Are we overlooking our children’s behaviour?

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder characterised by hyperactivity, inattention and impulsivity. ADHD is the most common psychiatric disorder affecting children. A recent study found that nearly 9% of American children meet criteria for ADHD. However only 32% of these children are receiving the medications they need. Poorer children are the least likely to be appropriately treated. These results are contrary to the consensus of the general public who tends to think ADHD is overdiagnosed and that we shouldn’t be exposing our children to unnecessary psychostimulant medications.

Attention-deficit/hyperactivity disorder (ADHD) is a developmental disorder characterised by a persistent pattern or poor attention, hyperactivity, poor impulse control and distractibility. These impairments must occur in at least two environments to fit the diagnosis (for example inattention noticed both at school and at home).

ADHD is usually diagnosed in children but adults may also be affected. Approximately 60% of children with ADHD will continue to have symptoms into adulthood. ADHD is a long-term condition that currently has no cure; however some medications (such as dexamphetamine) can help to control or reduce symptoms.

The general public tends to believe that ADHD is overdiagnosed and that children are been inappropriately exposed to pshychostimulant medications. However new research in the United States reveals the exact opposite.

A study team headed by Dr. Tanya E. Froehlich, a paediatrician at Cincinnati Children’s Medical Centre, found that many children who fit criteria for ADHD have not been diagnosed or treated.

In the study, only approximately half of children with features of ADHD had been diagnosed by a health professional and only one third of children with the disorder were receiving appropriate medications. Therefore there are large numbers of children with clinically significant inattention and hyperactivity who are not receiving optimal interventions.

Researchers found that overall approximately 8.7% of American children met the diagnostic criteria for ADHD. This equates to national figures of approximately 2.4 million. The rates in lower socioeconomic and poorer groups of children are even higher. This is postulated to be caused by increased rates of exposure to tobacco during pregnancy, childhood lead exposure, and higher pregnancy complications in these groups.

In addition researchers discovered that the poorer groups (with the highest prevalence rates) were also the least likely to receive continuous medical treatment. ADHD is not a trivial disorder. Underdiagnosis and undertreatment of this disorder has the potential to cause significant impairment in a child’s social and educational functioning.

ADHD has been associated with lower rates of school and career achievement and increased rates of substance abuse, incarceration, injuries and car accidents. It is therefore essential that ADHD is identified and managed appropriately to reduce this significant burden.

This new study therefore concludes that ADHD is a common condition in the community that is currently being under recognised and poorly treated. Further research and development is needed in this field to help identify patients at risk and to provide appropriate treatment to all children with ADHD.