Since in the opening words of a book with the same title as my blog, and
which I highly recommend, “Attention-Deficit/Hyperactivity Disorder (ADHD)
seems to be everywhere these days” (Hinshaw & Ellison, 2016, xv), it is
important for anyone who is interested in the mental health of children to
have a grasp of the some of basic facts of ADHD. This blog, in a series of
3 presentations, will highlight some of the most important facts. For a
more in depth discussion, the reader should consult the Hinshaw and Ellison
book. This blog will focus on answering 2 basic questions: What is ADHD? And, How Widespread is it?
What is ADHD?
In a nutshell, ADHD is a neurodevelopmental disorder that can result in a
number of symptoms in two major groupings: inattention/disorganization and
impulsivity/hyperactivity. Neurodevelopment means that the disorder is
primarily caused by genes and typically manifests during the child
development period, i.e., by age 12. Contrary to some musing in the popular
press, the validity of ADHD as a real disorder has been established by
numerous scientific studies. Like other mental disorders such as depression
and many medical disorders (e.g., high blood pressure), ADHD symptoms vary
along a spectrum of number and severity. It is only when the signs of ADHD
reach a sufficient level to cause impairment in child’s functioning that a
diagnosis is made. Also, and most importantly, symptoms such as inattention
can vary markedly depending upon level of interest in the activity in which
the child is engaging, e.g., homework or computer games. Hence an ability
to focus for an extended period of time on some activities does not rule
out ADHD. Lastly, with regard to symptoms, one of the foremost authorities
on ADHD, Russell Barkley (2015), has made a strong case for symptoms of
emotional impulsivity (e.g., low frustration tolerance, impatience, easily
angered, emotional over-reaction) being as central to ADHD as the classic
symptoms involving inattention/disorganization and
How Widespread/Prevalent is ADHD in the United States Today for
Juveniles and Adults?
This is a vexed question since prevalence estimates for juveniles (5-17)
can vary markedly from 5% to 12% depending upon the methodology of the
study. Furthermore, it is important to distinguish between true prevalence (i.e., the percentage of juveniles who truly have
ADHD), as distinct from diagnosed prevalence, i.e., the percentage
who have received a diagnosis from a clinician, whether or not the
diagnosis is accurate. If the methodology is a response by parents to the
question “Has a doctor or health professional even told you that your child
has ADHD?,” the prevalence is 12%, with boys being approximately 2 to 3
times more likely to have the diagnosis than girls, i.e., 16.5% vs. 7.3%
(Collins & Cleary, 2016). There are also ethnic differences with, for
example, the Hispanic prevalence being 7.7%. The 12% estimate is probably
too high, since, despite some under diagnosis, it is likely that ADHD is
being over diagnosed largely because of superficial diagnostic procedures.
This problem will be discussed in another blog.
With regard to adult prevalence, there is far less research with a commonly
accepted prevalence being 5%. In contrast to the sex difference among
juveniles, if anything, there might be a greater prevalence of ADHD among
women based upon formal diagnosis by a clinician. However, since women
might be more likely to seek out help for problems that can be diagnosed as
ADHD, this difference may not be real. Lastly, since the criteria for
diagnosing ADHD in adulthood are exactly the same as juvenile criteria,
there is concern that these criteria are not appropriate and hence, in
contrast to juveniles, there may be an under diagnosis of ADHD.
The next blog will discuss causes of ADHD and how ADHD changes over the
Written by Robert Eme, Ph.d
Professor of Clinical Psychology at the
Illinois School of Professional Psychology
, Argosy University,
: Collins, K., & Cleary, S. (2016). Racial and ethnic disparities in
parent-reported diagnosis of ADHD. Journal of Clinical Psychiatry, 77, (1), 52-59.
Barkley, R. (2015). Attention-Deficit/Hyperactivity Disorder, (4th ed.): A handbook for diagnosis and treatment. Guilford Press.
Hinshaw, S., & Ellison, K. (2016). ADHD: What everyone needs to know. New York: Oxford University
Press. ISBN-13: 978-0190223793
The information and opinions expressed herein represent the independent
opinions and ideas of the faculty and do not represent the opinions and
ideas of Argosy University.