ADHD seems to be everywhere these days. In recent years, the number of diagnoses has skyrocketed. More than 6.4 million U.S. youth — one in nine children between the ages of four and 17 — have now, at some point in their lives, received a diagnosis of ADHD, according to a major national survey of parents. The disorder has recently become the second most frequent diagnosis of a chronic condition for children, after asthma.
We predict that, for the next few years, the numbers of both young and adult Americans diagnosed with ADHD will keep rising. One of the most important factors for this is the increased awareness and acceptance of the disorder. Moreover, an ADHD diagnosis provides a ticket for accommodations and special services in school, and can also garner payments from Medicaid and other health insurance programs. When conditions are explicitly linked to services and funding, their rates of diagnosis often rise beyond their actual prevalence. More fuel for the rise in rates comes from doctors who are diagnosing ever-younger children. Key professional groups, such as the American Academy of Pediatrics, now urge that diagnosis and treatment begin as early as age four. Here we aim to provide straight talk and sound guidelines for educators, policymakers, health professionals, parents, and the general public.
>> How much influence do parents have on their child’s ADHD?
Although ADHD always begins with biology (genes), a parent’s behavior can matter quite a bit. Skillful parenting makes a great difference in the lives of children with biological risk for ADHD. Researchers have found the gold standard to be “authoritative” parenting, which blends warmth with clear limits and strong guidance toward independence. A parent’s love can’t be overestimated when it comes to a child’s mental health.
A child with impulsive behavior is not easy to raise. What makes it harder is that, given the strong hereditary nature of ADHD, one or both of the child’s parents may be struggling with the same disorder or with similar symptoms. So the parent and child unintentionally violate each other’s personal boundaries and react emotionally.
It is important for parents of children with ADHD to make sure they acknowledge and treat any mental problems of their own that may be compromising their ability to help their offspring.
>> Who is most likely to diagnose ADHD correctly?
All licensed physicians and mental health professionals are technically qualified to diagnose ADHD. Currently the majority of U.S. children are diagnosed by their pediatricians, which we consider a discouraging state of affairs.
Although pediatricians are authorized to prescribe medication, few are expert in calculating optimal dosage levels and monitoring effectiveness — and even fewer are well informed about behavioral, school, and family-based interventions. Many pediatricians are aware of their limitations but end up conducting evaluations anyway, due to the serious national shortage of child and adolescent psychiatrists and developmental-behavioral pediatricians.
On the other hand, clinical child psychologists are a good option for diagnosis. They outnumber child and adolescent psychiatrists and developmental-behavioral pediatricians, and, if well trained, offer a wide range of psychosocial treatments.