A new study reports some attention getting numbers. The first is that about 9% of children in the United States have attention deficit hyperactivity disorder - ADHD. The second number is that only about 1/3 of them are getting medical treatment.

There have been a number of similar studies done through the years, but this study is considered important because it used the most modern diagnostic criteria for ADHD today, the Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition.

The ADHD Information Library has written and maintained for years that about 5% of children in the US had ADHD, and that it has been both "over-diagnosed" and "under-diagnosed."

Over-diagnosed in the sense that often the medical evaluations leading to a diagnosis don't consider the differential diagnoses that need to be ruled out before diagnosing ADHD, such as fetal alcohol syndrome, head injuries, tourette's syndrome, bipolar disorder, and more (see http://newideas.net/adhd/differential-diagnosis ). Our concern is that this study may have fallen into the same trap. Simply reporting that 9% of children meet the DSM-IV criteria for ADHD is not the same as 9% of the kids having ADHD. Rather, many children who meet the criteria for ADHD actually have some other disorder.

It's back to school time! Here are some questions that parents might want to ask the school to try to optimize the management of a child with ADHD:

1. What strategies does this school have for assessing, and meeting, the needs of an ADHD child?

2. Who are the people that provide actual evaluations or assessments of children at your school? If they are making an assessment of my child, will they contact me to get a good family history, developmental history, and medical history of my child?

3. Is there a school psychologist on campus? Is there one available? Does he/she do achievement and ability testing?

4. Is there an advocate or case manager available to my child?

Several important and controversial studies have been published in the past few months on ADHD, making the summer research reading all the more fun. Here are summaries of two summer studies for you:

August 2007

Depressed Dopamine Activity in Caudate and Preliminary Evidence of Limbic Involvement in Adults With ADHD

Some very impressive researchers were involved in this study on ADHD, dopamine, and substance abuse. The researchers included Dr. Nora Volkow who is the Director of the National Institute on Drug Abuse, and Dr. James Swanson from U.C. Irvine. I've been a fan of Dr. Swanson's work on ADHD treatment for many years.

This study concludes that ADHD is a real disease (ed.note: and not just something made up by drug companies to sell meds). ADHD is biologically caused and that dopamine production in individuals with ADHD is decreased, and that Ritalin increases dopamine production.

None of this is particularly new news, but the study is helpful to support this position, which we have held for about twenty years.