Duke Health Briefs: A Look Behind ADHD Statistics
Approximately 5 percent of school-aged children should be
diagnosed with attention deficit hyperactivity disorder, or
ADHD. The most common ADHD symptoms are the inability to
sustain attention and impulsive, hyperactive behavior. The
disorder is typically treated with medications or other
Jeff Epstein, Ph.D, an assistant professor in the department
of psychology and behavioral sciences at Duke University
Medical Center, says the past decade has seen a steady rise in
"There appear to be more and more diagnosed each year. The
reasons for that are probably both because there is a greater
understanding of the disorder among the population, and the new
criteria, DSM IV (Diagnostic
and Statistical Manual of Mental Disorders - Fourth
Edition), are a little bit more inclusive," Epstein says.
The new criteria are also helpful in distinguishing between
ADHD and more generalized anxiety disorders.
"One of the things we know about anxiety disorders is that
some of their symptoms can mimic ADHD or overlap with ADHD,"
says Epstein. "Many people with anxiety disorders have trouble
with inattention and concentration. The way we usually pull
that out is by looking at the course of the anxiety problems
and the course of the ADHD symptoms, in order to find out what
may be the presenting, underlying problem that the child or
adult is having."
Epstein says treatment for ADHD should be a team effort. "It
should be the parents in collaboration with the physician that
determines whether the child should be on any type of medical
or psycho-social treatment," he says. "That should be a
collaborative decision. But teachers need to also be part of
the process, letting parents and physicians know how the child
is responding to the medication or other intervention. Rating
scales that the teacher fills out, frequent phone to the
teacher to find out how the child is doing -- these are very
important to determine treatment efficacy."
Some studies have found that ADHD is up to 10 times more
common in boys than girls, but Epstein says this statistic is
"In clinical samples, you see more boys, because they tend
to be much more disruptive than girls, therefore they get
referred to clinics much more. When you go out into the
epidemiological world, where you'd survey a whole sample of
children, it's not that high. It's usually two to one, maybe
even three to one."