Many Kids With ADHD Aren’t Diagnosed
Poorer Children Receive Less Treatment
Sept. 4, 2007 -- A new study shows that ADHD is grossly undiagnosed.
An estimated 2.4 million children between the ages of 8 and 15 in the U.S.
have attention deficit hyperactivity disorder (ADHD), but fewer than half of
them have been diagnosed or are receiving appropriate treatments, researchers
The findings are based on the first national ADHD prevalence study to use
the most widely accepted diagnostic tool to identify the disorder.
Previous estimates from the American Academy of Pediatrics suggest that ADHD
afflicts as few as 4% and as many as 12% of school-aged children in the U.S.
The new assessment places the figure at 8.7%.
"Our analysis suggests that some children with clinically significant
inattention and hyperactivity symptoms of ADHD may not be receiving optimal
interventions," Cincinnati Children's Hospital pediatrician and researcher
Robert Kahn, MD, said in a news release.
Half With ADHD Undiagnosed
The assessment was based on 3,082 interviews collected between 2001 and 2004
as part of an ongoing national health survey.
After analyzing the data, researchers from Cincinnati Children's and the
University of Cincinnati College of Medicine concluded that 52% of children who
met the American Psychiatric Association's criteria for ADHD had not been
diagnosed with the disorder.
Boys were about twice as likely as girls to meet the criteria for ADHD, but
girls who had ADHD were far less likely than boys to have their condition
Children from the lowest-income homes were twice as likely to meet ADHD
criteria as those from the wealthiest homes, but they were also three to five
times less likely to receive consistent drug treatment.
The study, which was partly funded by the National Institutes of Health,
appears in the September issue of Archives of Pediatrics & Adolescent
"We know that poorer children are often disadvantaged in their schools
already," researcher Tanya E. Froehlich, MD, of Cincinnati Children's
Hospital tells WebMD. "Having untreated ADHD is just an added burden that
very well may add to the cycle of poverty."
Raising ADHD Awareness
Only about a third of children with ADHD were found to be receiving
consistent drug treatment for the symptoms of inattention, hyperactivity, and
impulsivity that characterize the disorder.
While the findings indicate that many children who could benefit from taking
stimulant-based or other drug treatments aren't getting them, Froehlich says
the study should not be seen as a call to increase medication.
"The message is that we need to raise awareness to make sure that
children don't fall through the cracks," she says. "We have good
diagnostic assessments to identify children with ADHD, but a diagnosis doesn't
automatically mean medication. There are also good behavioral interventions out
She adds that it is not clear if poorer children are less likely to be
treated because they are medically underserved or for some other reason.
"There may be more distrust and concern about the use of medication in
this population," she says.
Whether ADHD is treated with drugs, behavioral interventions, or both,
ensuring that all children have access to treatment would benefit everyone, she