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Why Are ADHD Rates Rising in Children?

ADHD cases have significantly increased in the U.S.

As of 2022, about 1 in 9 children had been diagnosed with attention-deficit/hyperactivity disorder (ADHD) at some point in their lives, according to a study published Wednesday. Approximately 6.5 million children ages 3 to 17 had ADHD that year, up from 5.4 million in 2016.

The study’s lead author, Melissa Danielson, a statistician at the Centers for Disease Control and Prevention, identified two primary reasons for this trend. First, increased awareness among doctors, parents, teachers, and children has made ADHD symptoms easier to recognize. Second, the availability of more treatment options encourages doctors to diagnose and treat the disorder.

“There are more providers comfortable with making those diagnoses and treating ADHD, which can help children through medications, behavior therapy, or school services. More opportunities for assistance create an incentive for diagnosis,” she explained.

Danielson also suggested that increased screening could be a positive outcome, potentially due to the Covid-19 pandemic, which may have exacerbated ADHD symptoms or allowed parents more observation time with their children.

The study, published in the Journal of Clinical Child & Adolescent Psychology, was based on over 45,000 responses from the 2022 National Survey of Children’s Health. Mental health professionals who diagnose and treat ADHD affirmed that the data aligns with their experiences.

Dr. Willough Jenkins, a psychiatrist at Rady Children’s Hospital-San Diego, noted that doctors are better at recognizing ADHD in girls and older children. “Previously, ADHD was seen as a disorder affecting mainly young, hyperactive boys. This perception has changed significantly in recent years.”

ADHD is one of the most commonly diagnosed neurodevelopmental disorders in children and teenagers. Cases have been rising for several decades as awareness has increased. The disorder is often characterized by difficulty concentrating, sitting still, or exercising self-control.

Danielson mentioned that younger children with ADHD tend to be more hyperactive or impulsive, while in adolescence, the disorder shifts more towards inattention, such as daydreaming, hyperfocusing, or struggling to complete tasks.

Other mental health experts agree that the pandemic likely accelerated ADHD diagnoses. Thomas Power, director of the Center for Management of ADHD at Children’s Hospital of Philadelphia, pointed to the stress of remote learning, social isolation, family health concerns, and disrupted routines as factors that could worsen symptoms.

Yamalis Diaz, a child and adolescent psychologist at NYU Langone’s Child Study Center, added that parents spent more time at home, giving them prolonged observation periods of their children’s struggles with focus and academic work.

However, Jenkins noted a potential rise in misdiagnoses during the pandemic due to increased rates of depression and anxiety, which share overlapping symptoms with ADHD.

Discussions of ADHD on social media also rose during the pandemic, possibly leading some older children to self-diagnose, according to Danielson. While excessive screen time has been shown to increase the risk of ADHD, it is considered a lesser factor in the trend.

Jenkins also highlighted the impact of changes in diagnostic guidelines from the American Psychiatric Association. Since 2013, children can be diagnosed with both autism and ADHD, and the age requirement for symptom onset has been extended from before age 7 to before age 12.

Diaz emphasized that expanding the diagnostic criteria has likely helped more children access treatment. “The goal of the diagnosis is to identify challenges that can be addressed and corrected.”

Despite this, 30% of children with ADHD in 2022 did not receive behavior therapy or medication, compared to 23% in 2016. Danielson noted that virtual learning during the pandemic might have cut off access to school-based behavior therapy, and the FDA reported a shortage of ADHD medications starting in 2022, partly due to high demand from rising diagnoses.

Diaz mentioned that finding appointments with ADHD specialists remains challenging. “Even in places with abundant treatment options, like New York City, there are waiting lists everywhere. It’s possible that parents wanted or tried to get treatment but couldn’t access it.”

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