Study: Nearly 1 in 10 U.S. kids diagnosed with ADHD
Over the last decade, an increasing
number of American children have been diagnosed with attention-deficit
hyperactivity disorder (ADHD), a new government survey reveals.
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Researchers
from the U.S. Centers for Disease Control and Prevention found that
between 2007 and 2009, an average of 9 percent of children between the
ages of 5 and 17 were diagnosed with the disorder. This compared with
just under 7 percent between 1998 and 2000.
The
survey also indicated that previously notable racial differences in
ADHD incidence rates have narrowed considerably since the turn of the
millennium, with prevalence now comparable among whites, blacks and some
Hispanic groups.
"We don't have the data to
say for certain what explains these patterns, but I would caution
against concluding that what we have here is a real increase in the
occurrence of this condition," stressed study author Dr. Lara J.
Akinbami, a medical officer with the National Center for Health
Statistics. The findings appear in an Aug. 18 report from the agency.
"In
fact, it would be hard for me to argue that what we see here is a true
change in prevalence," Akinbami added. "Instead, I would say that most
probably what we found has a lot to do with better access to health care
among a broader group of children, and doctors who have become more and
more familiar with this condition and now have better tools to screen
for it. So, this is probably about better screening, rather than a real
increase, and that means we may continue to see this pattern unfold."
According to the National Institutes of Health, ADHD is the most common behavioral disorder among children.
Children
with ADHD are apt to have problems staying focused, and often suffer
learning and behavioral problems as a result of a tendency to engage in
hyperactive and/or impulsive behaviors.
The new survey was conducted by interviewers from the U.S. Census Bureau
through face-to-face and telephone interviews involving a nationally
representative group of parents. Basic family demographic information
was collected, along with the ADHD status of each household's children.
Although
rates rose among both boys and girls, a greater percentage of boys were
diagnosed with ADHD overall, rising from roughly 10 percent in
1998-2000 to more than 12 percent between 2007 and 2009. Across the same
time frame, the prevalence rate among girls rose from just below 4
percent to between 5 percent and 6 percent.
One
group, however, appeared to buck the trend: Mexican children. This
group consistently registered the lowest ADHD prevalence rate, both in
1998-2000 as well as a decade later in 2007-2009. Akinbami said the
reason for this remains unclear, although she suggested that less access
to health care and/or particular cultural proclivities might contribute
to fewer diagnoses overall.
In addition to the principal findings, the authors were also able to track both financial and geographical trends.
For
example, ADHD prevalence hit above-average levels among two groups:
households where the family income was below the poverty line (10
percent) and households where income fell somewhere between the poverty
line and double the poverty line (11 percent).
Location
also seemed to play a role, as the current prevalence rate among those
living in both the Midwest and the southern part of the country shared
an above-average prevalence rate of 10 percent. This was a shift from 10
years earlier, when the South had a higher prevalence rate than all
other regions.
"Even if we're not exactly
clear on what accounts for the rise in ADHD, on a population level the
increase of this condition really signals a challenge for the education
system and the health care system," said Akinbami.
"Children
of ADHD," she noted, "use a lot more health care dollars than their
peers, because the condition itself requires a lot of monitoring. And
they are also much more likely to have other chronic health care
conditions, such as asthma or learning disabilities or conduct diagnoses
like conduct disorder, which makes managing them for schools and
physicians and parents much more difficult. So, it's clearly something
for public policy experts to be concerned about."
Dr. Tanya Froehlich, a developmental and behavioral pediatric specialist at the Cincinnati Children's Hospital Medical Center, said discerning what is driving the higher numbers will be difficult.
"There's
no way to tell just based on this data," she said. "But we know that
there has been a great emphasis over the last 10 years on raising doctor
awareness of ADHD and giving them better tools to diagnose."
"For instance," Froehlich noted, "in 2001 the American Academy of Pediatrics
put out clinical practice guidelines on the assessment and treatment of
children with ADHD. And a tool kit was also put out giving physicians
actual measures to use to assess ADHD. All of this has really empowered
physicians and parents. So given that, I would not really be surprised
if that's why more and more kids have been diagnosed."
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