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Ten percent of children diagnosed with ADHD

Dominika Osmolska Psy.D.'s picture

A new government study released today by the Centers for Disease Control and Prevention (CDC) indicates that 1 in 10 of the nation’s children suffers from attention deficit hyperactivity disorder (ADHD). That translates to a startling ten percent of the pediatric population. Although ADHD has been rumored to be overdiagnosed, the new statistics at least call for a renewed debate about the condition.

The new numbers represent an increase of more than 2 percent in ADHD diagnoses compared to a decade ago, researchers from the CDC said today. The study’s lead author Dr. Lara Akinbami, a medical officer at the CDC’s National Center for Health Statistics, was quick to point out that the findings don’t necessarily mean that more kids are developing ADHD. The increased statistical numbers are real, she says, and reflected in numerous national data sets. However, it is impossible to say if the increase is in prevalence or just better detection.

Akinbani feels that both educators and parents are more informed now than at any other time in the past, which leads them to seek help early. “It probably indicates that children have a better opportunity to get diagnosed now, rather than a huge change in the numbers of children with ADHD,” she said.

The new data are from a national survey that included approximately 40,000 households per year, Akinbami explained. From that survey, researchers collected information on 8,000 to 12,000 children each year in a nationally representative sample.

Akinbami and her colleagues found that ADHD diagnoses rose almost equally in boys and girls between 1998 and 2009. Diagnoses in girls climbed from 3.6 percent to 5.5 percent, as compared to 9.9 percent to 12.3 percent in boys. The researchers were also surprised to discover that minority children, excepting Mexican children, have almost caught up to white children in the numbers diagnosed with the disorder. And researchers are genuinely stumped to explain why Western states continue to report much lower rates – anywhere from 5.4 to 5.8 percent over the last decade.

“I really don’t know quite what to make of it,” Akinbami said. “It does match trends for several other chronic conditions which have lower prevalence in the west. Also, it may be related to a greater proportion of children being made up of Mexican children who have lower prevalence rates.”

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Dr. Bradley Peterson, an ADHD expert, agreed that the new findings most likely indicate an increase in diagnosis rather than an increase in the actual occurrence of the disorder. “A lot of things will affect diagnosis,” said Peterson, chief of child psychiatry at New York-Presbyterian/Columbia Medical Center. “That can be anything from an increasing awareness of the condition to increasing access to health care – doctors can’t diagnose a child with ADHD if the child doesn’t get to see the doctor.”

But Dr. Peterson adds something very important to the discussion – namely, he says, that the increase may also be due to our changing expectations for children’s behavior. “We are increasingly more academically, cerebrally, and intellectually focused than we were two, three, five decades ago,” he explained. “And our requirements for kids to do well in school – having to sit still, stay focused, and attuned – have changed over time. I think the tolerance and threshold for saying a particular child is too fidgety, too distracted, has likely changed over time, too.”

Double cheer for that observation, Dr. Peterson. Today’s children are increasingly being asked to leave their childhoods behind in order to purportedly prepare them better for the academics ahead. By trying to force a short-cut to academic success, we may be doing the children more harm than we realize.

You see, children need physical movement in order to develop intellectually down the line. Actually, physical movement continues to be an important adjunct to brain development throughout our lives. Just ask my former neuropsychology professor – he organized a sea kayaking club for his students as part of a regimen of neuropsychological health and maintenance. This medical health professional with decades worth of experience felt that the complex balancing and maneuvering involved in the hair-raising sport was the optimal foundational exercise for intellectual growth.

I wish he could sit parents and educators down across the country and tell them that.

Consider that ADHD is defined as a dysfunction in the executive control center of the brain, which is located in the frontal lobe. The frontal lobe of the brain, in turn, plays a key role in higher mental functions. It is concerned with the planning, initiation and control of physical movement. In other words, the practice of coordinated physical movement in the frontal lobe is a precursor and a pre-requisite to coordinated planning which we deem purely mental, such as attention and sustained focus. In reality, however, physical and mental coordination fall on a single continuum.

Unlike Dr. Peterson, however, I do not advocate the use of medication as a first line of defense, most especially in very young children, which are increasingly prescribed these psychoactive drugs. The brain of a child is still in the process of formation and we truly do not know the extent of the impact these drugs will have a decade or two down the line.

Image credit: Wikimedia Commons