ADHD on the Rise Among Children in California

Loud, screaming  young boy

A new study on California health records reveals that the number of children who have Attention Deficit Hyperactivity Disorder (ADHD) has increased 24% since 2001, reaching “epidemic proportions.” The rates of increase are especially apparent among boys and children from higher-income families. However, many believe the increase in ADHD diagnoses can be attributed to an increasing awareness of ADHD among physicians instead of an actual increase of ADHD in the population.

ADHD is one of the most common chronic psychiatric disorders in children. While most children are diagnosed before the age of 10, 7 out of 10 of those children continue to have symptoms of ADHD until adulthood. Many also run a greater risk of other psychiatric disorders in adulthood, like depression or bipolar disorder.

Children with ADHD tend to be inattentive, overactive, or impulsive at school or home. Though most children have problems from time to time, they tend to have behavioral problems that extend beyond the normal range of childhood behavior. Because an ADHD diagnosis is based on a doctor’s observations and on complaints from the teachers and parents, many children are often incorrectly labeled with ADHD.

The researchers used data from the Kaiser Permanente Southern California (KPSC) healthcare system, which tracks ADHD diagnoses in detailed medical records. They reviewed over 842,000 medical records of children between the ages of 5 and 11 years. Using this data, they were able to link the trends of ADHD with the child’s age, race/ethnicity, sex, and household income.

They found that the diagnoses of ADHD increased 24% from 6869 diagnoses in 2001 to 8006 diagnoses in 2010. There were increases among children who were white, African-American, and Hispanic, while rates among Asian/Pacific Islanders remained unchanged over time. African-American children had the highest increase in ADHD diagnoses, especially among African-American girls. Among all racial/ethnic groups, however, boys are still three times more likely to be diagnosed with ADHD overall.[MOU1]

No one is entirely sure where ADHD comes from. There are most likely multifactorial causes. Multiple studies have connected ADHD risk with family history; exposure to tobacco smoke, toxins, or lead; maternal use of antidepressants during pregnancy; and low birthweight.

However, there are many social factors that can cause a child to become more disruptive and exhibit ADHD-like symptoms. Higher levels or stress or anxiety stemming from events such as a parental divorce or teasing from other children can cause a child to ‘act out’ at home or school and trigger a teacher to suspect ADHD. However, current psychiatric guidelines require children satisfy strict criteria before qualifying for a diagnosis. Children must have the disruptive or inattentive symptoms for at least 6 months and show them in at least two settings (home and school). Parents and teachers must also fill out a behavioral checklist that allows them to chronicle the child’s emotional and behavioral problems.