bigmind-the-gap

In a recent podcast recorded by  Dr. John T. Walkup of Journal of the American Academy of Child and Adolescent Psychiatry (January 2014), he chatted about the CDC’s latest findings on treatment and management of ADHD with Dr. Susan Visser.  She is a CDC expert and the lead author on research related to generating population-based estimates of ADHD, rates of medication treatment among youth with ADHD, and factors associated with ADHD medication treatment, shared the latest trends in ADHD about diagnosis and treatment.

I heard the 20 minute podcast and then followed up by reading some pretty startling facts about the new survey and report called, “Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated ADHD: United States, 2003—2011.” You can find the podcast I listened to here at Journal of American Academy of Child & Adolescent Psychology.

Dr. Visser discussed several trends in research that she and her team use help inform policy makers and other stakeholders using data while working with students and teens with ADHD, Autism. and other childhood disorders.  She and her team have monitored and reported on the trends happening with the CDC since 2003.  I will attempt to share the how this information impacts parents of ADHD children and may impact decision making for your family.

What the Trends Are Telling Us About Our Children

With all of the misinformation out there about ADHD the legitimacy of the actual diagnosis including the hysteria about over-treatment,  I found this article pretty telling which I excerpt here.  Check it out the full CDC article called  Key Findings: Trends in the Parent-Report of Health Care Provider-Diagnosis and Medication Treatment for ADHD: United States, 2003—2011:

More than 1 in 10 (11%) US school-aged children had received an ADHD diagnosis by a health care provider by 2011, as reported by parents.

  • 6.4 million children reported by parents to have ever received a health care provider diagnosis of ADHD , including:

    • 1 in 5 high school boys

    • 1 in 11 high school girls

The percentage of US children 4-17 years of age with an ADHD diagnosis by a health care provider, as reported by parents, continues to increase.

  • A history of ADHD diagnosis by a health care provider increased by 42% between 2003 and 2011:

    • 7.8% had ever had a diagnosis in 2003

    • 9.5% had ever had a diagnosis in 2007

    • 11.0% had ever had a diagnosis in 2011

  • Average annual increase was approximately 5% per year

The percentage of children 4-17 years of age taking medication for ADHD, as reported by parents, increased by 28% between 2007 and 2011.

  • Percentage of children taking medication for ADHD was:

    • 4.8% in 2007

    • 6.1% in 2011

  • Average annual increase was approximately 7%  per year

The average age of ADHD diagnosis was 7 years of age, but children reported by their parents as having more severe ADHD were diagnosed earlier.

  • 8 years of age was the average age of diagnosis for children reported as having mild ADHD

  • 7 years of age was the average age of diagnosis for children reported as having moderate ADHD

  • 5 years of age was the average age of diagnosis for children reported as having severe ADHD

More US children were reported by their parents to be receiving ADHD treatment in 2011 compared to 2007, however treatment gaps may exist.

  • In 2011, as many as 17.5% of children with current ADHD were reported by their parents as not receiving either medication for ADHD or mental health counseling

  • More than one-third of  children reported by their parents as not receiving treatment were also reported to have moderate or severe ADHD

The patterns in ADHD diagnosis and medication treatment showed increases in the percentages overall, however some new patterns emerged between 2007 and 2011.

  • The percentage of children reported by their parents to have a history of health care provider diagnosed ADHD increased for most demographic groups (for example, across racial groups, boys and girls) from 2003 to 2011; however,

  • Between 2007 and 2011, the percentage of children reported by their parents to have a history of a health care provider diagnosed ADHD:

    • Was similar among older teens

    • Decreased among multiracial children and children of other races when compared to black or white children

The number of US families impacted by ADHD continues to increase.

  • An estimated 2 million more children were reported by their parents to be diagnosed by a health care professional with ADHD in 2011, compared to 2003

    • By 2011, 6.4 million children were reported by their parents to be diagnosed by a health professional with ADHD compared to 4.4 million in 2003

  • An estimated 1 million more children were reported by their parents to be taking medication for ADHD in 2011, compared to 2003.

    • By 2011, 3.5 million children were reported by their parents to be taking medication for ADHD compared to 2.5 million in 2003

Putting this Report in Context for Parents

This report shares the raw facts about ADHD and the impact on diagnosis and the treatment gap that still remains.  There is no question that ADHD is real and has real implications for children and families if left untreated.  My take-aways after listening and working with families are these:

  • Yes, ADHD diagnosis has increased by the health care professionals to 11.0 percent.  Is that such a surprise when you consider the amount of time health care advocates, educators, and other professionals have been sharing to help parents to become more informed about ADHD?  Parents are making informed decisions about their children rather than allowing status quo and untreated ADHD control them.

  • In 2011, the median age of diagnosis was 6 years but more severe cases were diagnosed earlier.  The brain researchers and other health professionals have been making huge leaps in this field and are able to provide support earlier to the parents of children who desperately need them.

  • The number of school aged children reported to be taking medication by their parents for ADHD in 2011 is now at 6.1 percent. Many parents are now taking action, know how to get help, and no longer accept the old notion that “bad parenting” is causing poor behavior.

  • In 2011, more school aged children were diagnosed with ADHD but only 1 in 5 were getting any kind of treatment (medication or mental health counseling). I think this statistic is the most alarming to me personally. Why are children diagnosed and then not treated?  Many reasons including inability to purchase medication,  choosing other alternative treatments, and even unfortunately,  seeing ADHD as some little, harmless, childhood thing that can be outgrown.  Making sure parents and caregivers understand the real implications of diagnosed and untreated ADHD is paramount to gaining the right help for kids and their family.

Questions Still Out There

The data is always telling but listening to Dr. Visser state that this research is used to monitor health of children and young adults, help with policy making at the state and national level, and determine support and training for groups working with ADHD children and teens.  She has some follow up studies scheduled and concedes that a part of the ADHD diagnosis is about “impairment” which is the much more subjective part of the diagnosis than meeting a checklist of symptoms.

She also shared some fascinating information about ADHD prevalence which can be variable  across the US due to so many reasons including: the population and demographics of the regions, the implementation of health care policy including Special Education policy and  funding; access to health care doctors , the levels of  poverty and ethnic groups, and cultural differences in the acceptance as ADHD diagnosis.

I’m looking forward to this follow up survey and even more detailed information about ADHD rather than the opinion pieces of media savvy editors who continue to use ADHD as a “marketing tool” to increase readership.

 

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