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Is ADHD On The Rise? Part One: Some Scientific Questions and Answers

Tuesday, August 30th, 2011

Many parents have seen reference to new data released by the Centers for Disease Control and Prevention (CDC) that suggests that rates of ADHD have risen over the past decade. Whenever data like these are publicized, it raises questions for parents that range from the scientific to the practical. Here is a little scientific Q & A — with myself — that focuses on some typical scientific questions that parents might ask: cdc_logo1

Is ADHD really increasing?

These data don’t speak to this issue. The data were drawn from Census reports and are, in essence, descriptive. All we know is that as compared to prior data gathering efforts that used the same approach, more parents reported that their kids had ADHD.

So the parents reported on their kids ADHD?

Yes, parents were asked the following question (quoted from the CDC website):

“Has a doctor or health professional ever told you that your child had Attention Deficit Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD)?”

Is this a good way to determine the rates of ADHD?

Well, it’s not the best way. The gold standard would be to conduct diagnostic interviews with large numbers of parents and children who are representative of the population. This survey assumes that a given child has already been referred for assessment. So in fact it may be that some kids in the study showed signs of ADHD but if they were not referred for screening, or did not seek it out on their own, then they may in fact meet diagnostic criteria as well.

Does that mean the data could actually underestimate ADHD?

Yes, that’s possible. That said, the estimates from this study are in line with other diagnostic studies of kids.

Why should be concerned with the idea that the rate of ADHD may be going up?

There are two concerns here. First, it may be that, in the past, we have underestimated the rate, and now we are getting better estimates of the number of kids who might require assessment and proper treatment. Second, if the rate is really going up, then it suggests that there might be changes in either the frequency of risk factors, or the emergence of new risk factors, which could be targeted in prevention or earlier intervention.

In Part Two, we’ll continue with this idea that there may be changes in risk factors that are increasing the rates of ADHD.

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