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By Monica E. Oss

The prevalence of attention-deficit/hyperactivity disorder (ADHD) is rising dramatically—and a quick look at the headlines proves it.

Between 1997 and 2016, the prevalence of ADHD in children and adolescents increased from 6.1% to 10.2% in the U.S. (see U.S. Prevalence Of Child ADHD Increased From 6% To More Than 10% In A Decade). And in a different study, 10.4% of children ages 5 to 12 and 13% of children ages 13 to 17 had an ADHD diagnosis in 2015 (see 10.4% Of Children Ages 5 To 12 & 13% Ages 13 To 17 Have ADHD Diagnosis). Between 2008 and 2015, the diagnosis rate rose among children ages 5 to 12, from 8.5% in 2008 to 10.4% in 2015 (see 10.4% Of Children Ages 5 To 12 & 13% Ages 13 To 17 Have ADHD Diagnosis). Among older children ages 13 to 17, the ADHD diagnosis rate remained at about 13%, from 13.2% in 2008 to 13.4% in 2015.

In addition to the high prevalence, this is a high-comorbidity population. Two of three children with ADHD had at least one other mental, emotional, or behavioral disorder (see Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016); this includes anxiety, depression, autism spectrum disorder, and Tourette Syndrome (see Attention-Deficit / Hyperactivity Disorder (ADHD) Data & Statistics). Children with both autism spectrum disorder (ASD) and ADHD are 2.2 times as likely to have anxiety disorder, and 2.72 times as likely to have mood disorder, compared to children with ASD alone (see Children With Both ASD & ADHD Have An Increased Risk Of Anxiety & Mood Disorder).

Unsurprisingly, with this increased prevalence, there is an increased interest in ADHD. During the first half of 2018, ADHD was the most frequent medical condition searched for using Google (see ADHD The Top Medical Condition Googled In The U.S. During 2018).

Why is prevalence of ADHD on the rise? Current research raises a lot of possibilities—from geography, to socioeconomic status, to parental trauma, to brain injury. Children and youth in the “western” geographic region of the United States were significantly less likely to have ADHD (7.0%) than those in the Northeast (10.3%), Midwest (12.2%), and the South (11.0%).

Lower family income was associated with higher instances of reported ADHD diagnosis during the 2014 to 2015 period: 14.5% of children in poor households compared to 9.3% of children in upper income households. Other new research notes that parents with adverse childhood experiences (ACEs) have 2.1 times higher odds of having children with ADHD (see Parents With Adverse Childhood Experiences More Likely To Have Children With Behavioral Health Problems). Adolescents with a higher frequency of digital media use have higher odds of developing symptoms of ADHD (see Adolescents With A Higher Frequency Of Digital Media Use Have Higher Odds Of Developing ADHD). And lastly, severe traumatic brain injury (TBI) in childhood is associated with a later onset of ADHD, known as secondary ADHD (SADHD)-those with severe TBI are 3.62 times more likely to develop SADHD (see Severe TBI In Childhood Associated With Later Onset Of ADHD).

While looking into these numbers, the annual societal “cost of illness” for ADHD as estimated by CHADD ranged between $143 billion to $266 billion (see Cost Of ADHD)—amounting to $12,447 per child (ages 3-4), and $2,222 to $4,690 per child (ages 5-18). This money is spent on special education; occupational, speech and physical therapy; grade retention; and disciplinary incidents and school counseling.

What is considered “best practice” for treating ADHD? The American Academy of Pediatrics (AAP) provides evidence-based recommendations for both the diagnosis and treatment of children with ADHD (see ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents). The AAP recommends that an evaluation for ADHD should be undertaken by a primary care physician for any child ages four through 18 who presents issues with inattention, hyperactivity, or impulsivity. Recommended treatment for children diagnosed with ADHD varies with age, but all treatment models recommend a combination of behavior therapy (provided by parents or teachers) and medication. For provider organizations, this offers expanded opportunities for family counseling and parent training in behavior therapy (see Behavior therapy for young children with ADHD).

Addressing ADHD is another growing challenge for government entities, health plans and health systems—and as with any challenge, there is opportunity. For more, check out these resources from the OPEN MINDS Industry Library:

  1. 11% Of School-Aged Children With ADHD Had Unmet Treatment Need
  2. Tris Pharma Expands ADHD Portfolio With Acquisition Of NextWave Pharmaceuticals
  3. What’s Driving ‘Whole Health’ For Children?
  4. ADHD Drugs Do Not Improve Cognition In Healthy College Students
  5. NQF Endorses Four Behavioral Health Measures
  6. 95% Of Children With Autism Have At Least One Common Co-Occurring Condition
  7. Two-Thirds Of Adolescents With ADHD Have At Least One Psychiatric Comorbidity That May Result In Non-Suicidal Self-Injury
  8. ADHD Prescriptions Increase Over 300% Among Young Women
  9. Brain Scan Accuracy In Detecting ADHD In Children At 74%
  10. Akili’s Video Game Therapy Hits Goal In Pivotal ADHD Trial

For more, join Michael Golinkoff, Ph.D., M.B.A., Senior Vice President, Innovation Advisor, AmeriHealth Caritas, on October 24 at The 2018 OPEN MINDS Technology & Informatics Institute for his keynote session, Building Successful Partnerships with Health Plans: An Insider Guide to Payer Relationships Plenary Address.

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