A general perception is that the diagnosis of attention deficit hyperactivity disorder (ADHD) and the subsequent use of potent medications for the behavioral condition is occurring at a far greater frequency than ever before in children.
A problem with the premise is that a national population-based prevalence of the disorder in children has never been firmly established. A new study helps establish parameters for the occurrence of the condition including identification of socio-economic groups that are at high risk.
Researchers discover nearly 9 percent of U.S. children age 8 to 15 may meet diagnostic criteria for attention-deficit/hyperactivity disorder. However, fewer than half receive treatment.
The report is published in the September issue of Archives of Pediatrics & Adolescent Medicine.
ADHD is characterized by hyperactivity, impulsive behavior and an inability to pay attention to tasks; the condition affects social behaviors and achievement at school and work.
Tanya E. Froehlich, M.D., of Cincinnati Children’s Hospital Medical Center, and colleagues studied a group of 3,082 children designed to represent the entire population of 8- to 15-year-olds in the United States.
Between 2001 and 2004, children’s parents or other caregivers were interviewed by phone and provided information about each child’s ADHD symptoms, including when they first appeared and any impairment they caused during the previous year.
They also reported whether their child had ever been diagnosed with ADHD or taken medicine to treat it, in addition to providing sociodemographic details.
Based on standard diagnostic criteria, 8.7 percent of the children (equivalent to 2.4 million children nationwide) fulfilled criteria for ADHD in the year prior to the survey.
Hispanics were less likely than whites to have ADHD and boys were more likely than girls to meet criteria, although girls who did have ADHD were less likely to have their condition recognized. A total of 47.9 percent of the children who met ADHD criteria had previously been diagnosed with the condition.
The poorest one-fifth of children were more likely than the wealthiest one-fifth of children to have ADHD.
“Reasons for the increased likelihood of ADHD in poorer children may include the elevated prevalence of ADHD risk factors (i.e., premature birth and in utero or childhood exposures to toxic substances) in this group,” the authors write.
“In addition, given the high heritability of ADHD and its negative impact on social, academic and career outcomes, it is plausible that families with ADHD may cluster within the lower socioeconomic strata.”
Among children meeting criteria for ADHD, 39 percent had received some medication treatment and 32 percent were treated consistently with ADHD medications during the previous year.
Despite the prevalence of ADHD in poorer children, they were least likely to receive medications consistently. This finding “warrants further investigation and possible intervention to ensure that all children with ADHD have equitable access to treatment when appropriate,” the authors conclude.
Source: JAMA and Archives Journals