Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)


Physician Assistant Studies

First Advisor

Julie Solberg


Attention deficient hyperactive disorder; Rural; Urban; Primary care providers


Attention deficient disorder with hyperactivity (ADHD) is an increasing psychiatric disorder affecting children across the world. With significant debate on diagnosis, ADHD is commonly underdiagnosed in children, even today. Approximately 4.6 million children are diagnosed with ADHD, but more than two thirds of these children are untreated. Primary care providers remain the responsible stakeholders for assessing, diagnosing, and treating children with ADHD appropriately. This literature review is aimed to investigate the correlation between the assessment and early diagnosing of ADHD among children in rural settings compared to that of the metropolitan/urban communities. Providing children with ADHD symptoms an early diagnosis, improves day to day development and minimizes the risks of comorbidities presenting later in life. Timely diagnosing and adequate treatment allow medical providers to change lives of those who suffer from long-term effects related to ADHD. A comprehensive literature review was performed using electronic search databases including PubMed, Embase, Access Medicine, and Clinical Key. A variety of key terms were used when researching. Articles were limited to the past 28 years when ADHD became a studied topic. Randomized controlled trials, prospective studies, cross-sectional studies, peer-reviewed journal articles, and systematic reviews were closely reviewed. These articles expanded the research used to access the primary outcomes of early diagnosis and treatment of children faced with ADHD, comparing rural to metropolitan/urban communities and access to specialized care. Exclusion criteria consisted of editorials, abstracts, on-going trials, and studies performed outside the United States.