New Study Offers Insights into ADHD Diagnosis and Treatment
Friday, September 28, 2012 - Campus News - Contact Theresa Green, (405) 833-9824
More than one in 10 children in Oklahoma meet the case definition for Attention Deficit/Hyperactivity Disorder, according to a new study – one of the largest community-based, epidemiologic studies of ADHD in the country.
The study was funded by the CDC's National Center on Birth Defects and Developmental Disabilities. It screened more than 10,000 elementary school-aged children in two diverse communities in Oklahoma and South Carolina.
Researchers found ADHD prevalence rates were at the upper end of previous community-based estimates of ADHD – 10.6 percent in Oklahoma and 8.7 percent in South Carolina. However, it also found that some children in Oklahoma who meet the study's definition for ADHD are not being treated for it. In fact, the total percentage of children taking ADHD medication is only 7.4 percent in Oklahoma.
"There are a number of kids who meet the criteria for diagnosis but are not on treatment," said lead author Mark Wolraich, M.D., the CMRI/Shaun Walters Professor of Pediatrics in the OU College of Medicine.
In addition, the study found that of the children who are being treated for ADHD with medication, two-thirds were not meeting the case definition for the disorder. Of the 1 in 3 children in Oklahoma (28.3%) who are taking ADHD medication and who did not meet the case definition, it was not possible to determine how many were adequately treated children with ADHD or were inappropriately diagnosed and on treatment. All who did not meet the case definition were not counted in the prevalence even if they were on medication.
A large portion of the children taking ADHD medication who did not meet the case definition were found to have more ADHD symptoms, on average, than other comparison children. Researchers said this suggests that some children taking ADHD medication who did not meet the study criteria were probably appropriated treated, resulting in a decrease in their symptoms. However, researchers also said some children may have had insufficient symptoms or impairment and therefore may have been inappropriately treated with medications.
"There is a need for more assessment, but also for parents and health care practitioners to regularly revisit treatment plans to make sure they are appropriate," Wolraich said. Wolraich and fellow researchers believe the findings highlight the need for consistent application of recognized criteria when assessing a child for ADHD.
ADHD is the most common neurobehavioral disorder of childhood. It is usually first diagnosed in childhood and often lasts into adulthood. ADHD can significantly impact a child's ability to function well in all aspects of life.
"Untreated ADHD can lead to school failure, problems with social relations, and getting into trouble with legal authorities," Wolraich said. "It is a condition of consequence that does need to be identified; and once identified, appropriate help needs to be provided for children and adults with ADHD and their families."
In most cases, ADHD is best treated with a combination of medication and behavior therapy.
Results of the study are published online in the Journal of Attention Disorders.
ADHD Study at a Glance
• Involved participants from a mix of urban, suburban and rural schools
• 10.6 percent of children met the case definition for ADHD
• 7.4 percent of Oklahoma children were taking ADHD medication
• Only 28.3 percent of those taking medications met the case definition for ADHD
• Involved schools in a community with a higher socio-economic level
• 8.7percent of children met the case definition for ADHD
• 10.1 percent were taking ADHD medication
• Only 39.5% met the case definition for ADHD
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