Childhood attention deficit/hyperactivity disorder (ADHD) is becoming increasingly common, with a new study revealing that one in nine American kids have been diagnosed with the condition—equating to 7.1 million children.
Many more children in the U.S. have been diagnosed with ADHD recently. In 2022, there were 1 million more cases compared to 2016, potentially fueled by the COVID-19 pandemic’s effect on children’s mental health and virtual schooling putting symptoms on display.
Pandemic Stressors May Have Fueled Rise in ADHD
The research article, published in the Journal of Clinical Child & Adolescent Psychology, provided insight into how the COVID-19 pandemic potentially influenced ADHD diagnoses. The higher prevalence could reflect “a generally increasing awareness of and pursuit of care for ADHD and/or a reflection of poor mental health among children during the COVID-19 pandemic,” the researchers wrote.
Previous studies have shown that the COVID-19 pandemic wreaked havoc on the mental and social well-being of young people, who experienced stressors such as illness and death in the family and community, changes in parents’ work habits, disruptions in school life, decreased social interaction, and increased fear and uncertainty. A 2022 study found that these pandemic-related stressors “can increase symptoms of inattention, impulsivity, and hyperactivity.”
The COVID-19 pandemic likely helped encourage an increase in diagnoses, as previously unobserved ADHD symptoms were front and center in households when children attended school virtually, according to the new study.
Conversely, during the pandemic, schools faced greater challenges in providing support for those students, “may have led more parents to seek diagnoses to ensure access to support for their child,” the research team wrote.
What It Takes for a Child to Be Diagnosed
ADHD is one of the most common developmental conditions affecting children in the U.S. In the three-year span before the COVID-19 pandemic, nearly one in 10 children had received a diagnosis. To be diagnosed with the condition, a child must exhibit at least six symptoms of either inattention or hyperactivity-impulsivity for at least six months.
The symptoms must be severe enough to be “maladaptive and inconsistent with developmental level” or negatively impact social, academic, and occupational activities, according to the Diagnostic and Statistical Manual of Mental Disorders.
Common symptoms of inattention include difficulty maintaining attention during tasks or play, not following instructions, often losing items required for an activity or task (like a pencil for homework), or being forgetful in daily activities.
Examples of hyperactivity include fidgeting with hands or feet, leaving one’s seat in the classroom or situations where they’re expected to remain seated, or having difficulty playing quietly. Examples of impulsivity include difficulty waiting for their turn or often interrupting others.
ADHD Gender Gap Narrows
In the U.S., more boys than girls have typically been diagnosed with ADHD, but new data shows that the gap between the two sexes is narrowing. Before 2022, the boy-to-girl diagnosis ratio was 2:1, while in 2022, it dropped slightly to 1.8:1, according to the study.
Among children aged 3 to 17 with ADHD, 41.9 percent had mild cases, 45.3 percent moderate, and 12.8 percent severe. Certain factors were linked to more severe ADHD: being aged 6-11 (vs. adolescents), living in households with lower education or income levels, and having a co-occurring mental/behavioral/developmental disorder.
More white American children are diagnosed with ADHD than minority children, though the research team noted that “with increased awareness, such gaps in diagnoses have been narrowing or closing.”
Children with public health insurance had the highest prevalence levels, as did children whose caregivers’ highest level of education was high school.
ADHD in children was most common in the Northeast, Midwest, and South, compared to children living in the West.
The report notes that the prevalence of ADHD in children is higher in the United States than in other countries. The reason “may be the result of variation in availability of clinicians trained to diagnose and manage ADHD, state and local policies, and regional differences in demographic characteristics,” the research team wrote. Future research could determine the differences between clinical guidelines and practices across countries.
