The number of kids who are diagnosed with ADHD these days is huge—and growing. Reported cases of the disorder have increased by 42 percent since 2003. But a new study suggests that some of these children might actually be suffering from a different condition that often goes undetected.
Most of the referrals that pediatrician Ira Chasnoff gets at his clinic at the Children’s Research Triangle in Chicago are for behavioral issues. He and his team analyzed a sample of 156 foster children who had been referred to his clinic and found that 81 percent of them had fetal alcohol spectrum disorders that had not previously been detected by a physician. The most common reason they had been referred to Chasnoff was ADHD.
FASD, as this group of conditions are known, is related to the better-known fetal alcohol syndrome and can cause similar behavioral and learning problems. Unlike children affected by fetal alcohol syndrome, which is the most severe condition on the spectrum, those with other types of FASD may not have facial anomalies. Thus, the issue may go unnoticed by physicians for years.
“Many alcohol babies will look normal, so no one thinks of doing the toxicology,” Chasnoff said. Nationally, about 20 percent of women drink during pregnancy, but only about 3.6 percent of children have been diagnosed with FASD. Race and class plays a role in under-diagnosis: In past studies, Chasnoff has found that doctors are more comfortable interviewing poor and African-American women about alcohol use than they are their white, middle-class patients—even though white women are, in some states, likelier to drink during pregnancy.