1 in 10 US kids has ADHD, study finds

Increase in diagnoses due to more awareness, rise of cases in minority and poor children

Nearly one in 10 children in the United States is being diagnosed with attention deficit hyperactivity disorder, according to a new government study.

That’s an increase of more than 2 percent in ADHD diagnoses compared to a decade ago, researchers from the Centers for Disease Control and Prevention reported today.

The new findings don’t necessarily mean that more kids are developing ADHD, said the study’s lead author Dr. Lara Akinbami, a medical officer at the CDC’s National Center for Health Statistics.

“This change is reflected in numerous national data sets,” Akinbami explained. “It’s robust and real. But we can’t say whether it’s a true increase in prevalence or just better detection.”

For her part, Akinbami suspects that health professionals and parents are just more tuned in to the diagnosis. “It probably indicates that children have a better opportunity to get diagnosed now, rather than a huge change in the numbers of children with ADHD,” she said.

The new data are from a national survey that included approximately 40,000 households per year, Akinbami explained. From that survey, researchers collected information on 8,000 to 12,000 children each year in a nationally representative sample.

Akinbami and her colleagues found that ADHD diagnoses rose almost equally in boys and girls between 1998 and 2009. Diagnoses in girls climbed from 3.6 percent to 5.5 percent, as compared to 9.9 percent to 12.3 percent in boys.

The biggest surprise for Akinbami and her colleagues was the rise in diagnoses in minority and poor children, who, with the exception of Mexican children, have more than caught up with the rest of the population.

One finding that has the researchers puzzled is the continued low rate of ADHD in the Western states, where the diagnosis has ranged from 5.4 percent to 5.8 percent over the last decade.

“I really don’t know quite what to make of it,” Akinbami said. “It does match trends for several other chronic conditions which have lower prevalence in the west. Also, it may be related to a greater proportion of children being made up of Mexican children who have lower prevalence rates.”

An ADHD expert, Dr. Bradley Peterson, agreed that the new findings most likely indicate an increase in diagnosis rather than an increase in the actual occurrence of the disorder.

“A lot of things will affect diagnosis,” said Peterson, chief of child psychiatry at New York-Presbyterian/Columbia Medical Center. “That can be anything from an increasing awareness of the condition to increasing access to health care – doctors can’t diagnose a child with ADHD if the child doesn’t get to see the doctor.”

Still, Peterson said, other studies that have rigorously examined the issue have determined that the actual prevalence of ADHD is somewhere between 3 to 5 percent.

So why are we seeing such large numbers of children diagnosed?

Some of the increase may also be due to our changing expectations for children’s behavior, Peterson said.

“We are increasingly more academically, cerebrally, and intellectually focused than we were two, three, five decades ago,” he explained. “And our requirements for kids to do well in school – having to sit still, stay focused, and attuned – have changed over time. I think the tolerance and threshold for saying a particular child is too fidgety, too distracted, has likely changed over time, too.”

So, today we may be seeing kids with milder symptoms getting a diagnosis they wouldn’t have received ten years ago, Peterson said. And, there may be some children being diagnosed with ADHD who have another issue and don’t actually have the disorder.

Ultimately, Peterson said, treatment for ADHD will help even those with milder symptoms. And the medications “have a good margin of safety,” he said. “So they are unlikely to do a great deal of harm if they are given for an incorrect diagnosis.”