The prevalence of ADHD in children and youth has been increasing immensely in recent decades; however, according to a study in the Journal of Attention Disorders, that’s because clinicians are more likely to diagnose it, not because more children and youth are having symptoms of ADHD.
Daniel Safer of the Departments of Psychiatry and Pediatrics at the Johns Hopkins University School of Medicine reviewed 6 parent surveys and 12 outpatient physician office visit surveys, and contrasted those with 26 sets of systematic ratings of behaviors associated with ADHD from teachers, parents, and students, all done between 1985 and 2015. He found that while teachers, parents, and self-reporting students have apparently detected largely the same rates of behaviors associated with ADHD in children and youth over these decades, the prevalence of diagnoses of ADHD have increased.
“The major finding of this review is that whereas the diagnostic prevalance of ADHD in youth increased in recent years, the temporal prevalence of its associated features did not,” concluded Safer.
In his discussion section, Safer commented that, “The prevalence of clinician-reported diagnoses of ADHD in the community over the last 25 years in the United States has increased generally in tandem with increased rates of ADHD medication treatment. This relationship appears to be bidirectional; drug therapy increased the diagnosis of ADHD and vice versa.” He also discussed how “diagnostic rates of ADHD have been altered by changes in categorical definitions, drug response, reported side effects, treatment options, marketing, public attitudes, and social circumstances.”
Safer, Daniel J. “Is ADHD Really Increasing in Youth?” Journal of Attention Disorders, June 17, 2015, 1087054715586571. doi:10.1177/1087054715586571. (Abstract)
Thank you mental health anti-stigma advocates for enabling more psychiatric diagnoses of our children.
Or in others words, clinicians’ and pharmaceutical companies’ need for ever-increasing profits has resulted in ever-increasing diagnoses of a non-existent illness.
There is an important issue apart from the way ADHD is being pushed for the benefit of the industry. Speak to elementary school teachers who has been working for over 15 years, and they will all tell you about the increase in classroom behaviour problems. There are important societal changes that have occurred that is leading to more chaotic kids and frustrated teachers. Teachers who usually have access to limited resources, may then end up encouraging psychiatric assessments and the use of medication. While teachers should not suggests diagnoses to parents, it is not teachers’ faults that they are overwhelmed in the class. In addition to blaming self-interests of the industry , we need to address numerous social problems that are leading to the diagnosing and the drugging of kids. All children need a safe, stable, sensible and connected world to grow up in.
Agreed, Norman. But I would add also that kids are expected to do things at younger ages, such as reading in Kindergarten or doing homework in first grade, that my teachers knew better than to expect. Additionally, recess and PE and art and music have been reduced and in some cases practically eliminated from the curriculum, and hours per week of classroom instructional time (generally dull times when kids have to sit still and do as they are told) have increased. Homework loads for older kids also appear to have climbed dramatically. And class sizes are at an all-time high for our recent history in the USA.
All of these are in-school variables that could be altered in order to reduce the “ADHD” diagnosis rates. Consider the Canadian study where they noted that a one-year delay in school admission led to a 30% reduction in the “ADHD” rates! Clearly, there is a disconnect between children’s development and what is now expected of them, and this is a big contributor to “ADHD” diagnosis rates. We’re also expecting too much of teachers to manage classes of 30+ Kindergarteners. Reduce class size, increase time spent on “non-academic” pursuits like art, PE, music, and plain old garden variety RECESS and FREE PLAY, and the “ADHD” epidemic would fade out rather quickly. Except, of course, that there are forces at work which don’t want such things to happen.
It’s really blatant…. I will omit some details, OK?….
My friend has a 6yr old son, and shares custody with “Mom”, and her “girlfriend”….
I’m putting mom&girlfriend in quotes because they are also part of what I call the
“lipstick mafia”, which is a group of local lesbians who use the local “Community Mental Health Center” as their private playground. As much as I’d like to avoid the “sexual politics” angle, – I can’t.
It’s part of how the scam works. Mom got the quack shrink to write a Ritalin Rx., because the DRUG
makes the boy sleep more at home. More sleep, quieter kid, Mom has more time to party with girlfriend. there’s nothing “medical” about it.
(Also, the local schools get more $$$$ per student, when they have a “diagnosis”. Yes, it’s DRUGGING
children for *MONEY*…. My God….)….
Yes, it’s using DRUGS as behavior control, and chemical straitjackets…..
So-called “ADHD” is an almost totally BOGUS “diagnosis”…..
This started in the 1950’s with Thorazine.
MY GOD, what is *wrong* with *you*people*…????….
(Obviously, I don’t mean my friends here at MIA…..
I’ve been a school psych for over 16 years and educational reading specialist for about 18. Yes, ADHD truly does exist like the research shows, and yes, medication is very effective when used correctly.
From my experience, this is what I observe:
– There is a much larger resistence to medication for ADHD then there is support by all staff including other school psychs.
– There is an increase in medication use for non-ADHD students but an UNDER prescribed rate of medication for children and adults who are TRULY ADHD, and these children and adults suffer the majority of their life from not achieving at their potential in anything: school, friends, familiy, driving, fincance, and employment.
– The strong negative talk again the “pharmaceutical industry” has hurt the truly adhd individuals the most because they are the one’s more likely to play against the odds (e.g., gambling, risk taking, drug use, sex, etc.) due to their impulsivity and difficulty processing long-term consequences of their behaviors.
– Children are more difficult in the school systems because in the past 50 years or so MORE children are attending and staying in school. Prior to that around a third or more children didn’t attend past the sixth grade, especially if they had any kind of disability or chronic problem. They were either kicked out or just stopped going.
So I do not find it productive point the finger at the “pharmaceutical industries” or the parents. Teachers cannot go into the homes and change the parents, so they need to start working with what they have. They need far far more training and support. Pharmaceutical complanies can be an awesome addition to our society and they are already highly regulated. Stop whining about them and do your jobs.