ADHD Diagnoses On the Rise, Especially Among Girls and Hispanics

A new study suggests rates of ADHD in children has increased, especially among girls. REUTERS/Ognen Teofilovski

Rates of diagnosis for attention deficit hyperactivity disorder (ADHD) in kids are on the rise in the U.S., especially among girls and the Latino population, according to a new study published Tuesday in the Journal of Clinical Psychology.

The study, based on parent-reported questionnaires, finds that 12 percent of children and teenagers in the country were diagnosed with ADHD in 2011 compared with 8.4 percent in 2008. This marks a 43 percent increase in that time period.

The study is based on an analysis of data from the National Children's Survey from 2003 to 2011 that involved 190,408 children aged 5 to 17. The researchers say their findings suggest that currently 5.8 million children in the U.S. have an ADHD diagnosis.

A sharp increase was observed in girls. Parent-reported prevalence for girls rose from 4.7 percent in 2003 to 7.3 percent in 2011, adding up to a 55.3 percent increase, compared to a 39.8 percent increase among boys.

ADHD is the most common mental disorder in children; those with the condition may be described as hyperactive, struggle with impulse control and have trouble concentrating, especially in school.

Sean Cleary, associate professor of epidemiology and biostatistics at Milken Institute School of Public Health at the George Washington University and lead author on the study, says it's unclear why this dramatic increase in ADHD diagnoses has occurred, specifically in girls, but he speculates it may be related to behaviors related to gender differences.

"Because the condition is more evident in boys, they externalize, whereas females tend to withdraw," he says. "Females may manifest the syndrome in verbal expression like teasing and name calling, whereas males would manifest it through shouting, which is easier to observe."

Ultimately, this means that health professionals are much more aware of the various ways ADHD manifests, and it's no longer seen as just a condition of young boys with poor impulse control.

Cleary says it's also unclear why so more Latino families reported an ADHD diagnosis for a child in 2011 as compared to 2003. Rates of diagnosis in this population increased by 83 percent in that timeframe, according to the study. He suggests it may be due partially to the community's changing views of the condition. " The problem behavior among Latinos may be dealt with within the family rather than seeking medical help," he says. "That's one possible explanation." Cleary suggests that some Latino families may be receptive to seeking out professional help for a child who is struggling in school or has behavioral problems.

Physicians and the public in general also have a greater understanding of ADHD, which has likely contributed to an uptick in diagnoses. "You could say the same thing about autism," says Dr. Eric Mick, a psychiatric and genetic epidemiologist at the University of Massachusetts Medical School. "Is it really an increase in prevalence or diagnoses or change in context?"

This question is important because the condition is treated with medications such as Ritalin, a stimulant drug that requires a high level of patient monitoring and can be detrimental when prescribed to someone who doesn't need it. On the other hand, accurate and early diagnosis is key— undiagnosed and untreated ADHD can have repercussions that will follow a child well into adulthood. "If you wait a year longer to treat [ADHD] that's a year lost of learning," says Mick, who was not involved in the research. Kids with untreated ADHD are more likely as teens and adults to abuse drugs and alcohol, struggle with other psychiatric problems and engage in unsafe sex.