11 Percent of Children Diagnosed with ADHDby Eileen Bailey Health Writer
In the United States, 11 percent of school-aged children have been diagnosed with ADHD and that number rises to 20 percent when limited to high school boys. New data released by the Centers for Disease Control show that the number of children diagnosed with ADHD has more than doubled over the past 10 years. The data also showed that 2/3s of children diagnosed with ADHD were being treated with medications to help symptoms, such as Ritalin or Adderall.
This information has raised serious concerns about over-diagnosing and over-medicating young and adolescents kids. And while these issues need to be addressed, the numbers may not tell the whole story.
According to an article, "Understanding the Rise in ADHD Diagnoses: 11% of U.S. Children are Affected" in Time Magazine, "...the information on ADHD rates came from parents reporting on the diagnosis for their children during telephone interviews. Such reports are useful but not as reliable as the verified diagnoses from medical or school records."  If you look at the data from these types of records, the article states, overall rates for ADHD are between 7.5 and 9.5 percent, with boys being in the higher range.
A complete evaluation and assessment for ADHD should include reports from parents and teachers or other caregivers describing hyperactive, impulsive and inattention behaviors and how the child reacts in different situations. Some doctors recommend complete physical examinations to rule out any other causes of these behaviors before determining that the child may have ADHD. The doctor should then review all of the information, including how disruptive these behaviors are on the child's daily life.
Unfortunately, doctors may forego a long evaluation such as this because of time constraints or because insurance companies aren't willing to pay for an extended evaluation. When this happens, doctors diagnose based on parent's reporting of symptoms. This can cause misdiagnosis - both over and under. In some cases, doctors may be quick to diagnose and medicate a child but in some areas, such as rural areas, mental health services may be more difficult to find and ADHD may go undiagnosed. According to the survey, those in both rural and urban areas had a lower rate of ADHD than in affluent neighborhoods.
The rise in the number of diagnoses has some critics of the new DSM worried. They believe the new criteria will make it even easier for children to be diagnosed with the disorder. While the final wording hasn't yet been released to the public, the New York Times reports that the proposed changes include symptoms appearing before the age of 12 (as opposed to the current - before the age of 7) and symptoms must "impact" a child's daily life (as opposed to "cause impairment").  Because of the stigma and fear surrounding a diagnosis of ADHD in the past, doctors and advocacy groups have battled to educate the public on ADHD and the risks of undiagnosed ADHD. But is it possible that we have reversed the trend and where once underdiagnosis was a problem, overdiagnosis is now?
Just as with over-diagnosis, some medical professionals are concerned with how often medications are used as a first-line of treatment for ADHD. The American Academy of Pediatricians recommends that children under the age of 6 start with behavioral interventions before being given any medications. But this requires close monitoring and more trips to doctors and therapists. Again, time constraints and insurance payments may interfere with this type of approach. Thomas Power, director of the center for management of ADHD at Children's Hospital of Philadelphia tells Time Magazine, "WHen I talk to pediatricians and primary-care physicians, they tell me they don't want to be diagnosing ADHD as often as they are, and they don't want to be using medications as often as they are, but they don't have many other options available." 
Treatment for ADHD isn't a one-size fits all approach. Each child (or adult) with ADHD needs to have a customized approach to managing and treating symptoms. A combination of behavioral interventions, school interventions, parent training and if needed, medications works best. But the combination may be different based on the severity of the symptoms, the age of the child and the type of symptoms. Parents must work closely with medical providers and schools to come up with the best plan for their child.
"ADHD Diagnosis Rates Rise to 11% of U.S. Children: Is Attention Deficit Disorder Being Misdiagnosed?" 2013, April 1, Roxanne Palmer, International Business TImes
 "A.D.H.D. Seen in 11% of U.S. Children as Diagnoses Rise," 2013, March 31, Alan Schwarz and Sarah Cohen, The New York Times
  "Understanding the Rise in ADHD Diagnoses: 11 % of U.S. Children are Affected," 2013, April 2, Alice Park, Time Magazine