The prevalence of Attention-Deficit/Hyperactivity Disorder (ADHD) among children in the United States has seen a significant rise, with one in nine children now diagnosed with the condition. According to a new report from the Centers for Disease Control and Prevention (CDC), 7.1 million children and adolescents aged 3 to 17 were diagnosed with ADHD in 2022, marking an increase of one million diagnoses since 2016.
Melissa Danielson, a statistician with the CDC's National Center on Birth Defects and Developmental Disabilities and the lead author of the study, attributes the surge in part to the heightened stress and anxiety experienced by children during the COVID-19 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 explains.
The report, published in the Journal of Clinical Child & Adolescent Psychology, utilized data from the National Survey of Children's Health, which collects comprehensive information from parents. The findings underscore the growing awareness of ADHD and the various ways it can manifest, particularly among girls. Historically, boys have been diagnosed with ADHD at more than twice the rate of girls. However, this gap is narrowing as more girls are being identified with inattentive types of ADHD, characterized by daydreaming and lack of focus rather than hyperactive behaviors.
Despite the increase in diagnoses, treatment rates appear to be lagging. The report indicates that only about half of the diagnosed children were receiving medication for ADHD in 2022, compared to two-thirds in 2016. This decline in medication use could be related to ongoing shortages of ADHD medications that began around the time the data was collected.
Dr. Max Wiznitzer, a professor of pediatric neurology at Case Western Reserve University, suggests that some parents may be hesitant to medicate their children due to misconceptions about addiction. "There's the myth that it's addictive, which it's not," he asserts, noting that studies have shown no increased risk of drug abuse among individuals treated for ADHD. Wiznitzer emphasizes the importance of medication in managing symptoms of impulsivity, overactivity, and inattention, but also stresses the need for behavioral therapy to teach children and their parents strategies to cope with the condition.
The study also highlights that nearly 78% of children diagnosed with ADHD had at least one other co-occurring disorder, such as anxiety, behavioral or conduct problems, or developmental delays. These comorbid conditions can complicate the management of ADHD and underscore the need for comprehensive treatment approaches.
ADHD, if left untreated, can lead to significant health risks in adulthood, including higher rates of depression, anxiety, substance abuse, and serious health concerns such as diabetes and heart disease. Dr. Wiznitzer points out that increased awareness and diagnosis are crucial for early intervention and management of these risks.
The pandemic's impact on children's mental health has likely played a role in the rising ADHD diagnoses. Virtual schooling during lockdowns may have made issues of inattention or hyperactivity more apparent to parents, prompting more evaluations and subsequent diagnoses. However, the pandemic also disrupted access to treatment, particularly behavioral therapies often provided through schools.
Scott Krakower, a child psychiatrist at Northwell Health in New York, who was not involved in the study, echoes the sentiment that the increase in diagnoses is not entirely surprising. "By and large, childhood ADHD has hovered around 10 percent for years," he says, attributing the recent rise to both increased awareness and the unique circumstances of the pandemic.
The report's findings call for a balanced approach to ADHD treatment, combining medication with behavioral therapy. Parents seeking treatment for their children are advised to consult their pediatricians and explore resources provided by organizations such as CHADD (Children and Adults with ADHD), where experts like Dr. Wiznitzer serve on the advisory board.
