Is ADHD On The Rise – Or Just Overdiagnosed?

The latest numbers on the rate of ADHD are extraordinary. The New York Times has reported data collected from the Centers for Disease Control and Prevention which suggest that 11% of youth (between 4 and 17 years of age) have been diagnosed with ADHD at some point in their lifetime. 

This is troubling – primarily because the data come from phone surveys of parents. This means that parents are receiving this diagnosis at unprecedented rates – not that kids are being properly diagnosed with ADHD at higher rates than before. It is too easy for kids to get labeled ADHD and not go through the comprehensive screening that should take place as administered by a multidisciplinary team of professionals.

It’s becoming clear that ADHD is being used as a label to try to provide a quick handle on behavior that may – or even may not – be somewhat troublesome. ADHD involves much more than not sitting still and not paying attention. All kids exhibit “ADHD” like behaviors now and then. It’s a difficult condition to diagnose because it is based on increased frequencies of a number of behaviors across a number of contexts (home and school) for a sustained period of time which cause impairment for the child. Without a detailed diagnostic process, it can be too easy to misread normative behaviors as symptoms of ADHD.

Part of the increase comes from diagnoses of older kids including those in high school. Diagnostic criteria are beginning to reflect the thinking that symptoms can develop later in childhood and even in the teen years (and not just the early years). That said, it can also become another convenient label for a kid who is not doing well in school. At the other end of the spectrum, diagnosing preschoolers can raise related issues in terms of figuring out which kids are really showing early signs and which kids are just being kids.

There are a number of problems with overdiagnosis. Kids typically get treated with drugs that are not appropriate for them. They get labeled rather than receive the kind of attention that they deserve (for example, to improve their engagement in the classroom). And some kids get diagnosed simply because they are in very large classrooms which promote inattention and not sitting still.

The less obvious issue is that the cursory diagnosing that may be going on is also a disservice to kids who do suffer from ADHD. They should be getting full assessments and comprehensive treatment plans that find optimal combinations of psychosocial intervention and, when necessary, well monitored use of drug therapy. Tossing around labels and drugs as a diagnostic and treatment strategy is not going to give them the help they need, especially since we know that ADHD can persist into adulthood and cause much in the way of academic and social impairment.

The bottom line? If you are a parent, and you (or someone else) suspects that your child might have ADHD, try to seek out an assessment from a multidisciplinary team that has the requisite experience to know how to sort out normative behaviors and issues from clinically meaningful ADHD. You might need to network with other parents, your pediatrician, and educators to locate a provider. But it will be worth your time and effort to make sure your child isn’t misdiagnosed as having ADHD – or not given the proper assessment and treatment plan if they do show the clinically meaningful symptoms of ADHD.

ADHD image via Shutterstock.com

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  1. by Hector

    On April 9, 2013 at 3:37 pm

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  2. by Mikki Chalker

    On April 28, 2013 at 9:47 am

    I think perhaps, it is partially that ADHD is on the rise, but also that we are NOT acknowledging a few things about modern society that could muddy the waters, so to speak. Sleep deprivation will cause symptoms that mimic ADD- but unlike ADD go away when a normal sleep pattern is established. And modern society is increasingly sleep deprived. Also, I think we are finding our bodies more and more filled with toxins due pesticide use in agriculture. We already have studies that show people with ADD have a higher toxin load than others. Maybe toxicity is the trigger that is causing add (and autism) rates to skyrocket.

  3. by Amanda Faith Shephard

    On April 28, 2013 at 10:25 am

    My son was diagnosed with ADHD and he is now 6. It is very hard for me because he’s so young. We manage his symptoms with medications and I worry that it can cause him to have major health problems later in life. I do think there may be some underlying medical issues that could be causing some of his ADHD-like symptoms. However, getting him in to a facility that has a team of professionals is a long waiting process. We are also dealing with “labels”in the school amongst his peers and teachers. He has been labeled a troublemaker and aggressor because of his symptoms. Any feedback, input, suggestions or comments anyone can provide would be greatly appreciated.

  4. by Shaun

    On April 28, 2013 at 11:57 am

    I would NEVER administer ADHD or ADD drugs to my kids. I did a lot of research on this when one of my kids teachers kept hinting that he needed to be tested. I found that these drugs are as addicting as cocaine, and in a kid’s later years, have a high percentage of them going through depression, which the Dr. will then give them depression medications. (This learned after a discussion with my Dr) Once you are on these drugs, they are on your health chart for LIFE! You cannot join the military with this on your record, and your insurance rates will always be higher becuase now you have a pre-existing condition! Most kids that are “diagnosed” with these are just not stimulated enough in the classroom. When my son’s teacher thought I had taken him to the Dr. and put him on meds, she quit sending home reports of attention problems. She in fact told me how much better he was doing, because she THOUGHT he was on them. This was in the 5th grade. Once he got into middle school and got more engaged and began playing in the band, he blossomed like you wouldn’t believe! Parents just need to step up and get more involved in homework and other activities, like music, that will expand these kids minds and make them want to become more engaged. Be very careful giving your kids medications at such an early age, if at all! All people, especially kids, need to learn to deal with life and how their own minds work…we are all individuals, and giving kids these meds to make it easier for their teachers and them to just zone out and concentrate is a cop out in my opinion. I’ve seen too many kids turn into zombies after taking ADD/ADHD meds. Be strong as a parent and help your child learn to work with what they have and they will develop and grow a whole lot easier, and their personalities won’t change along the way! Check their diets too! Much of this is caused by eating the wrong foods!

  5. by kandi

    On April 28, 2013 at 3:03 pm

    Amanda my son was diagnose with ADHD when he was 7 I refuse to give him medication because now days in school if your child does not keep a body temp below 98 degrees (if you know what I mean) will be diagnosed with ADHD period. kids now days just cant be kids anymore, running, yelling or playing around its just unacceptable behavior in schools now days. They are taught to just sit and be quiet like robots sadly enough. My son was also being called names and put on labels by teaches and school staff. I ended up giving medication to my son but only after 2 years of having my pediatrician and several doctors (including psychologists, shrinks and even a neurologist make sure this was the right choice ) and gave him the med ONLY for school. My son just turned 14, at his own request was taken off the medication and has been doing great without it for over a years now. every child is different some children do need it to help them concentrate and do better in school, but most do not! and a lot of children are diagnosed with ADHD when the problem might be something else like lack of sleep, stress, problems at home or school even their diet, just make sure your child really needs the med and its not something you are doing because its going to make other people jobs easier. and by the way if you are having trouble getting him to a place that can help its easy refuse to give him the medication (that’s what I did) and the school and the state will jump on you like a hungry lion and provided you with all the help you and your child need because in this case by helping you they are helping themselves. Hope this helps

  6. by Dr. S

    On April 28, 2013 at 5:45 pm

    The incidence of ADHD is less than 2% of 1% (2 kids out of a thousand)in Europe and even less in Africa. So how are Americans diagnosed at 11%? Since the vast majority of kids on meds are of European or African extraction, it is NOT genetically possible, evolution does NOT work that fast. It is a cultural phenomenon.
    We prize risk taking, exciting, and permissive parenting. More structure for 18-36 month olds with more direct parental involvement would help. When kids are herded into large groups at a young age, as at day care, they learn to vie for attention and the ante to get noticed keeps rising. It takes very attentive and structured parents to compensate. ALL young children need routines, regular bedtimes, nutritious meals and snacks, and NO junkfood or super excitement. Kids become habituated to excitement and much like a drug addict, need higher and more frequent hits to feel alive.

  7. by Dawn

    On April 28, 2013 at 8:15 pm

    I am really disappointed with this article. If you want to educate parents about ADHD why don’t you discuss how gifted children are typically misdiagnosed with the disorder. For more information, please view the following YouTube video from SENG:

    http://www.youtube.com/watch?v=9XN7IOteagI&feature=player_embedded#!

  8. by Elizabeth

    On April 29, 2013 at 8:34 am

    I’ve had ADD my whole life, and was diagnosed in 3rd grade. My brother was also diagnosed with ADD–although for him it was much earlier because my parents recognized the symptoms. We were both on medication until adulthood, although we both experimented (with dr supervision) going without meds. Neither of us take meds now. I still have trouble focusing, but have learned coping strategies to help me with studying and focusing on the job. My son will likely have ADD too, as it more commonly affects boys. It’s not a death sentence, far from it. In fact, kids with ADD are often above average in intelligence and highly creative.

  9. by Kerry

    On April 29, 2013 at 10:30 am

    This article is disappointing. If read quickly, it actually supports some ignorant perceptions that some have that diagnoses of ADHD (and autism) are truly a result of poor parenting. One would hope that a magazine with a reach as broad as Parents would do a better job presenting such an important issue.

    @ Dr. S. – something to consider…government regulations in Europe are stricter than the U.S. with regards to artificial ingredients in foods. Years ago we noticed a positive change in our autistic son’s behaviors when we eliminated ALL foods with artificial flavors and colors from his diet. He was never a candy eater, but foods he used to eat such that seemed ‘wholesome’ like an Eggo Blueberry Waffle contain artificial ingredients that are not good for children sensitive to artificial ingredients.

  10. by Jan Baer

    On May 1, 2013 at 2:01 pm

    The article and each of the previous comments have some truths, I think. Also, as a teacher in preschool, I kept “overactive” children near me or a parent volunteer, I assured the child that I would not let him or her (mostly him) hit other children, suggested words the child could use in play situations or problem situations, etc.–children respond positively and are calmed by caring adults physically near them. So many parents are working–I wonder if that is creating behavior problems with some children.