Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopment disorders among children.
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About 1 in 9 children in the U.S., between the ages of 3 and 17, have been diagnosed with ADHD. That's according to a new report from the Centers for Disease Control and Prevention that calls attention-deficit/hyperactivity disorder an "expanding public health concern."
Researchers found that in 2022, 7.1 million kids and adolescents in the U.S. had received an ADHD diagnosis – a million more children than in 2016. That jump in diagnoses was not surprising, given that the data was collected during the pandemic, says Melissa Danielson, a statistician with the CDC's National Center on Birth Defects and Developmental Disabilities and the study's lead author.
She notes that other studies have found that many children experienced heightened stress, depression and anxiety during the pandemic. "A lot of those diagnoses... might have been the result of a child being assessed for a different diagnosis, something like anxiety or depression, and their clinician identifying that the child also had ADHD," Danielson says.
The increase in diagnoses also comes amid growing awareness of ADHD — and the different ways that it can manifest in children. Danielson says that may help explain why girls are becoming more commonly diagnosed with ADHD compared to boys than they had been in the past. She says boys have long been diagnosed with ADHD at around two and half times the rate of girls, but the new reports finds that difference is narrowing.
Decades ago, ADHD was thought of as a disorder of hyperactivity among boys, Danielson says. "Boys will often have hyperactive or impulsive ADHD, where they'll run into the street or jump off things or do things that might make them more likely to be injured," she says.
“Girls tend to manifest their ADHD in a more inattentive way. They’ll be daydreaming or have a lack of focus or be hyper-focused on a particular task that maybe is not the task that they need to be focused on,” says Danielson.
The study, which appears in the Journal of Clinical Child & Adolescent Psychology, was based on data from the National Survey of Children's Health, which gathers detailed information from parents.
While the report found that the number of kids diagnosed with ADHD had risen since 2016, only about half of them were taking medication to treat the condition — compared with two-thirds of children back in 2016. The data didn’t look into reasons why this might be, but Danielson notes that reports of shortages of ADHD medications began around the time the data was collected.
Dr. Max Wiznitzer, a professor of pediatric neurology at Case Western Reserve University, says he suspects some parents may be reluctant to put their kids on ADHD medication out of misguided concerns. "There's the myth that it's addictive, which it's not." He says studies have shown people treated with ADHD have no increased risk of drug abuse.
Wiznitzer says medication is important because it can help kids focus by controlling symptoms of impulsivity, overactivity and inattention. But ADHD treatment also requires therapy that can teach children — and their parents — behavioral and educational strategies to manage their condition. "It's always a two-pronged approach," he says. He finds it troubling that the report found less than half of kids and adolescents diagnosed with ADHD were getting any behavioral therapy.
The report also found that nearly 78% percent of children diagnosed with ADHD had at least one other diagnosed disorder. The most common were behavioral or conduct problems, anxiety and developmental delays. Autism and depression were also frequently observed, Danielson says.
Kids with ADHD are at increased risk for other conditions including depression, anxiety and substance abuse and if left untreated, ADHD can raise the risk of serious health concerns in adulthood. This includes a higher risk of diabetes, heart disease and shortened life span, Wiznitzer says — which is why increased awareness and diagnosis is important.
Danielson says parents can also find information on treatment and services at CHADD — Children And Adults with ADHD, a non-profit resources organization where Wiznitzer serves on the advisory board.
He says parents seeking treatment for their kids should start with a conversation with their pediatrician.
This story was edited by Jane Greenhalgh.
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