Increasing ADHD Diagnoses in the U.S.: Trends, Causes, and Implications

The prevalence of ADHD diagnoses in the United States has significantly risen. As of 2022, approximately 1 in 9 children had been diagnosed with attention-deficit/hyperactivity disorder (ADHD) at some point in their lives, according to a study published on Wednesday. This represents around 6.5 million children aged 3 to 17 diagnosed with ADHD that year, up from 5.4 million in 2016.

Key Factors Behind the Increase

Melissa Danielson, a statistician at the Centers for Disease Control and Prevention and the lead author of the study, identified two primary reasons for this trend. Firstly, increased awareness among doctors, parents, teachers, and children about ADHD symptoms has facilitated easier identification of cases. Secondly, the availability of more treatment options has provided doctors with greater incentive to diagnose and treat ADHD.

“There are more providers who are comfortable diagnosing and treating ADHD, which can allow children to benefit from medications, behavior therapy, or school services. With more opportunities for these kids to be helped, there’s more incentive to get that diagnosis,” Danielson explained.

Danielson also suggested that the COVID-19 pandemic may have exacerbated ADHD symptoms or allowed parents to observe their children more closely, thus increasing the rate of diagnoses. She proposed that increased screening for ADHD during the pandemic “could be a positive finding.”

Study Insights and Professional Perspectives

The study, published in the *Journal of Clinical Child & Adolescent Psychology*, was based on over 45,000 responses to the 2022 National Survey of Children’s Health. Mental health professionals who diagnose and treat ADHD have found the data to be consistent with their experiences.

Dr. Willough Jenkins, a psychiatrist at Rady Children’s Hospital-San Diego, noted, “We’re seeing more and more families and patients wondering if they have ADHD.” Jenkins emphasized the improved recognition of the disorder in girls and older children, correcting the previous belief that ADHD primarily affected young, hyperactive boys.

Understanding ADHD: A Common Neurodevelopmental Disorder

ADHD is one of the most commonly diagnosed neurodevelopmental disorders in children and teenagers. Its prevalence has been rising for several decades due to increased awareness. The disorder is characterized by difficulty concentrating, sitting still, or exercising self-control. Younger children with ADHD tend to be more hyperactive or impulsive, while adolescents often exhibit inattention, such as daydreaming, hyperfocusing, or struggling to complete tasks.

Impact of the Pandemic on ADHD Diagnoses

The pandemic likely accelerated ADHD diagnoses, as remote learning, social isolation, family health scares, and disrupted routines heightened stress and made symptoms more visible. Thomas Power, director of the Center for Management of ADHD at Children’s Hospital of Philadelphia, explained, “For children with mild attention difficulties, learning in that context would be more challenging, potentially triggering an attention-deficit disorder.”

Yamalis Diaz, a child and adolescent psychologist at NYU Langone’s Child Study Center, added that parents spending more time at home may have noticed their children’s struggles. “Parents observed their children trying to focus and do academic work, realizing issues like frequent interruptions,” she said.

Potential for Misdiagnosis and Social Media Influence

Jenkins cautioned that there might have been a slight increase in misdiagnoses during the pandemic, as symptoms of depression and anxiety, which also surged, can overlap with ADHD. Social media discussions about ADHD also increased during the pandemic, possibly leading some older children to self-diagnose. Danielson noted that as kids and adolescents spent more time on social media, they might have recognized ADHD traits in themselves.

Excessive Screen Time and ADHD

Excessive screen time has been linked to an increased risk of ADHD. Thomas Power pointed out that heavy involvement in social media and video games might contribute to the rise in ADHD cases.

Changes in Diagnostic Guidelines

Changes in diagnostic guidelines from the American Psychiatric Association have also contributed to the rise in ADHD diagnoses. Previously, a child could not be diagnosed with both autism and ADHD, and symptoms had to appear before age 7. Updated guidelines now allow for a diagnosis if symptoms appear before age 12 and do not exclude children with autism.

Treatment and Access Challenges

Doctors often recommend behavior therapy for younger children with ADHD, while older children may receive a combination of behavior therapy and medication. However, the study found that 30% of children with ADHD in 2022 did not receive behavior therapy or medication, up from 23% in 2016. Virtual learning during the pandemic may have limited access to behavior therapy, and an ADHD medication shortage starting in 2022 has further complicated treatment.

Access to Treatment

Finding appointments with doctors who treat ADHD remains challenging. Diaz noted, “Even in areas with saturated treatment options, like New York City, there are waiting lists everywhere.” The shortage of ADHD medications, partially due to rising diagnoses, has exacerbated access issues.

Conclusion

The rise in ADHD diagnoses underscores the need for continued awareness, accurate diagnosis, and accessible treatment. As understanding and awareness of ADHD improve, so does the ability to provide effective support and interventions for those affected.