August 18, 2011
Lara Akinbami, is a board-certified pediatrician and conducts epidemiologic research on child health and chronic conditions, and focuses on childhood asthma.
About the topic
Nearly one in 10 U.S. children is being diagnosed with attention deficit hyperactivity disorder (ADHD), according to a new analysis of federal data released Thursday. Dr. Lara Akinbami, one of the researches who worked on the analysis, will answer reader questions about the study and what they found, including how ADHD affects children by age, race, gender, location and more.
Ask your question now!
Lara Akinbami :
Good afternoon--I'm happy to answer questions about the data from CDC on Attention Deficit Hyperactivity Disorder in kids.
–
Q.
ADHD
My husband has ADHD. My son is 4 and has some symptoms of ADHD. Is he pre-destined for it?
–
August 18, 2011 1:42 PM
Permalink
A.
Lara Akinbami :
ADHD certainly does run in families, but that doesn't necessarily mean your son is predestined to have ADHD. We don't fully understand what causes ADHD or know how to prevent it. The signs and symptoms usually appear before age 7 and can be related to either inattention (distracted easily, being forgetful), or the hyperactivity and impulsivity (being "driven by a motor" or not waiting your turn to talk or play). An official diagnosis often isn't made until children are in school because more symptoms may become apparent when children are required to perform tasks in which they may not necessarily be interested or find fun. I would ask your son's doctor more about the diagnosis process, but don't be surprised if they advise you to wait and see how he grows and develops. Try not to worry and just enjoy his childhood!
– August 18, 2011 2:04 PM
Q.
Research
How did you conduct the research? What steps were taken to come to these conclusions?
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August 18, 2011 2:00 PM
Permalink
A.
Lara Akinbami :
The data that show that ADHD has been increasing over the past decade come from the National Health Interview Survey that is administered by the National Center for Health Statistics (part of the Centers for Disease Control and Prevention). Each year, about 40,000 households undergo face-to-face interviews with detailed health questions. Depending on the year, about 8,000 to 12,000 children ages 0-17 are included to represent the total population of children in the United States. The ADHD data are based on a parent reporting for these sampled children that they had received a diagnosis of ADHD from a doctor or other health professional at some point in the past. We then assess trends in the percent of children diagnosed with ADHD by race and ethnicity, by income, and by geographic region.
– August 18, 2011 2:07 PM
Q.
Nutrition?
Would you say that nutrition ( or lack thereof) is a major contributor to ADHD in children from low-income areas?
–
August 18, 2011 1:46 PM
Permalink
A.
Lara Akinbami :
I wish we had the information to answer that great question. There are many factors that likely come into play. But at present, we do not know which factors determine who gets ADHD, how to predict who will get ADHD, or to prevent it from occuring. There is effective treatment once a child is diagnosed.
The increased prevalence of ADHD in low income children over the past decade is very interesting. We think it has to do primarily with better opportunities among this population to get diagnosed through increased access to healthcare and increased recognition of the condition by parents, teachers, and doctors.
– August 18, 2011 2:10 PM
Q.
What do we know about diagnosis and race?
I wonder what we know about rates of diagnosis in racial groups and, not unrelated, what we know about diagnosis and family income?
–
August 18, 2011 2:07 PM
Permalink
A.
Lara Akinbami :
The patterns of ADHD prevalence by race and family income over the past decade are interesting. At the beginning of the decade, non-Hispanic white children had higher ADHD prevalence than other race groups. By the end of the decade, non-Hispanic black children and Puerto Rican children had caught up to non-Hispanic white children so that they all had about 10% prevalence of ADHD. Mexican children, however, had lower ADHD prevalence throughout the decade and had about 4% ADHD prevalence at the end of the decade. We don't have the data from the National Health Interview Survey to understand exactly why these difference exist or why the patterns have changed over the past decade, but as said above, it may have to do a lot with the opportunities of different groups to obtain a diagnosis. The diagnosis actually takes many steps and requires continued evaluation. Ideally, a family will have a sustained relationship with the health care provider guiding through the process.
For income, the pattern also changed through the decade where all income groups had similar prevalence at the beginning of the decade, but prevalence rose steadily for low income children. At the end of the decade, children with family income below 200% of the federal poverty level had higher prevalence of ADHD compared with children with family income above 200% of the poverty level. Again, this may be due to changing access to healthcare, or better recognition of the condition among low income children.
– August 18, 2011 2:20 PM
Q.
ADHD Girls
My daughter was diagnosed iwth ADHD in the second grade (after spending most of the first grade in the hall). After trying a modified diet and behavioural therapy we finally agreed to drug therapy which has been moderately successful. What is the prevalence of ADHD in girls and what are the long-term outcomes for girls as a group diagnosed with ADHD.
–
August 18, 2011 2:28 PM
Permalink
A.
Lara Akinbami :
Oh, sorry about all the hallway time! The prevalence in girls (5.5%) is lower than in boys (12.3%), and this has been consistent over time--prevalence in boys and girls has grown over the past decade at about the same rate.
Girls are more likely to have the inattentive symptoms rather than the hyperactive symptoms, but it varies from individual to individual. And while the prognosis for children with ADHD is lower academic achievement and socialization problems, this varies from person to person. The noteworthy risk is higher incidence of automobile accidents as teenagers. It is great that you have already started with behavioral therapy. Coping skills in staying organized and establishing a routine are wonderful tools to help your daughter successfully navigate her way. And your staying engaged in her childhood to help her make good choices will also be key. And don't be shy about helping her become a safe driver:)
– August 18, 2011 2:45 PM
Q.
Birth Control Connection?
Probably 100% of our woman took birth control pills one time or another. Has there ever been a connection let alone a long term study to connect the pill to our children's chronic ailments?
–
August 18, 2011 2:44 PM
Permalink
A.
Lara Akinbami :
I am not aware of any theories or studies linking contraception to ADHD or other chronic conditions.
– August 18, 2011 2:54 PM
Q.
US percentages compared with European percentages
I am curious what the percentage of European children diagnosed with ADD and ADHD is. Do you have this data? I have brought 2 children up in New York with one being diagnosed when he was about 6. He is now 16 and living in Europe and doctors there say he is a perfectly normal child. Is there a case of over diagnosis in the US?
–
August 18, 2011 2:55 PM
Permalink
A.
Lara Akinbami :
I don't have a recent estimate of ADHD in European countries, but there have been studies in the past that suggest that on a population level, the prevalence of ADHD in other countries is similar to that in the US.
I can't really comment on the 16 year old living in Europe, except to suggest that perhaps he has learned to cope with the symptoms and could look a lot different than when he was 6 years old. Also, in some people, the symptoms do seem to abate with age. Or perhaps he is eating some wonderful Belgium chocolate. That cures all ills...
OK, enough of chocolate reverie--I don't have the data to be able to comment on whether ADHD is over-diagnosed in the US. But I will say that the established diagnostic criteria is specific, it requires the symptoms to be present at a young age, that the symptoms be persistent for at least 6 months, and that the symptoms be present in multiple settings. It shouldn't be a diagnosis made at one point in time, but after some in-depth assessment.
In sum, you may have a good idea for some additional research.
– August 18, 2011 3:07 PM
Q.
Diagnostic process changing?
What I find fascinating about the increase in diagnosis in low-income children,
Lara Akinbami, is a board-certified pediatrician and conducts epidemiologic research on child health and chronic conditions, and focuses on childhood asthma.
About the topic
Nearly one in 10 U.S. children is being diagnosed with attention deficit hyperactivity disorder (ADHD), according to a new analysis of federal data released Thursday. Dr. Lara Akinbami, one of the researches who worked on the analysis, will answer reader questions about the study and what they found, including how ADHD affects children by age, race, gender, location and more.
Ask your question now!
Lara Akinbami :
Good afternoon--I'm happy to answer questions about the data from CDC on Attention Deficit Hyperactivity Disorder in kids.
–
Q.
ADHD
My husband has ADHD. My son is 4 and has some symptoms of ADHD. Is he pre-destined for it?
–
August 18, 2011 1:42 PM
Permalink
A.
Lara Akinbami :
ADHD certainly does run in families, but that doesn't necessarily mean your son is predestined to have ADHD. We don't fully understand what causes ADHD or know how to prevent it. The signs and symptoms usually appear before age 7 and can be related to either inattention (distracted easily, being forgetful), or the hyperactivity and impulsivity (being "driven by a motor" or not waiting your turn to talk or play). An official diagnosis often isn't made until children are in school because more symptoms may become apparent when children are required to perform tasks in which they may not necessarily be interested or find fun. I would ask your son's doctor more about the diagnosis process, but don't be surprised if they advise you to wait and see how he grows and develops. Try not to worry and just enjoy his childhood!
– August 18, 2011 2:04 PM
Q.
Research
How did you conduct the research? What steps were taken to come to these conclusions?
–
August 18, 2011 2:00 PM
Permalink
A.
Lara Akinbami :
The data that show that ADHD has been increasing over the past decade come from the National Health Interview Survey that is administered by the National Center for Health Statistics (part of the Centers for Disease Control and Prevention). Each year, about 40,000 households undergo face-to-face interviews with detailed health questions. Depending on the year, about 8,000 to 12,000 children ages 0-17 are included to represent the total population of children in the United States. The ADHD data are based on a parent reporting for these sampled children that they had received a diagnosis of ADHD from a doctor or other health professional at some point in the past. We then assess trends in the percent of children diagnosed with ADHD by race and ethnicity, by income, and by geographic region.
– August 18, 2011 2:07 PM
Q.
Nutrition?
Would you say that nutrition ( or lack thereof) is a major contributor to ADHD in children from low-income areas?
–
August 18, 2011 1:46 PM
Permalink
A.
Lara Akinbami :
I wish we had the information to answer that great question. There are many factors that likely come into play. But at present, we do not know which factors determine who gets ADHD, how to predict who will get ADHD, or to prevent it from occuring. There is effective treatment once a child is diagnosed.
The increased prevalence of ADHD in low income children over the past decade is very interesting. We think it has to do primarily with better opportunities among this population to get diagnosed through increased access to healthcare and increased recognition of the condition by parents, teachers, and doctors.
– August 18, 2011 2:10 PM
Q.
What do we know about diagnosis and race?
I wonder what we know about rates of diagnosis in racial groups and, not unrelated, what we know about diagnosis and family income?
–
August 18, 2011 2:07 PM
Permalink
A.
Lara Akinbami :
The patterns of ADHD prevalence by race and family income over the past decade are interesting. At the beginning of the decade, non-Hispanic white children had higher ADHD prevalence than other race groups. By the end of the decade, non-Hispanic black children and Puerto Rican children had caught up to non-Hispanic white children so that they all had about 10% prevalence of ADHD. Mexican children, however, had lower ADHD prevalence throughout the decade and had about 4% ADHD prevalence at the end of the decade. We don't have the data from the National Health Interview Survey to understand exactly why these difference exist or why the patterns have changed over the past decade, but as said above, it may have to do a lot with the opportunities of different groups to obtain a diagnosis. The diagnosis actually takes many steps and requires continued evaluation. Ideally, a family will have a sustained relationship with the health care provider guiding through the process.
For income, the pattern also changed through the decade where all income groups had similar prevalence at the beginning of the decade, but prevalence rose steadily for low income children. At the end of the decade, children with family income below 200% of the federal poverty level had higher prevalence of ADHD compared with children with family income above 200% of the poverty level. Again, this may be due to changing access to healthcare, or better recognition of the condition among low income children.
– August 18, 2011 2:20 PM
Q.
ADHD Girls
My daughter was diagnosed iwth ADHD in the second grade (after spending most of the first grade in the hall). After trying a modified diet and behavioural therapy we finally agreed to drug therapy which has been moderately successful. What is the prevalence of ADHD in girls and what are the long-term outcomes for girls as a group diagnosed with ADHD.
–
August 18, 2011 2:28 PM
Permalink
A.
Lara Akinbami :
Oh, sorry about all the hallway time! The prevalence in girls (5.5%) is lower than in boys (12.3%), and this has been consistent over time--prevalence in boys and girls has grown over the past decade at about the same rate.
Girls are more likely to have the inattentive symptoms rather than the hyperactive symptoms, but it varies from individual to individual. And while the prognosis for children with ADHD is lower academic achievement and socialization problems, this varies from person to person. The noteworthy risk is higher incidence of automobile accidents as teenagers. It is great that you have already started with behavioral therapy. Coping skills in staying organized and establishing a routine are wonderful tools to help your daughter successfully navigate her way. And your staying engaged in her childhood to help her make good choices will also be key. And don't be shy about helping her become a safe driver:)
– August 18, 2011 2:45 PM
Q.
Birth Control Connection?
Probably 100% of our woman took birth control pills one time or another. Has there ever been a connection let alone a long term study to connect the pill to our children's chronic ailments?
–
August 18, 2011 2:44 PM
Permalink
A.
Lara Akinbami :
I am not aware of any theories or studies linking contraception to ADHD or other chronic conditions.
– August 18, 2011 2:54 PM
Q.
US percentages compared with European percentages
I am curious what the percentage of European children diagnosed with ADD and ADHD is. Do you have this data? I have brought 2 children up in New York with one being diagnosed when he was about 6. He is now 16 and living in Europe and doctors there say he is a perfectly normal child. Is there a case of over diagnosis in the US?
–
August 18, 2011 2:55 PM
Permalink
A.
Lara Akinbami :
I don't have a recent estimate of ADHD in European countries, but there have been studies in the past that suggest that on a population level, the prevalence of ADHD in other countries is similar to that in the US.
I can't really comment on the 16 year old living in Europe, except to suggest that perhaps he has learned to cope with the symptoms and could look a lot different than when he was 6 years old. Also, in some people, the symptoms do seem to abate with age. Or perhaps he is eating some wonderful Belgium chocolate. That cures all ills...
OK, enough of chocolate reverie--I don't have the data to be able to comment on whether ADHD is over-diagnosed in the US. But I will say that the established diagnostic criteria is specific, it requires the symptoms to be present at a young age, that the symptoms be persistent for at least 6 months, and that the symptoms be present in multiple settings. It shouldn't be a diagnosis made at one point in time, but after some in-depth assessment.
In sum, you may have a good idea for some additional research.
– August 18, 2011 3:07 PM
Q.
Diagnostic process changing?
What I find fascinating about the increase in diagnosis in low-income children,
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