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Why have rates of ADHD in children become so high?

ADHD cases have increased significantly in the United States

By 2022, about 1 in 9 children had been diagnosed with attention-deficit/hyperactivity disorder at some point in their lives, according to a study released Wednesday. About 6.5 million children ages 3 to 17 had ADHD that year, up from 5.4 million in 2016.

The study’s lead author, Melissa Danielson, a statistician at the Centers for Disease Control and Prevention, said there were two main reasons for this trend. First, doctors, parents, teachers and children are increasingly aware of ADHD symptoms, making it easier to identify cases. Second, as more treatments are available today, doctors have more reason to test and diagnose children.

“There are more providers who are comfortable making these diagnoses and treating ADHD, which may allow children to be helped with different medications, behavioral therapy or school services. So as there are more opportunities to help these children, I think there is more incentive to get this type of diagnosis,” she said.

Because the study results suggest more children are being screened, she added, that “could be a positive outcome.”

A third factor in this trend, Danielson said, could be the Covid-19 pandemic, which could have worsened ADHD symptoms or allowed parents to observe their children more closely.

His study’s estimates, published in the Journal of Clinical Child & Adolescent Psychology, were based on more than 45,000 responses to the 2022 National Survey of Children’s Health.

Mental health professionals who diagnose and treat ADHD said the data is consistent with their experiences.

“It’s something we see every day. We’re getting more and more families and patients wondering if they have ADHD,” said Dr. Willough Jenkins, a psychiatrist at Rady Children’s Hospital in San Diego, who was not involved in the study.

In particular, Jenkins said, doctors have become better at recognizing the disorder in girls and older children.

“It used to be thought that ADHD was a condition that only affected young, hyperactive boys,” she said. “In the last 15 or 10 years, things have really changed. And even in the last five years, we’re seeing a lot of improvements in diagnostics.

ADHD is one of the most commonly diagnosed neurodevelopmental disorders in children and adolescents. Cases have been increasing for several decades as awareness has grown. The disorder is often characterized by difficulty concentrating, sitting still, or exercising self-control.

Danielson said young children with ADHD tend to be more hyperactive or impulsive, while during adolescence the disorder tends to progress more toward inattention — behaviors like daydreaming, hyperfocusing or forgetting. difficulty completing tasks.

Other mental health experts agree that the pandemic has most likely accelerated ADHD diagnoses.

Thomas Power, director of the ADHD Management Center at Children’s Hospital of Philadelphia, said the stress of remote learning, social isolation, family health fears and disrupted routines may have worsened children’s symptoms, leading them to become more visible.

“Particularly for children who have mild attention difficulties, learning in this type of context would be that much more difficult and could be enough to trigger attention deficit disorder,” he said.

As parents spent more time at home, they also may have noticed their children were struggling, said Yamalis Diaz, a child and adolescent psychologist at the Child Study Center at NYU Langone.

“It gave parents an extended period of observation of their child trying to concentrate and do their schoolwork,” Diaz said. “Parents now observe, ‘My God, my child interrupts me 50 times a day just to complete a task. »

But Jenkins said there may have been an uptick in misdiagnosis during the pandemic because rates of depression and anxiety have increased during this time and symptoms may overlap.

“People may not have realized that anxiety and depression could be a reason why you can’t pay attention,” she said.

Discussions about ADHD on social media also increased during the pandemic, according to a 2022 study. Danielson said that could have led some older children to self-diagnose.

“As children and teens spend more time on social media and learn more about ADHD, they might see it in themselves a little more,” Danielson said.

However, excessive screen time has been shown to increase the risk of ADHD, according to some previous research — so that could be another, albeit smaller, reason for this trend, Power said.

“There’s certainly been a lot of focus recently on the downsides of children’s heavy involvement in social media and video games, so I think that may be a contributing factor,” he said.

Jenkins pointed to another important contributor to ADHD rates: changes in the American Psychiatric Association’s diagnostic guidelines.

Until 2013, doctors would not diagnose a child with both autism and ADHD, out of fear that attention problems related to autism would be confused with ADHD. A child also had to show symptoms of ADHD before age 7 to be diagnosed. But for more than a decade, an updated diagnostic manual says children can be diagnosed with ADHD if they have autism, as well as if their symptoms began before age 12.

Diaz said expanding the criteria likely helped more children access treatment.

“The reason for diagnosis is not just to label children,” she said. “It’s really about identifying the challenges that we can actually rectify and correct. »

Doctors typically recommend behavioral therapy for young children with ADHD, while older children may benefit from a combination of behavioral therapy and medication.

But according to the new study, 30% of children with ADHD in 2022 received no behavioral therapy or medication, compared to 23% in 2016.

Danielson said some children receive behavioral therapy at school, so virtual learning during the pandemic may have cut off access. The Food and Drug Administration also reported a shortage of ADHD medications starting in 2022 — a problem that persists to some extent today, although some shortages have been resolved recently, the FDA said.

Some drugmakers have attributed the shortage, in part, to high demand due to increased ADHD diagnoses.

Diaz said it can still be difficult to find appointments with doctors who treat ADHD.

“Even in places where treatment options are saturated, like New York, there are waiting lists everywhere,” she said. “It’s possible that parents wanted or tried and just couldn’t access good treatment.”

News Source : www.nbcnews.com
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