This is one in an occasional series about children’s health issues. We know that many of our readers are grandparents keenly interested in the health and well-being of grandchildren. We hope this series will provide readers useful health information you can share with your family.
A large, recently-published national study reports that in 2011 nearly 6 million U.S. children ages 5 to 17 had a diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD), a 43 percent increase over the number with that diagnosis in 2003.
According to the U.S. Centers for Disease Control and Prevention, children and teens with ADHD may be forgetful, have trouble paying attention, and be impulsive or prone to making careless mistakes. If the condition is not treated, it can lead to difficulties at school, at home and in social situations.
Dr. Lynn Williams is a licensed clinical health psychologist and family psychiatric nurse practitioner with a private practice on the barrier island; she is familiar with the study. Dr. Williams says, “There are many potential reasons for the increase, including the possibility of misdiagnosis. The symptoms of ADHD can mimic those of other conditions, including mood disorders and high thyroid.”
The research uncovered an unexpected increase in ADHD among girls. (Traditionally, boys have been more likely to get a diagnosis of ADHD.) “We found the parent-reported prevalence for girls diagnosed with ADHD rose from 4.3 percent in 2003 to 7.3 percent in 2011. That’s an increase of 55 percent over an eight year period,” says lead researcher Sean D. Cleary, an associate professor of biostatistics and epidemiology at Milken Institute School of Public Health at the George Washington University. (Epidemiology is the study of patterns, causes and effects of health and disease conditions in defined populations.)
The study showed an even sharper jump in diagnosed cases of ADHD in certain subgroups. In addition to the surprising increase among girls, there was a 52 percent increase for adolescents (children age 11 and older) and an 83 percent increase among Hispanic youth.
The researchers mined data from a survey sponsored by the Maternal and Child Health Bureau and the National Center for Health Statistics of the U.S. Centers for Disease Control and Prevention. Their findings were published online in the peer-reviewed Journal of Clinical Psychiatry in December.
Lead researcher Cleary says the study was not designed to look at the underlying reasons for such changes in prevalence. The increase in ADHD diagnoses could be reflective of a true increase in the ADHD cases, or – as Vero’s Dr. Williams mentioned – it could be the result of a tendency to over-diagnose the condition. Additional research is needed to determine which it is; that’s important, because a diagnosis of ADHD often comes with a prescription for a stimulant, such as Ritalin or Adderall. These drugs can cause side effects such as headache, anxiety, insomnia, nausea, and abdominal pain; critics worry that they may be overprescribed.
Through her telepsychiatry services, Dr. Williams sees many young patients each week who have been diagnosed with ADHD. (Telepsychiatry is psychiatry practiced via videoconferencing.) She tells parents that diagnosing ADHD must include an assessment of the child’s bloodwork by their primary care physician, to rule out other conditions that can cause hyperactivity. She also advises parents to meet with the school psychologist and insist their child be given an assessment using a well-respected screening tool, such as the Connors Test or the Vanderbilt Questionnaire. Dr. Williams says the parent should contact the school board if they aren’t satisfied with the response.
Underscoring the fact that ADHD is very much – perhaps too much – in our consciousness, Dr. Williams often talks to college students who think their inability to focus on their studies is due to ADHD. She says, “I ask them if they had any problems concentrating in third grade or before. If they say no, I tell them their problem is something other than ADHD.”
Dr. Williams says the single most important thing for children diagnosed with ADHD, or showing its signs, is what she calls “good sleep hygiene.” Their bedroom should be dark and cool, and when they go to bed it should be without anything electronic, including their smart phones, tablets or TV. She also says setting and following a schedule is important, as it can have a significant impact on behavior.
The amount of physical activity a child gets is also important. Speaking of a technique called “green space therapy,” Dr. Williams says, “Studies have shown that playing in areas with grass and trees is very helpful.” She emphasizes that physical activities should take place at home as well as at school.
Dr. Williams’ office is located at 725 Flamevine Drive in Vero Beach; her office phone is 772-234-4511.