They found diagnosis rates to vary widely among the states, with the highest rates in the mostly southern states that were early movers in tying public school funding to children’s test scores.Īs US parents, teachers, doctors and social critics debate whether ADHD is over-diagnosed or under-diagnosed, the answer is most likely both. In his 2014 book The ADHD Explosion: Myths, Medication, Money, and Today’s Push for Performance, Stephen Hinshaw and his colleague Richard Scheffler describe the additional impact of changes in US public school policies, including increasing reliance on high-stakes, standardized tests, as possibly the single greatest factor in raising the diagnosis rate. One factor in the United States, often cited by medical historians, includes the 1991 incorporation of ADHD under the Individuals with Disabilities Education Act, which provided incentives to diagnose children who could now be eligible for special tutors and more time on standardized tests. There are many possible reasons for this. Israel, where one in seven children have been diagnosed, may be the world champion. But unlike asthma, ADHD provokes tremendous controversy, particularly when it comes to the numbers of children who are diagnosed and, often, medicated.Įxperts believe the prevalence rates of ADHD are roughly the same the world over, and yet the United States, along with Canada and Australia, has some of the highest rates of diagnosis in the world. The disorder is now the second most frequent diagnosis of a chronic condition for children, after asthma. At last count more than one in nine US children (including roughly one in seven boys) between the ages of 2 and 17 have received a diagnosis. If you think you’ve been hearing a lot about ADHD in recent years, you have, and for good reason. In the most recent B-GALS update, published in 2019, Hinshaw and UC Berkeley psychologist Elizabeth Owens linked unplanned pregnancies to lower academic achievement earlier in life.ĬREDIT: YANLEV / SHUTTERSTOCK Is the United States ground zero for ADHD? Research has shown rates of more than 40 percent, versus 10 percent for young women without ADHD. Moreover, whereas teenage boys with ADHD are more likely than girls with the disorder to abuse illegal drugs, the girls face a higher risk of becoming involved with violent partners.Īnother major problem for girls with ADHD is risky sexual behavior that leads to strikingly high rates of unplanned pregnancies. The studies show that, as a group, girls with ADHD are also far more prone than boys with ADHD or other girls to self-harm, including cutting and burning themselves, and to suicide attempts. PRODUCED BY HUNNIMEDIA FOR KNOWABLE MAGAZINEĪnother key longitudinal study on girls, led by Harvard psychiatrist and scientist Joseph Biederman, has found that major depression in teen girls with ADHD is more than twice as common as in girls without the disorder. Compared with boys who have the disorder, as well as with girls without it, girls with ADHD suffer more anxiety and depression. Girls and women, in general, engage in more “internalizing” behavior than boys, Hinshaw says, meaning they tend to take their problems out on themselves rather than others. As he and fellow researchers followed their subjects into womanhood, they found that girls with ADHD have many of the same problems as boys with the disorder, and some extra ones.Įscaping notice is just one of girls’ special burdens. Hinshaw began studying girls with ADHD in 1997, in a federally funded project that became known as the Berkeley Girls with ADHD Longitudinal Study (B-GALS). So girls with inattentive problems are not thought to have ADHD.” Instead, he says, educators and others assume the problem is anxiety or troubles at home. More boys than girls have aggression problems, have impulsivity problems. “You get referred if you’re noticeable, if you’re disrupting others. “Who gets noticed as having ADHD?” asks Stephen Hinshaw, a psychologist at the University of California, Berkeley, and a leading researcher on ADHD in girls. Whereas many boys with ADHD are normally more physically restless and impulsive, traits clinicians refer to as “hyperactive,” many girls with the disorder may be more introverted, dreamier and distracted - or in clinical jargon, “inattentive.” In part due to these subtler symptoms, experts suspect that many girls with ADHD are still escaping notice - and missing out on treatment. The higher rates of diagnosis in the United States are probably due to several factors, including shifts in educational policies that emphasize student test scores and changes in medical benefits coverage. Estimates suggest that worldwide, 5 to 7 percent of youth have ADHD. The diagnosis of ADHD in the United States has surged in recent years, though current numbers are probably higher than its true prevalence.
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