It was the headline of the week: Rates of attention deficit-hyperactivity disorder (ADHD) in children are skyrocketing. This data, from a Centers for Disease Control and Prevention (CDC) report, said 11 percent of children aged four to 17 have the disorder, a 16 percent jump since 2007 and a 53 percent rise over the last decade. The most dramatic increase was among high school boys; one in five are said to have ADHD, which is characterized by an inability to pay attention for extended time periods, impulsive behavior, hyperactivity and difficulties forming relationships.
Another study of nearly 850,000 5-to-11-year olds found that African-American children are diagnosed with ADHD at much higher rates than children of other races and ethnicities.
What’s almost as troubling as these diagnosis statistics? About two-thirds of the children diagnosed with ADHD are being treated with stimulants such as Adderall, Concerta or Ritalin, which come with significant side effects, including addiction, anxiety, suppressed growth and serious weight loss.
Experts caution that these numbers may need closer study. The CDC data was collected via phone interviews with parents, not from more reliable medical or school records.
“We think the numbers are not growing,” said Rahn K. Bailey, M.D., chair of the department of psychiatry at Wake Forest in North Carolina. “They’re [holding steady] at about 5 percent. The numbers aren’t substantially different in boys and girls. They’re not substantially greater in blacks.”
This discrepancy highlights a problem: If the numbers in this new report are wrong, a significant chunk of children are being misdiagnosed. This misdiagnosis could lead to improper treatment with dangerous medications.
An appropriate diagnosis (the American Academy of Pediatrics updated its guidelines) should include evaluation from a physician and input from the child’s parents and teachers. Often these evaluations aren’t covered by health insurance, which leads some pediatricians or primary care physicians to pull out their prescription pads instead of seeking effective non-drug treatments, such as behavior therapy.
Both Ritalin and Adderall are stimulants commonly used to treat the symptoms (inattention and hyperactivity) of ADHD by boosting levels of brain chemicals called neurotransmitters. Though they relieve symptoms, according to the Mayo Clinic, they don’t cure the disorder. In addition to the side effects of these stimulants, some experts are concerned that early use of behavior-modifying medications might alter a child’s social development.
Just as worrisome as misdiagnosis and overmedication is underdiagnosis. In areas where mental health services are scarce, ADHD diagnoses are less common. Children in rural or urban areas with a legitimate diagnosis of the disorder are less likely to be treated properly, putting their long-term health at risk. Studies also show roughly 60 percent of children with ADHD have a learning disability, and 60 percent could go on to develop another mental illness by age 19.
“If children legitimately have ADHD, they need treatment,” Dr. Bailey said. “They need good quality care to have good quality life.”
If your child has been diagnosed with ADHD, follow these tips:
- Focus on good qualities. “Catch” your child behaving well at least three times a day and tell them you noticed.
- Tell your kid what you want them to do, instead of what you don’t want them to do. (Say “Walk” instead of “Don’t run.”)
- Provide immediate, constructive feedback often throughout the day. Keep it brief, specific and descriptive.
- Make sure your child gets regular meals and snacks of healthy food. (They may have difficulty sitting still long enough to eat because of hyperactivity and side effects from medication.)
- Make sure your child is safe. Kids with ADHD may need to be watched more closely than other kids their age because they can be active and impulsive. There are certain things you should do to keep them safe, like make sure they wear a helmet when biking or rollerblading.
- Make sure your child’s caregivers are familiar with daily routines and behavioral goals.