A new study from the CDC is bound to raise more questions than it answers:
More than one in 10 children and adolescents are diagnosed with attention-deficit/hyperactivity disorder (ADHD), an increase of 42 percent in less than a decade, according to a study published online Nov. 25 in the Journal of the American Academy of Child & Adolescent Psychiatry.
This is an extensive, nationwide study, and the results seem shocking. In 2011, researchers found that 11% of children and adolescents in the United States had at one time received a diagnosis of ADHD and 9% had the diagnosis of ADHD currently (in 2011). Of those children and teens with a current diagnosis of ADHD, 69% were taking medication for it. The study reveals even more stunning details:
From 2003 to 2011, a parent-reported history of ADHD increased by 42 percent. Based on 2007 estimates, the prevalence of a history of ADHD, current ADHD, medicated ADHD, and moderate/severe ADHD increased significantly in 2011. From 2007 to 2011, the prevalence of medicated ADHD increased by 28 percent.
“Efforts to further understand ADHD diagnostic and treatment patterns are warranted,” Visser and colleagues conclude.
Boy, that’s an understatement.
Still, important questions remain. For example:
- Why do so many kids have a diagnosis of ADHD, and why are their numbers growing? Is there something in the diet, in the culture, or in the way we parent and teach them that is contributing to this increase? Are there toxic environmental factors at play?
- Why is ADHD more common in the United States than in other countries? (9% vs. 5.3% worldwide).
- Why is the prevalence of ADHD greater in the Midwest and South than in the rest of the country?
- Why are 31% of children and teens diagnosed with ADHD not being treated with medication? Does insurance coverage (or lack thereof) determine whether prescriptions are being filled? Does poverty play a role in the diagnosis and treatment of ADHD? Do parents and teachers find other strategies to improve focus and control the impulsiveness and hyperactivity that usually accompanies ADHD, making medication unnecessary? Are some parents and teachers just more tolerant of their child’s inattentiveness, hyperactivity, and impulsiveness, preferring behavioral modification techniques over medication?
Walkup, et al see a silver lining in these otherwise shocking statistics:
Although substantial increases in the rate of diagnosis and treatment of ADHD have occurred over the past decade, the CDC’s prevalence estimate of ADHD diagnosis is very close to the community-based prevalence of ADHD as ascertained in high-quality epidemiologic studies. Further, the rates of treated ADHD continue to be lower than the rate of ADHD diagnosis, suggesting a pattern of undertreatment of ADHD, not of overtreatment, as commonly thought. Reports of high and rising rates of psychiatric disorders and medication treatment always seem to draw public attention, but the issue is really not about rising rates but how close we are as a society to understanding the true prevalence of a condition and how well we identify those with the disorder and assuring that they have the opportunity to receive evidence-based treatment. With ADHD it appears that we are getting close—after more than 2 decades of advocacy—to identifying and treating a majority of children and adolescents with ADHD.
The emphasis above is mine. I’m not sure I share the optimism. If one in ten children and teenagers have ADHD, then that means 10% of students are not learning effectively in the classroom. That’s 10% (2-3 kids in a class of 25, for instance, plus another 2 who may have other learning disabilities) who are not able to focus on what the teacher is teaching and on their individual tasks; who require special attention from the teacher to control their hyperactivity and impulsivity; who require individual prompts to keep them attentive; and, who need extra help with organization (a skill which is almost uniformly lacking in children with ADHD). While I would argue that the needs of the 10% of students with ADHD do not affect the educational needs and experiences of the other 90% of students without the diagnosis, the point to be made is that children with ADHD have learning needs that are different. Trying to teach them the same way as the other 90% is like trying to bang a square peg into a round hole. As we see in children with learning disabilities, that method doesn’t work and, in fact, is often a disservice to those students.