ADHD Diagnoses Continues to Rise

Eileen Bailey Health Guide
  • Back in 1998, the National Institutes of Health estimated that between 3 and 5 percent of children had ADHD. Since that time, this number has risen significantly. The Centers for Disease Prevention and Control completes a children’s health survey with parents every four years. In 2003, parent’s responses indicated that 7.8 percent of children had been diagnosed with ADHD, in 2007 this number rose to 9.5 percent and in the most recent survey, it rose again, to 11 percent.

     

    This number, 11 percent, seems like a huge jump and is bound to bring up questions of whether ADHD is being overdiagnosed and overtreated. Are parents using ADHD as a catch-all condition for any behavior problems? Are parents rushing out to have their child diagnosed and given medication to help them calm down and behave? Critics are sure to think so. Others believe that we are finally coming close to the true prevalence rate.

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    Results of the Survey

     

    Between February 2011 and June 2012, over 95,000 phone interviews were completed. The surveys were on a variety of health topics but included questions about the diagnosis and treatment of ADHD. According to the data collected:

    • 11 percent of children between the ages of 4 and 17 years old have been diagnosed with ADHD at some point
    • 8.8 percent of children are currently diagnosed with ADHD
    • 6.1 percent are currently taking medication for ADHD

    These numbers show a 42 percent increase in the number of diagnoses and a 28 percent increase in the number of children taking medication since 2003.

     

    One Side of the Argument

     

    It is certainly a large increase. Dr. Allen Frances, former chairman of the psychiatry department at Duke University told CNN, “The numbers shouldn’t be taken at face value. The history of psychiatry is a history of fads, and we are now suffering from a fad of ADHD.” [1] Frances believes pressure from the pharmaceutical companies selling stimulant medications is driving up the number of diagnoses.

     

    Another concern is that doctors are medicating normal childhood behavior. Susanna Visser, lead author of the study points out that more than half of the diagnoses were made before the age of 6. “A lot of symptoms of ADHD, like hyperactivity, can also be appropriate developmental markers of age. You have to see a more ‘wait and see’ approach. Can they better be attributed to other things: sleep, divorce, trauma? A lot of things can look like ADHD, and once those symptoms aren’t appropriate for a child’s age, then we need to get treatment,” Visser told CNN. [2]

     

    The Other Side

     

    It is easy to jump to conclusions and assume that the number of diagnoses are rising because parents and doctors quickly diagnose ADHD without looking further. But that isn’t always the case. Dr. John Walkup wrote and editorial about the study in the same journal the results were published (Walkup was not associated with the survey).

     

    Walkup points out that as early as 1998 studies suggested that as many as 12 percent of children had ADHD. And, more recent studies place the prevalence rate at between 9 and 11 percent. That means the numbers from the survey are not necessarily higher than previously thought, they are in line with studies dating back 15 years.

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    The discrepancy between those who had been diagnosed at some time – 11 percent – and those currently diagnosed – 8.8 percent also tells us something. According to Walkup, “There seems to be some pruning…because children and teens no longer meet the criteria or perhaps because the initial impression of ADHD was incorrect.” [3] Out of the children currently diagnosed with ADHD, however, only 70 percent are taking medication. This, according to Walkup, shows “a pattern of undertreatment.” [4]

     

    Even the rise in the number of children diagnosed can be explained, according to Walkup. A increase in the number of primary doctors who are better qualified to identify and treat ADHD means more children are diagnosed. Different organizations, such as CHADD, have also spent years on outreach programs, educating parents about ADHD and treatments. These efforts are paying off, ADHD does not have the same stigma it did 10 or 20 years ago. Parents are not scared of a diagnosis and are more aware of what ADHD is, what the symptoms are and how treatment can help their child.

     

    References:

     

    [1] [2] “ADHD Diagnoses Rise to 11% of Kids.” 2012, Nov. 22, Nadia Kounang, CNN

     

    “Attention-Deficit/Hyperactivity Disorder: Data & Statistics,” Updated 2013, Nov. 13, Centers for Disease Control and Prevention

     

    [3] [4] “Beyond Rising Rates: Personalized Medicine and Public Health Approaches to the Diagnosis and Treatment of Attention Deficit/Hyperactivity Disorder,” 2013, Nov 25, John Walkup, Lauren Stossel, Rebecca Rendleman, Journal of the American Academy of Child and Adolescent Psychiatry

Published On: December 02, 2013