What's Behind the 53 Percent Rise in ADHD Diagnoses?

The diagnosis of ADHD is being handed out too freely.

Posted Apr 01, 2013

A widely read article in today's New York Times presents shocking new data from the Center for Disease control about the explosive surge in ADHD diagnoses among American children and teenagers. A whopping 11% of school-age children, or approximately 6.4 million children, have received a diagnosis of ADHD. This is a 16 per cent increase since 2007 and a 53 per cent rise in the last decade.

None of the medical doctors interviewed in the article argue that the increasing numbers of ADHD diagnoses actually represent the spreading of a disease. On the contrary, the doctors point to a purely iatragenic cause for the epidemic: "slipshod" diagnoses, use of drugs for "enhancement" of the abilities of children who are otherwise healthy, parental pressure on doctors to drug their kids to improve school performance, and "an alarming rate of misuse of the diagnosis."

Even Dr. Ned Hallowell, a child psychiatrist and leading defender of the ADHD diagnosis, is quoted as having second thoughts. He believes that the high rates of children being identified as having ADHD signify that the diagnosis of ADHD is being handed out too freely.

Hallowell even admits that he has been reassuring parents for years that Adderall and other stimulants were "safer than aspirin." Now he has reassessed his point of view about the safety of these drugs: "I regret that analogy," he said, and he "won't be saying that again." Hallowell adds: "I think now's the time to call attention to the dangers that can be associated with making the diagnosis in slipshod fashion..."That we have kids out there getting these drugs to use them as mental steroids--that's dangerous, and I hate to think I have a hand in creating that problem."

Dr. Jerome Groopman, a professor of medicine at Harvard University, said that there is a push to think of normal behaviors--like a child not sitting quietly at his desk--as "abnormal" or "pathological instead of just childhood."

Several doctors point to drug industry advertisements aimed at consumers and doctors as driving the prescription and sale of ADHD drugs. Parents are being encouraged to give their children everything they can to help them succeed--including performance enhancing stimulants.

Another encouragement for doctors to diagnose even more kids with ADHD is the forthcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, or DSM-5, which widens the criteria for an ADHD diagnosis. It will now require that symptoms appear before age 12 instead of age 7. And illustrations of symptoms of ADHD have become even more ludicrous than in previous editions--for example, a child losing his cell phone repeatedly or losing his focus during paperwork. With these criteria, my adult children, many of my friends, not to mention myself, would be diagnosed with ADHD and drugged accordingly--except that there were no cell phones before I was twelve.

At the time I am writing this, more than 1000 readers have left comments on the Times article. Some of them are especially worth noting. A school psychologist in New York writes: "I have watched the rise in ADHD being diagnosed in children for the last thirty-four years. The diagnostic criteria for ADHD could be well termed: 'Things that children do that annoy adults'." A Connecticut woman points out that drug treatments in other countries are not the first line of treatment as they are in this country: "In England the treatment first recommended for ADHD is family therapy." And a New York woman sums it up beautifully: "we expect kids to not be kids."

 Marilyn Wedge is the author of Pills are not For Preschoolers: A Drug-free Approach for Troubled Kids.

Her latest book, A Disease called Childhood, is forthcoming from Penguin/Avery in March, 2015.