Increases Greatest Among Teens, Hispanics
By Salynn Boyles
WebMD Health News
Reviewed by Laura J. Martin, MD

Nov. 10, 2010 -- Nearly one in 10 children in the U.S. has a diagnosis of ADHD, with rates rising by 22% in just four years, government health officials said Wednesday.

The CDC estimates that between 2003 and 2007, a million children and teens were diagnosed with attention deficit hyperactivity disorder, which is characterized by problems with attention, hyperactivity, and/or impulse control.

In 2007, 5.4 million children between the ages of 4 and 17 were estimated to have ever been diagnosed with ADHD, up from 4.4 million four years earlier.

Two out of three children in this age group with a current ADHD diagnosis -- 2.7 million children in all -- were taking medication for the disorder.

The figures come from nationally representative surveys of parents conducted by CDC researchers in 2003 and again in 2007, but it is not clear if the dramatic increase is solely due to greater awareness and more aggressive diagnosis of the disorder.

CDC epidemiologist Susanna Visser, MS, who led the study, says regardless of the reasons, the increase has major public health implications.

“This tells us that one in 10 children and their families are dealing with ADHD in America,” she says. “That is a very significant number.”

Slideshow: ADHD in Children
Big Increases Seen for Hispanics, Older Teens

The highest increases were seen in older teenagers and Hispanic children, possibly reflecting a shift in attitudes about diagnosis.

In the 1990s, ADHD was disproportionately diagnosed in white children from more affluent families. Today, more children living in poverty are diagnosed and ADHD rates are comparable among African-American and white children, Visser says.

Hispanic children have historically had the lowest ADHD diagnosis rates, but this appears to be changing. While ADHD diagnosis among Hispanics remained lower than non-Hispanics, the rate increased by 53% from 2003 to 2007. The increase may reflect better access to health care or changing attitudes about ADHD within the Hispanic community.

The survey also showed a 42% increase in the diagnosis of ADHD among 15- to 17-year-olds.
ADHD Trends State by State

The state with the lowest percentage of children diagnosed with ADHD in 2007 was Nevada, with a total of 5.6% of children having ever been diagnosed. Illinois and California had the next lowest rate, with 6.2% of children diagnosed in each state.

North Carolina had the highest percentage of children with ADHD. A total of 15.6% children in the state had a diagnosis of ADHD in 2007, followed by Alabama with a rate of 14.3%, Louisiana with a rate of 14.2%, and Delaware with a rate of 14.1%.

The increases probably reflect greater efforts to screen for ADHD and treat those who have the disorder, Visser says.

Twelve states reported increases in ADHD prevalence between 2003 and 2007, and all regions of the country, with the exception of Western states, saw increases.

ADHD Trends State by State continued...

Visser says Western states have traditionally had the lowest ADHD rates.

Ruth Hughes, of the advocacy group Children and Adults with Attention-Deficit/Hyperactivity Disorder, says parents, doctors, and teachers are clearly more aware of the disorder than they were even a few years ago.

She worries that some of the increase may be due to the misdiagnosis of children as an unintended consequence of this increased awareness.

“The hope is that physicians out there diagnosing children with ADHD are following the guidelines, and not just slapping an ADHD label on kids with ADHD-related behaviors,” she says.

The American Academy of Pediatrics states that symptoms like hyperactivity, inattention, or impulse control issues must be present for at least six months and they must have a profound negative impact on school work, social interactions, or home life to be considered ADHD.

“There are very good diagnosis and treatment guidelines, but it is hard to know if they are being followed,” Hughes says.