Many Kids With ADHD Aren’t Diagnosed

Poorer Children Receive Less Treatment

Medically Reviewed by Louise Chang, MD on September 04, 2007
From the WebMD Archives

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 report.

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 recognized.

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 Medicine.

"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 there."

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 adds.

Show Sources

SOURCES: Froehlich, T.E. Archives of Pediatrics and Adolescent Medicine, September, 2007; vol 161: pp 857-864. Tanya, E. Froehlich, MD, department of pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine. Robert Kahn, MD, Cincinnati Children's Hospital Medical Center. AAP Parenting Corner Q & A: ADHD.

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