As the parent of three children with attention deficit hyperactivity disorder, Shannon Low is familiar with its psychological, emotional and financial toll.
“They’re overwhelmed each and every day,” says the Calgary-based pharmacist, whose children range in age from 16 to 21. Despite being gifted learners, the neurodevelopmental disorder means they struggle with an inability to focus, difficulties with planning and organizing, and hyperactivity.
Like most parents, Ms. Low has strived to get her kids the help they need. She spent $1,800 for each child’s psychoeducational assessment, which are conducted by psychologists to determine whether a child has attention deficit disorder, ADHD, or learning disabilities.
She pays $120 a month for a drug plan that covers their ADHD medications, and has spent $230 an hour for a psychologist, paid for private tutoring and enrolled one daughter in a private school that costs $20,000 a year.
When a child is diagnosed with ADHD, most parents are unaware of the full financial outlay that can follow. In addition to the diagnosis and medication, a treatment plan could include out-of-pocket expenses such as psychological therapies, executive functioning coaching, tutors, or specialized schooling. Some treatments are covered by provincial health care but many are not, eroding family budgets and leading to financial strain.
Shannon Lee Simmons, a certified financial planner with the New School of Finance in Toronto, says the budgetary strain on households can be severe if parents do not have health benefits to cover additional costs and the ADHD diagnosis is not severe enough to qualify for tax credits.
“What I typically see among clients who struggle to afford the additional support are 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 to 9 per cent of all children in Canada. The switch to online learning during the pandemic, which translated to fewer activities and more screen time, led to an increased awareness of ADHD, in both adults and kids. An American survey by ADDitude Magazine found a jump in diagnosis since the start of the pandemic, as parents saw firsthand the attention and educational struggles their children faced during remote school.
The costs of ADHD treatment start before a child is even officially diagnosed. Although psychoeducational assessments by registered psychiatrists are covered by provincial health care, waitlists can run months or years, says Heidi Bernhardt, founder of the Toronto-based Centre 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. That formal diagnosis is needed to access school supports and flag other potential issues.
“Provincial health care programs do not cover anything other than seeing a child analyst/psychiatrist or developmental pediatrician and getting a prescription,” Ms. Bernhardt says. And ADHD medications are expensive – a month’s supply of a common ADHD drug, Concerta (27 milligrams), costs $128.
While provinces such as Ontario cover the cost of ADHD drugs for children under 25 with parents who don’t have private drug plans, other provinces make parents cover part of the prescription price above certain income thresholds. While private insurance plans can cover these costs, those families without private insurance – or those with employer-sponsored plans that don’t have 100 per cent drug coverage – can end up on the hook for these medications.
In addition to drugs, many doctors recommend psychological therapy to help kids with ADD or ADHD. While some is provincially covered, some is private, with price tags between $150 and $250 an hour, she says. Ms. Bernhardt says that many private benefit plans cap this type of therapy at $500 a person per year. “These costs can really add up,” she says.
Nelson, B.C.-based civil servant Tina Evans discovered this two years ago when her son, now 7, then daughter, now 10, were diagnosed. She has shelled out thousands 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, as her kids continuously lose them. She recently paid $1,000 to address 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 out about how to manage ADHD-related 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 for a child who has ADHD is considered a medical expense,” Mr. Heath says. “It can be claimed as a tax expense.”
Private school tuition may also be covered as an eligible medical expense, although a doctor needs to attest to the specialized services the school can provide, he says. Therapy provided by a social worker or psychologist will also qualify. For older children, note-taking services in university can be claimed.
The Disability Tax Credit, which can provide $1,700 in support a year, is also an option, provided a doctor certifies the child is severely impaired. Mr. Heath concedes this amount is often insufficient. “I see parents who are spending that per month,” he says.
David Blascik, a Hamilton-based disability consultant, says if a child qualifies for the DTC, parents can set up a registered disability savings plan, which is similar to a pension plan for the disabled.
Under the Canada Disability Savings Grant, if family income is below $95,259, the government will match each $1 contributed to the RDSP with up to $3. For those who make under $32,028, the government will also put in $1,000 each year for 20 years as part of the Canada Disability Savings Bond.
Mr. Blascik says that he often advises families to roll over a registered education savings plan into RDSPs, capitalizing on government grants on both fronts. “You’re getting government money all the way,” he says.
For Ms. Low, she’s encouraged by her children’s improvement in symptoms. And she’s prepared to spend more getting them future help. “This eats into my life,” she says. “But these kids deserve help.”
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