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News Roundup [abridged Versions Appear In The Paper Journal]

1.6 million elementary school children have ADHD, says report

BMJ 2002; 324 doi: https://doi.org/10.1136/bmj.324.7349.1296 (Published 01 June 2002) Cite this as: BMJ 2002;324:1296
  1. Scott Gottlieb
  1. New York

    About 1.6 million cases of attention deficit hyperactivity disorder (ADHD) have been diagnosed in American elementary school children, according to the Centers for Disease Control and Prevention (CDC).

    In a new report the CDC said that about half of the children in whom the disorder was diagnosed had also been identified as having a learning disability. “This report serves as a snapshot of a condition that has important consequences for the development of school age children,” said the CDC's acting director, David Fleming. “However, much more needs to be learned about ADHD and about the spectrum of impairments associated with ADHD.”

    The figures mean that 7% of US children aged 6 to 11 have the disorder. The survey also found that half of children in whom a diagnosis of ADHD is made are also said to have a learning disability.

    As it is calculated that at least a million children have a learning disability without ADHD, this brings the total number of children with at least one of these disorders to 2.6 million, according to the CDC. The results were obtained from national surveys conducted in 1997 and 1998, including interviews with family members of 8647 children between the ages of 6 and 11.

    According to the report, significant racial and sex differences exist in the frequency of diagnosis of ADHD and learning disability. Boys were three times as likely as girls to have a diagnosis of ADHD alone and twice as likely to have ADHD and a learning disability. Rates of diagnosis of ADHD are twice as high in white children as in Hispanic and black children.

    Children with a diagnosis of learning disability alone were more likely than other children to live in a low income or single mother household, and children from families with health insurance were more likely to have a diagnosis of ADHD without a learning disability.

    A study conducted by the Mayo Clinic and reported two months ago found that ADHD affects up to 7.5% of school age children (Archives of Pediatrics and Adolescent Medicine 2002;156:217-24). Previous studies had estimated the occurrence of ADHD to be anywhere between 1% and 20% of school age children.

    Methylphenidate, which is sold in many forms but best known by the brand name Ritalin, came into common use 15 years ago to treat ADHD in children. The drug has long been controversial, with some people asserting that ADHD is overdiagnosed and the drug overprescribed as a performance enhancer, while ADHD specialists say the drug should be available to more children.

    Critics of the drug say that the diagnosis is a convenient shortcut and the drug dispensed zealously to avoid discipline problems. Others say the diagnosis of ADHD and prescription of the drug can liberate children who have grown up labelled as troublemakers. ADHD is now the country's most commonly diagnosed behavioural disorder.

    The CDC's report is available at www.cdc.gov/nchs

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