Key Findings: Trends in the Parent-Report of Health Care Provider-Diagnosis and Medication Treatment for ADHD: United States, 2003—2011

Researchers from the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration have published a new study: “Trends in the Parent-Report of Health Care Provider-Diagnosed and Medicated ADHD: United States, 2003—2011.” You can read the abstract here 1 and listen to a podcast by the journal discussing the study and its findings here. See below for a summary of the findings from this article.

Health care providers who care for children with attention-deficit/hyperactivity disorder (ADHD) and public health practitioners should be aware that an estimated two million more US children were reported by their parents to be diagnosed by a health care provider with ADHD and a million more were reported to be taking medication for ADHD in 2011, compared to 2003. These health professionals should also be aware of the changing patterns of ADHD in the United States.

About attention-deficit/hyperactivity disorder and this study:

ADHD is a neurobehavioral disorder of childhood that often persists into adulthood. CDC uses national surveys that ask parents about their child’s health to monitor the number of children with ADHD and the treatment patterns for these children. The largest of these surveys is the National Survey of Children’s Health, which has been collected every four years since 2003. Previous results from the 2003 and 2007 surveys found that 7.8% and 9.5% of US children aged 4-17 years were reported by their parents to have ever been diagnosed with ADHD by a health care provider in 2003 and 2007, respectively. The current study looked at data from the third National Survey of Children’s Health, conducted in 2011-2012. The findings tell us more about ADHD diagnosis and treatment patterns, and reflect the substantial impact that ADHD has on families.

Important findings from this study include:

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

ADHD: CDC’s Activities

CDC monitors the number of children who have been diagnosed with ADHD through the use of national survey data. Including questions about ADHD on national or regional surveys helps us learn more about the number of children with ADHD, their use of ADHD treatments, and the impact of ADHD on children and their families. CDC has previously used national survey data to document increasing estimates of the number of children with ADHD from 2003-2007.2 CDC has also used these data to estimate the percentage of children taking medication for ADHD, nationally and by state.3

CDC also conducts community-based studies to better understand the impact of ADHD. The Project to Learn about ADHD in Youth (PLAY) is a study being conducted over time in two communities: one school district in South Carolina and five school districts in Oklahoma. Information from the PLAY study helps us better understand ADHD as well as the needs of children and families living with ADHD.

CDC supports the National Resource Center on ADHD, a program of Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), which is a Public Health Practice and Resource Center. Their web site (http://www.help4adhd.org/) has links to information based on the current best medical evidence about the care for people with ADHD and their families. The National Resource Center operates a call center with trained, bilingual staff to answer questions about ADHD. Their phone number is 1-800-233-4050.

More Information

To learn more about ADHD, please visit http://www.cdc.gov/adhd.

References

Visser S, Danielson M, Bitsko R, et al. Trends in the Parent-Report of Health Care Provider-Diagnosis and Medication Treatment for ADHD disorder: United States, 2003–2011. J Am Acad Child Adolesc Psychiatry. 2014,53(1):34–46.e2.
Centers for Disease Control and Prevention. Increasing Prevalence of Parent-Reported Attention-Deficit/Hyperactivity Disorder Among Children --- United States, 2003 and 2007. MMWR.2010;59(44):1439-1443.
Visser SN, Blumberg SJ, Danielson ML, Bitsko RH, Kogan MD. State-Based and Demographic Variation in Parent-Reported Medication Rates for Attention-Deficit/Hyperactivity Disorder, 2007-2008. Prev Chronic Dis. Jan 2013;10:E09.