“I really don’t know quite what to make of it,” Akinbami said. “It does match trends for several other chronic conditions which have lower prevalence in the west. Also, it may be related to a greater proportion of children being made up of Mexican children who have lower prevalence rates.”
An ADHD expert, Dr. Bradley Peterson, agreed that the new findings most likely indicate an increase in diagnosis rather than an increase in the actual occurrence of the disorder.
“A lot of things will affect diagnosis,” said Peterson, chief of child psychiatry at New York-Presbyterian/Columbia Medical Center. “That can be anything from an increasing awareness of the condition to increasing access to health care – doctors can’t diagnose a child with ADHD if the child doesn’t get to see the doctor.”
Still, Peterson said, other studies that have rigorously examined the issue have determined that the actual prevalence of ADHD is somewhere between 3 to 5 percent.
So why are we seeing such large numbers of children diagnosed?
Some of the increase may also be due to our changing expectations for children’s behavior, Peterson said.
“We are increasingly more academically, cerebrally, and intellectually focused than we were two, three, five decades ago,” he explained. “And our requirements for kids to do well in school – having to sit still, stay focused, and attuned – have changed over time. I think the tolerance and threshold for saying a particular child is too fidgety, too distracted, has likely changed over time, too.”
So, today we may be seeing kids with milder symptoms getting a diagnosis they wouldn’t have received ten years ago, Peterson said. And, there may be some children being diagnosed with ADHD who have another issue and don’t actually have the disorder.
Ultimately, Peterson said, treatment for ADHD will help even those with milder symptoms. And the medications “have a good margin of safety,” he said. “So they are unlikely to do a great deal of harm if they are given for an incorrect diagnosis.”