Feb. 7, 2011 -- Unfocused, hyperactive children are often dealing with a host of other problems that hinder their progress in school and hurt their relationships, a new study finds.
The research, published in the March issue of Pediatrics, finds that nearly 70% of children diagnosed with attention deficit hyperactivity disorder, or ADHD, have at least one other mental or physical problem, like a learning disability, conduct disorder, depression, anxiety, or difficulty with hearing or speech.
And about one out of five children with ADHD had three or more of those problems, increasing the odds that they would lag in school.
“ADHD is not an inconsequential condition,” says Mark L. Wolraich, MD, a pediatrician who is director of the Child Study Center at the University of Oklahoma in Oklahoma City. “The outcomes clearly show that they’re going to do more poorly in school; they’re going to have more accidents; and they’re going to get into more legal trouble.”
“It’s not just a bothersome condition that kids are going to grow out of as adolescents,” says Wolraich, an ADHD expert who was not involved in the research.
ADHD: A Complicated Picture
For the study, researchers at the University of California, Los Angeles surveyed the parents of nearly 62,000 school-aged children nationwide in 2007.
Kids were determined to have ADHD if their parents answered yes to two questions: Has a doctor ever diagnosed your child with ADHD? If so, does the child currently have ADHD?
Parents were then asked if their children had any of 10 other disorders, including learning disabilities, conduct disorder, anxiety, depression, speech problems, autism, hearing problems, epilepsy or seizures, vision problems, or Tourette’s syndrome.
About 8% of children in the study had been diagnosed with ADHD. That translates to about 4 million cases of ADHD in children aged 6 to 17 in the U.S., researchers said.
Compared to children without any reported attention problems, children with ADHD were significantly more likely to face a host of mental and physical health problems.
For example, even after researchers filtered the potential influences of characteristics like age, gender, race, household income, and the parents’ educational levels and marital status, children with ADHD were nearly eight times more likely than children without ADHD to have learning disabilities, nearly 13 times more likely to have conduct disorders, more than seven times more likely to have anxiety, and more than eight times more likely to have depression.
Children from low-income families were about 40% more likely to be diagnosed with ADHD compared to children from households with annual incomes of more than four times the federal poverty level -- about $88,000 annually for a family of four.
Being poor also made it more likely that children would have more associated medical conditions.
About 30% of children from low-income homes had three or more complicating conditions in addition to their ADHD, compared to just 8% of children from more affluent homes.
Impact of ADHD Felt at Home, School
“The impact of ADHD on American families is significant,” says Susanna Visser, the lead epidemiologist for the Child Development Studies Team in the National Center for Birth Defects and Developmental Disabilities at the CDC in Atlanta.
“The depth of that is really felt in terms of impact to family functioning to school and social functioning,” Visser says.
For example, more than 80% of children who had three or more other conditions along with their ADHD had problems in school, and nearly half of them had repeated a grade.
Visser and her colleagues published a study in 2010 in the Morbidity and Mortality Weekly Report that found that the number of U.S. children aged 7-14 whose parents reported that they were diagnosed with ADHD had increased from 7.8% in 2003 to 9.5% in 2007.
Better Understanding Needed
Researchers say this study points to a need for better screening of children with ADHD in order to determine and help them with the broader spectrum of conditions they may be facing.
“ADHD is one of the first to be diagnosed because it is based on behavioral symptoms that tend to be observed by parents, teachers, and physicians,” Visser says, and it may be the tip of the iceberg.
“These problems are probably not causally tied in any way to each other, but the underlying cause of them may be similar,” Visser says.
For example, “Children who are low-birth weight or preterm are more likely to have ADHD and other behavioral problems,” she says. “Children exposed prenatally to tobacco are also more likely to have all of these conditions.”