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California data shows ADHD cases rising
January 21st, 2013
04:39 PM ET

California data shows ADHD cases rising

In 10 years, diagnoses of attention deficit hyperactivity disorder (ADHD) increased 24% in southern California, according to a study published Monday in the journal JAMA Pediatrics.

Doctors reviewed anonymized medical records for children treated at the Kaiser Permanente Southern California physicians group between 2001 and 2010 - 842,830 children in all, according to the research.

Overall, in 2001, 2.5% of children aged 5 to 11 were diagnosed with ADHD, but that number crept up to 3.1% by 2010.

Researchers believe the study's method, reviewing actual medical records within a defined group, gives a more accurate picture of ADHD in Southern California than other estimates.

For example, the Centers for Disease Control and Prevention estimates a much higher rate of ADHD - about 9.5% of U.S. children aged 4 to 17 in 2007 – but that estimate relies on parents responding to telephone surveys, a relatively inaccurate method.

Also, the vast majority of ADHD diagnosis in the study were by specialists using a strict definition of ADHD, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). One study cited in the new research found that only 38% of primary care physicians actually used the DSM-IV for diagnosing ADHD, further complicating other estimates of the condition.

The lowest rate of ADHD - 1.1% - was seen in Asian and Pacific Islander children and did not increase in the 10-year period, though researchers noted that Asian-American children were particularly less likely to use mental health services and more likely to discontinue therapy.

Researchers found the largest percentage increase in ADHD diagnoses among African-American children. Rates increased 69.6% between 2001 and 2010 for that group.

Still, the overall rate of ADHD diagnosis was highest in white children, at 5.6% in 2010.

"Our study findings suggest that there may be a large number of factors that affect ADHD diagnosis rates, including cultural factors, that may influence the treatment-seeking behavior of some groups," said study lead author Dr. Darios Getahun from Kaiser Permanente Southern California's Department of Research & Evaluation. "These findings are particularly solid given that our study relied on clinical diagnoses of ADHD based on the criteria specified within the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders and that it represents a large and ethnically diverse population that can be generalized to other populations."

"Even if some of the reported increase is due to better awareness, these data seem to speak to a true increase. There's a fairly substantial list of environmental factors that have been linked to ADHD," says Dr. Philip Landrigan, Director of the Children's Environmental Health Center at Mount Sinai School of Medicine.

"That list includes prenatal exposure to maternal tobacco smoke, it includes lead; more recently, researchers at Mt. Sinai have linked prenatal exposure to phthalates, a plastics chemical, to ADHD. There's some evidence that prenatal exposure to organophosphate pesticides increases risk for ADHD. I think this is a list that we can expect to continue to grow in the years ahead because we now have very sophisticated scientific tools for testing linkage between prenatal exposure and conditions like ADHD in children."


soundoff (37 Responses)
  1. lostisland

    They're going to find the internet and it's training us for constant mental stimulation is a major contributor. I'm in my mid-50's, I'm a programmer, it's affecting ME dammit.

    January 21, 2013 at 18:41 | Report abuse | Reply
    • overstimulated

      Truth.

      January 22, 2013 at 02:53 | Report abuse |
  2. Sara

    Re the steady 1.1% in Asia – perhaps children in Asia are also taught to behave, stay in their seats, pay attention to teachers and elders, do their homework etc. I think the overly permissive dont-say-no-to-a-child generation has led to a lot more children who have few rules and few consequences, and they learn easily to make a fuss until they get what they want. They also don't concentrate or are disruptive in school and resist doing homework until someone else practically does it for them, etc. it sure was different when I was a kid when there were real school grades and real consequences to bad behavior.

    January 22, 2013 at 01:39 | Report abuse | Reply
    • Nick

      This kind of ignorance is the biggest problem plaguing people who suffer from ADHD. Please understand that only a small portion of ADHD involves "Not being able to focus" and "not sitting still". It's a serious mental disorder that can come along with over a dozen more issues besides "paying attention". Our brains are wired differently than yours. What you've said is like saying to a person suffering from multiple personality disorder that if someone had been around to tell them there was only one person in their head, they wouldn't have that problem. It's a condition your born with, and most will suffer with their entire lives. If you dont understand a disease, you should research it a bit more before making judgement calls. There's an err on the side of medicine for many physicians not properly diagnosing, but ADHD is very real, and can be very difficult to grapple with growing up.

      January 22, 2013 at 01:51 | Report abuse |
    • codes

      Erm. My parents tried to have me behave, sit still for more than 2 seconds, pay attention/interact/engage at school, said no a whole lot. And NO. And Oh Dear God NO. And gave me rules and consequences. I didn't 'fuss' to get what I wanted. I just went and got it. Though they tried to stop that too. In short, what I'm saying is, my parents parented me, as best they could.
      And still my brain is on acid.
      Believe me, it's real.

      January 22, 2013 at 02:24 | Report abuse |
    • incognito4884

      I used to think exactly like you. I thought that ADHD was just a way for parents to justify their child's bad behavior. I work at a daycare and care for a group of elementary aged boys. I have 14 in all and if I told you to find the one that had ADHD, it would take you less than a minute to pick him out. And I can tell you that his parents are very strict with him and so am I. The problem is that his brain works differently than others, so he has a hard time controlling himself. He blurts out things at inappropriate times, he shoves others when he is getting impatient, and he has to have his homework read aloud because he can't process things that he reads quietly to himself. He takes at least twice as long to do his homework compared the other boys, but he does do it...every single day. His parents hired him a tutor (they are fortunate enough to have the funds for that) that gives him two extra homework assignments every day. He is required to read aloud to himself for at least 30 minutes before bed. He is a good kid and he works three times as hard to be at the same level as the other kids in his grade. ADHD makes doing everyday normal things very difficult. It makes good kids seem "bad" to those that do not try to understand.

      January 22, 2013 at 03:04 | Report abuse |
    • gabc

      Growing up, I had never heard of this or ever knew any children with ADHD or autism, I now know four, right in my neighborhood. I often wonder, could it be environment, genetic? You are absolutely right about the "never say no" generation, seen it first hand in my own grandchildren. The many kids I come in contact with are only concerned with their iPad's, cell phones, computers.

      January 22, 2013 at 05:51 | Report abuse |
    • Sara

      Nick – I am not denying real ADHD exists. I just think a part of the reason for the RISING percentage diagnosed in the US vs the smaller steady number in Asia (for example) is societal and that some of those diagnosed as ADHD in the US do not really have it and were just never taught to be patient, to tackle challenges, to concentrate, to do their schoolwork etc.

      January 22, 2013 at 17:19 | Report abuse |
    • sophia

      I beg to differ. I have been diagnosed with adult ADHD, and as a child my mother tried to be ultra-strict, sit down, be still, calling me a busy-body, yelling, hitting, etc etc, and I suffered greatly in school and nobody noticed it (back then there was little or no awareness of ADHD), and the old pediatritian I had was a mean, old-school type guy who only encouraged her more in the disipline direction, never realizing I had a bona fide medical issue...ADHD. I am female so that made it worse because the boys would sometimes be diagnosed as "hyperactive", but girls would be overlooked back then (I was in first grade in 1967). Be careful about encouraging the strict disipline "stuff"....a lot of adhd kids suffered/are suffering at the hands of "old fashioned" or over religious evangical type parents due to the mistaken idea that you can "fix" the problem with discipline alone.

      January 23, 2013 at 22:49 | Report abuse |
  3. Dr Feelgood

    Dope 'em up! Stat!

    January 22, 2013 at 01:40 | Report abuse | Reply
  4. Seyedibar

    Overstimulation. Their ability to learn new things via media outpaces focused personal-discovery and self-reward.
    In other words, less internet and tv, more books and sports. No shortcuts for growing brains.

    January 22, 2013 at 02:33 | Report abuse | Reply
  5. Dan

    This is dumb. People haven't changed a bit, and are just the same as they were HOLY CRAP A CAT PICTURE!!!

    January 22, 2013 at 03:00 | Report abuse | Reply
  6. Tristen

    I wasn't surprised that the highest rate of ADHD "cases" continues to be white children. Many of these occur in the last 2 years of high school, when affluent, connected, white teenagers suddenly develop ADHD and are then rewarded with extended time on college admissions tests (with no penalty since the tests do not flag you for having extended time). Though ADHD is a real illness, it's one of those diseases that westerners have leveraged into an advantage or some sort of cultural rite of passage. See: bulemia, anorexia and white kids killing everyone.

    January 22, 2013 at 03:10 | Report abuse | Reply
  7. phloide

    they need to rephrase this "California data shows ADHD diagnosis rising", simply because 1) as people become aware of what is going on, they are taking action, and 2) all these psychological profiles are evolving. As psychological psychological evolve, people who would have been classified as xyz N number of years ago may be classified as jkl today. Example: Asperger’s has just been merged with Autism (the diagnosis, not the spectrum), so the number of people with Autism will systematically just increased

    January 22, 2013 at 08:42 | Report abuse | Reply
  8. rediranch

    In other unrelated news, parents are spending less and less time with their kids, depending on teachers, television, computers, and hand held devices to raise them.

    January 22, 2013 at 08:49 | Report abuse | Reply
  9. Tammy

    My 13 year old daughter was just diagnosed with ADHD. Contrary to what many of you seem to believe, you can't just go to the doctor, say your kid is hyper and viola! ADHD. She goes to a wonderful psychologist, who TESTED her for it. Yes, there is a TEST. Hyperactivity is, in her case, a small portion of the issue. She has serious impulse control issues, and she has social difficulties due to her inability to make good decisions. She will be prone, all her life, to OCD, Depression, and Anxiety disorders. Don't TELL me I didn't "parent her right". You have no idea how other people parent their children. Walk a mile in my shoes, then you can judge me. It's not about too much sugar. It's not about not enough discipline. Her brain is chemically different. Until you've lived with someone with ADHD and watched them struggle, you've no right to sit on your high horse and pass judgement.

    January 22, 2013 at 09:24 | Report abuse | Reply
    • April

      They tend to label the children as ADHD. but 90% of the time there is more to them than that. We were told that both our 12 and 9 year old both are ADHD. Now we are finding out that our 12 year old could actualy be autistic instead. I think they are using ADHD. If you find the right doctor that will do the appropriate testing inorder to get the correct diagnosis then more power to you. Then then child will actually have a better chance at life.

      April 28, 2013 at 23:07 | Report abuse |
  10. Jon

    ADHD, is a made up disorder which was invented to take advantage of gullible parents and line the pockets of the greedy psychiatric industry. There are NO chemical tests to prove its existence. Notice where this study was conducted, at the Kiaser Permenente Southern CA childrens center. Does that not slap you in the face? That is called bias. How long should a child stay on methamphetamine or amphetamine for ADHD? From age 7 to 70? Do you fools not understand what powerful stimulant DRUGS do to your cardiovascular system? Drugging children to SHUT THEM UP is not beneficial to children nor to their supposed adult parents who are also likely to be duped into taking other psychiatric drugs like antidepressants. Notice how neither behavioral intervention drugs nor antidepressants can actually cure these disorders. You cannot, for example, take 10 paxil and then be cured of depression, for that would put these companies out of business. Thus, they INVENT disorders, GET ADULTS AND CHILDREN ADDICTED TO DRUGS, the drugs DO NOT CURE THEIR problems they have yet to resolve, and going off means a miserable and dangerous withdrawal. The psychiatic industry which gets its inspiration from Brave New World want ALL OF US ON SOMA, and with the 11% of USA citizens over age 12 doped out on antidepressants, the drugging of our children on ritalin and amphetamine and paxil and xanax, the USA consuming 99% of the worlds vicodin and 80% of the worlds prescription opiates, we are well on our way to all being drugged by the prescription drug industry, but just remember, prescription drugs are side effect free and most actually cure other disorders and ailments we never new we had, not create new ones so they can put us on more drugs.....right????? Right? YOU DECIDE.

    January 22, 2013 at 10:18 | Report abuse | Reply
    • Nick

      Please, take your tin-foil hat elsewhere.

      January 22, 2013 at 21:29 | Report abuse |
  11. Willie

    My gosh, the ignorance on display in these comments is astounding. Personally, I think it is a real thing and not Big Pharma trying to make money (and believe me, I don't trust them at all). First, observe how many parents (even well-educated, white ones) put their kids in front of television and movies starting WAY too young. Second, the exposure to chemicals that can affect development of the fetus is huge compared to 50-70 years ago. Phthalates are one example, And again, smart well-educated people often don't want ot hear about those chemicals because it is just "too hard to keep track of them" or some other lame excuse. The chemical industry does not care about your health; they care about profit. The FDA and EPA can barely keep ahead of them and in most cases does not.

    January 22, 2013 at 14:13 | Report abuse | Reply
  12. Willie

    I should add that experts (go ahead argue about what an "expert" is) says that the brain is developing so fast between the ages of 0-3 that television, video games, etc. "wires" the little ones brains differently. It is the easiest thing to do in a way to prevent problems - don't let these be a baby sitter for you. And don't underestimate the ability of chemicals even in parts per billion to affect your body and your offspring's body.

    January 22, 2013 at 14:15 | Report abuse | Reply
  13. yvgeney

    Wait till May 2013, DSM V comes out and allows ADHD to be more easily diagnosed. Result, more drug sales, more money for everyone! Yey...f/n doctors suck. My stepson was diagnosed in March 2009, his mom (the f'n child abuser) wants him to stay on drugs to keep his grades up. GRRRRRRRRRRR! F'n doctors.

    January 22, 2013 at 15:48 | Report abuse | Reply
  14. Floppy

    ADHD is an excuse for lack of discipline. Little snowflake acts up and mommy doesn't want to discipline, so we say little snowflake has a form of ADD.

    January 22, 2013 at 16:28 | Report abuse | Reply
    • Flume

      Floppy, you are an idiot. I grew up in the 50s with ADD, and the thinking that a lack of discipline and laziness prompted this disorder was prevalant then, and it is anachranistic and ignorant now. ADHD can be diagnosed with a PET scan, it is a visible condition. Your comment is hateful and distructive. You need to learn about what you are talking about before you open your cake hole.

      January 22, 2013 at 21:58 | Report abuse |
  15. skepticus

    Definitely two sides to the issue. It wouldn't surprise me if ADD/ADHD is overdiagnosed to appease parents who won't leave the doctor's office without some pills to fix a kid who may not need fixing. Maybe he just needs more attention. At the same time, I can see where there may be an organic basis for the observed behaviors. An unusual novel told from the viewpoint of a kid with ADHD – The Son of Rage and Love. Sad story, but good. I also like what Dr. Michele Borba (I saw her on the Today Show) says about ADHD and overstimulation . TV and video games are not helping these kids.

    January 22, 2013 at 17:33 | Report abuse | Reply
  16. mimi

    I wish that my kid were diagnosed with ADHD, instead of Autism. At least with ADHD, the children can still interact and talk.
    Autism ruins lives.

    January 22, 2013 at 21:30 | Report abuse | Reply
    • Derp

      ADHD is now under the umbrella of autism, it's just on the mild side.

      February 25, 2013 at 12:22 | Report abuse |
  17. Michael Andrew Ruzicho

    I believe that there needs to be more research and a cure for this disability that affects to many.

    January 24, 2013 at 17:03 | Report abuse | Reply
  18. empresstrudy

    100% of the population is ADHD, autistic and allergic to nuts.

    February 1, 2013 at 09:48 | Report abuse | Reply
  19. Edilberto Durano

    ADHD is just a modern invention for parents to have something to blame on their incapacity to discipline the kids and prevent them from misbehaving. If ADHD is really a condition then its just a result of an evolutionary process for children born in the times when there is excessive sensory stimulation.

    Ed of DocuScanAmerica.com

    February 7, 2013 at 01:02 | Report abuse | Reply
  20. Kody

    I have ADHD. I was diagnosed with it when I was about five. The doctor said it was one of the most sever cases of ADHD he had ever seen, he said it was borderline insanity. I had a massive tantrum in preschool, hitting kids, throwing chairs, and got kicked out. I went to counciling for six years, and had to test nine different kinds of medicine. There was only one that slightly worked, and all it did was slow down my system, basically removing all my energy. So to those who say it isn't real, it is. It is a chemical disurption in the brain, and there is scientifical proof to back it up. It isn't a bad thing, and sometimes, it can be good, Alot of people with ADHD have done great things. But, when it gets serious like mine, then it becomes an issue.

    February 13, 2013 at 10:16 | Report abuse | Reply
  21. Derp

    The number of cases isn't increasing, the number of DIAGNOSES is. Derp. With parents more aware of the condition and more trained psychologists and doctors, of course you'll see an increase. It doesn't mean more children are born with ADHD than in the past, it's just that we're catching it more often. See if the number of adult cases won't increase after giving out information on it.

    February 25, 2013 at 12:21 | Report abuse | Reply
  22. Tutor In California

    Nice post and the information given in this blog is really good.

    March 3, 2013 at 04:08 | Report abuse | Reply
  23. Leslie

    My son has been diagnosed with ADHD and an anxiety disorder by a psychiatrist. We have declined pharmaceuticals but have spent over one year in weekly therapy with mixed results. We have found that exercise, good sleep, clear rules, reward systems, and lots of love and understanding are very helpful. Supplements including zinc, magnesium, and Omega 3 have been very effective. In retrospect, I realize that my son has shown signs of his disorders since birth! He may be unusual in that his IQ is high and he tests very well (he is a 3rd grader who has consistently since the age of 4 been at a reading level about 2/3 years ahead) and scores even better in standardized math testing. His self control and social skills have improved since his diagnosis and he can now complete his work at school almost all the time. Blurting out in class is still a problem, but his amazing teacher has helped with this but also accepts that this is beyond his control. After more than a year in weekly counseling, our therapist basically refused to continue to work with us without using pharmaceuticals, especially for the anxieties. His disorder presents as mild to severe phobias to some everyday things. We are now working with a naturopathic doctor who has testing his neurotransmitter levels and found them to be way out of whack and he believes that this is responsible for both his ADHD and anxiety. We are trying to use very targeted supplements to "retrain" his system to produce the right neurotransmitter levels at the right times. Some days are a huge struggle. But everyday is a gift with our beautiful, smart, funny, and incredibly lovable boy. I have very dear friends that I have not told any of this to because of their denial of ADHD as a real thing. I have very close relatives who tease and belittle him worse than any bully at school. Please stop and think before spouting criticisms of mental disorders and how we parents go about just trying to help our kids have a happy and complete life.

    April 2, 2013 at 17:20 | Report abuse | Reply
  24. April

    ADHD is being over used. Not all parents who have children who have this lack the discipline of the children nor do they depend on electronics to watch their children. Both of my kids have this and we have coached them in sports and encourage them to go outside and be active. on is on medication because of how severe he is and the other is not. We have done eight years of therepy with one with some not much progress. Even with the meds it does not always help. They both also have other stuff going on. ADHD is just part of it. They say that ADHD is most of the time accompanied with something else.

    April 28, 2013 at 23:20 | Report abuse | Reply
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    May 6, 2013 at 17:30 | Report abuse | Reply
  26. Omar Umbaugh

    Academic difficulties are also frequent. The symptoms are especially difficult to define because it is hard to draw a line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin. To be diagnosed with ADHD, symptoms must be observed in two different settings for six months or more and to a degree that is greater than other children of the same age.

    June 6, 2013 at 21:44 | Report abuse | Reply

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