Are You Listening? Your Child May Not Actually Have ADHD

Even as prescriptions for attention-deficit medication have soared, it's unclear that kids today are any more distracted than they were 30 years ago.


Quinn Ryan Mattingly/Flickr

There's a fascinating new paper out this week by researchers from the Food and Drug Administration on the kinds of prescription medications given to children between 2002 and 2010. Among the findings: prescriptions for anti-depressants actually declined five percent over the study period. Birth control was up more than 90 percent. And orders for asthma drugs increased 14 percent.

But one of the most interesting results is the remarkable rise in medication for attention-deficit hyperactivity disorder, or ADHD. From 2002 to 2010, prescriptions for the disorder jumped 43 percent.

The authors of the paper don't speculate as to the causes for shifts in prescription drug usage, although one doctor with the American Psychiatric Association told Reuters Health he thinks cultural reasons may be behind the trend in ADHD treatment:

"For the most part I think the overall increase reflects a reduction in the stigma," he told Reuters Health. "It used to be, 'You're a bad parent if you can't get your child to behave, and you're a doubly bad parent if you put them on medicine.'"

Of course, just because we're prescribing more Ritalin doesn't mean ADHD has necessarily worsened in America. As pressure on schoolkids has grown more intense, so has the phenomenon of using attention-deficit drugs for off-label purposes. Every year, doctors issue 21 million prescriptions of Ritalin, Adderall, and other focus medications that are meant to treat ADHD, but that in many cases find their way into the hands of students simply seeking an edge in the classroom.

Beyond the widening abuse of such drugs, new research also suggests that attention deficit disorder (ADD) may not be as widespread as we generally think it is. For one thing, it's become one of the world's most overdiagnosed diseases, increasing by an average 5.5 percent a year in the United States. There's no comprehensive clinical test for ADD and ADHD -- usually, doctors simply assess the disorder by intuition and rules of thumb.

Other scientists go so far as to suggest the explosion in inattentiveness has been manufactured out of whole cloth.

"Children are no more or less inattentive and impulsive today than in 1983," a team of Penn State psychologists wrote last week in the Journal of Attention Disorders. "[This suggests] inattention and impulsivity are stable neurobiological traits largely unaffected by cultural, educational, and environmental factors."

Using one type of attention test called a Gordon Diagnostic System, the university scientists examined four groups of children: one of 231 kids with autism; a group of 235 with a form of ADHD known as ADHD-Inattentive; a group of 562 children with another form of ADHD, ADHD-Combined; and a set of 445 children with no diagnosed disorders.

The Gordon Diagnostic System is a simple device: it's basically a box with one button and an LCD display. Whenever the display shows a "1" and a "9" in sequence together, test subjects are supposed to push the button. The better you are at completing the task, the better your score. When researchers compared the data they'd gathered over the four years of their study to baseline data from 1983, they found little difference:

The results showed that today's kids scored pretty much the same, on average, as the 1983 kids. The average age-standardized scores were extremely close to the 1983 means, across the board. Children diagnosed with ADHD, as expected, scored much worse. Oddly, kids with an Autism Spectrum Disorder did just as badly as the ADHD ones.

One study standing in the face of 21 million prescriptions a year -- and counting -- may not seem like much. But at the very least, it does suggest we ought to reconsider exactly what it is we're treating with these drugs.