Continued increases in ADHD diagnoses and treatment with medication among US children

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Elsevier
Continued increases in ADHD diagnoses and treatment with medication among US children New study led by the CDC reports that half of US children diagnosed with ADHD received that diagnosis by age 6 Washington D.C., November 22, 2013 – A new study published in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) found that an estimated two million more children in the United States (U.S.) have been diagnosed with attention-deficit/hyperactivity disorder (ADHD) between 2003-04 and 2011-12. One million more U.S. children were taking medication for ADHD between 2003-04 and 2011-12. According to the study conducted by the Centers for Disease Control and Prevention (CDC):

6.4 million children in the U.S. (11 percent of 4-17 year olds) were reported by their parents to have received an ADHD diagnosis from a healthcare provider, a 42 percent increase from 2003-04 to 2011-12.

Over 3.5 million children in the U.S. (6 percent of 4-17 year olds) were reported by their parents to be taking medication for ADHD, a 28 percent increase from 2007-08 to 2011-12.

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurobehavioral disorders of childhood. It often persists into adulthood. Children with ADHD may have trouble paying attention and/or controlling impulsive behaviors. Effective treatments for ADHD include medication, mental health treatment, or a combination of the two. When children diagnosed with ADHD receive proper treatment, they have the best chance of thriving at home, doing well at school, and making and keeping friends.

According to CDC scientists, children are commonly being diagnosed at a young age. Parents report that half of children diagnosed with ADHD were diagnosed by 6 years of age, but children with more severe ADHD tended to be diagnosed earlier, about half of them by the age of 4.

"This finding suggests that there are a large number of young children who could benefit from the early initiation of behavioral therapy, which is recommended as the first-line treatment for preschool children with ADHD," said Susanna Visser, of the Centers for Disease Control and Prevention, lead author of the study.

The study increases our knowledge of ADHD treatment. Nearly 1 in 5 or 18 percent of children with ADHD did not receive mental health counseling or medication in 2011-2012. Of these children, one-third were reported to have moderate or severe ADHD.

"This finding raises concerns about whether these children and their families are receiving needed services," said Dr. Michael Lu, Senior Administrator, Health Resources and Service Administration (HRSA).

The study also found that:

Seven in 10 children (69 percent) with a current diagnosis of ADHD were taking medication to treat the disorder.

Medication treatment is most common among children with more severe ADHD, according to parent reports.

States vary widely in terms of the percentage of their child population diagnosed and treated with medication for ADHD. The percentage of children with a history of an ADHD diagnosis ranges from 15 percent in Arkansas and Kentucky to 4 percent in Nevada.

Nearly one in five high school boys and one in 11 high school girls in the U.S. were reported by their parents as having been diagnosed with ADHD by a healthcare provider. For this study, data from the 2011-2012 National Survey of Children's Health (NSCH) were used to calculate estimates of the number of children in the U.S. ages 4-17 that, according to a parent, had received a diagnosis of ADHD by a healthcare provider and were currently taking medication for ADHD. The NSCH is conducted in collaboration between HRSA and CDC.

### The article "Trends in the Parent-Report of Healthcare Provider Diagnosed and Medicated Attention-Deficit/Hyperactivity Disorder: United States, 2003-2011" by Susanna N. Visser, Melissa L. Danielson, Rebecca H. Bitsko, Joseph R. Holbrook, Michael D. Kogan, Reem M. Ghandour, Ruth Perou, and Stephen J. Blumberg, appears in the Journal of the American Academy of Child and Adolescent Psychiatry, online November 22, 2013, published by Elsevier. The article is available 'open access' at http://jaacap.org/webfiles/images/journals/jaac/visser.pdf.

A related editorial, "Beyond Rising Rates: Personalized Medicine and Public Health Approaches to the Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder," by Dr. John T. Walkup, is published in the same issue and is available 'open access' at http://jaacap.org/webfiles/images/journals/jaac/walkup.pdf.

The National Survey of Children's Health is a module of the Centers for Disease Control and Prevention's State and Local Area Integrated Telephone Survey and was sponsored by the Maternal and Child Health Bureau of the Health Resources and Services Administration.

Notes for editors The article is available 'open access' at http://jaacap.org/webfiles/images/journals/jaac/visser.pdf. Journalists wishing to interview the authors may contact CDC's press office at media@cdc.gov or + 1 404 639 3286.

All articles published in JAACAP are embargoed until the day they are published as in press corrected proofs online at http://jaacap.org/inpress. Articles cannot be publicized as in press accepted manuscripts. Contents of the publication should not be released to or by the media or government agencies prior to the embargo date.

About CDC's work on ADHD CDC monitors the number of children who have been diagnosed with ADHD through national survey data. Including questions about ADHD on national or regional surveys helps CDC learn more about the number of children with ADHD, their use of ADHD treatments, and the impact of ADHD on children and their families. CDC also conducts community-based studies to better understand ADHD as well as the needs of children and families living with ADHD. Learn more at http://www.cdc.gov/adhd.

Additional Resource on ADHD The National Resource Center on ADHD, a program of CHADD (Children and Adults with Attention-Deficit / Hyperactivity Disorder) and supported by CDC, is the national clearinghouse for the latest evidence-based information on ADHD. They provide comprehensive information and support to individuals with ADHD, their families and friends, and the professionals involved in their lives. http://www.help4adhd.org

About JAACAP Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families.

The journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families.

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