Toronto-based Center for ADHD Awareness, Canada (CADDAC). Parents desperate for a more immediate diagnosis will pay between $1,000 and $3,500 at a private clinic, she adds. This formal diagnosis is necessary to access academic supports and flag other potential problems.

“The provincial health care programs don’t cover anything other than seeing a child analyst/psychiatrist or developmental pediatrician and getting a prescription,” says Bernhardt. And ADHD medications are expensive — a month’s supply of a common ADHD medication, Concerta (27 milligrams), costs $128.

While provinces such as Ontario cover the cost of ADHD medications for children under 25 whose parents do not have private drug insurance, other provinces require parents to portion of the prescription price above certain income thresholds. While private insurance plans may cover these costs, families without private insurance — or those with employer-sponsored plans that don’t have 100% drug coverage — may end up with these drugs.

In addition to medication, many doctors recommend psychological therapy to help children with ADD or ADHD. While some are covered by the province, others are private, with prices between $150 and $250 per hour, she says. Bernhardt says many private plans cap this type of therapy at $500 per person per year. “These costs can really add up,” she says.

Nelson, B.C. civil servant Tina Evans discovered it two years ago when her son, now 7, and then her daughter, now 10, were diagnosed. She’s shelled out thousands of dollars for private tutors, a special high-protein diet — which can help regulate mood — and medication.

Other costs are hard to quantify, such as paying for new shoes and coats because her children keep losing them. She recently paid $1,000 to fix her son’s dental issues. “His ADHD means he refuses to brush his teeth,” she says.

Jason Heath, managing director of Objective Financial Partners Inc., sees many parents stressed about managing ADHD costs.

He starts by providing his clients with advice on where to find federal supports that can help offset the costs they face. For example, “tutoring a child with ADHD is considered a medical expense,” says Heath. “This can be claimed as a tax charge.”

Tuition at private schools may also be covered as an eligible medical expense, although a doctor must certify what specialty services the school can provide, he says. Therapy provided by a social worker or psychologist will also qualify. For older children, college note-taking services can be requested.

The Disability Tax Credit, which can provide $1,700 of support per year, is also an option, provided a doctor certifies that the child is severely disabled. Mr. Heath concedes that this amount is often insufficient. “I see parents who spend this per month,” he says.

David Blascik, a Hamilton-based disability consultant, explains that if a child qualifies for the DTC, parents can set up a Registered Disability Savings Plan, which is similar to a disability pension plan.

Under the Canada Disability Savings Grant, if family income is less than $95,259, the government will match up to $3 on every dollar contributed to the RDSP. For those earning less than $32,028, the government will also pay $1,000 each year for 20 years through the Canada Disability Savings Bond.

Blascik says he often advises families to turn a registered education savings plan into an RDSP, capitalizing on government grants on both fronts. “You get government money all the way,” he says.

For Ms Low, she is encouraged by the improvement in her children’s symptoms. And she is willing to spend more for future help. “It’s eating away at my life,” she says. “But these children deserve help.”

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