In the U.S. and around the world, children and teens develop attention-deficit hyperactivity disorder (ADHD) at higher rates than any other mental or behavioral disorder. While many people think ADHD simply means an inability to pay attention or sit still – and a diagnosis is really no big deal – that’s inaccurate, only part of the story, and minimizes the reality of an ADHD diagnosis.
The reality is that severe ADHD symptoms can cause serious problems.
The disorder is characterized by impairments in daily functioning caused by persistent inattention, hyperactivity, and impulsivity. Data from the National Health Interview Survey (NHIS) and the National Survey of Children’s Health shows the following trends in ADHD prevalence in the early 2000s:
- 2003-2011: 42% increase
- 2003: 7.8%
- 2011: 11.0%
- 1997-2016: 67% increase
- 1997: 6.1%
- 2016: 10.2%
Although more children and adolescents have ADHD than any other mental health or behavioral disorder, we haven’t had a large-scale update on ADHD prevalence rates since 2016. However, a team of researchers initiated a study called “Prevalence and Trends in Diagnosed ADHD Among US Children and Adolescents, 2017-2022,” with this primary goal:
“Estimate the prevalence and trends of ADHD among children and adolescents in the US in 2017 to 2022.”
The researchers collected data published by the NHIS between 2017 and 2022. The final sample set included 37,609 people age 4-17. The demographic breakdown showed that roughly half were female, a quarter were Hispanic, a tenth were black, just over half were white, and just over a tenth identified as other race.
Let’s take a look at these new results on the prevalence of ADHD in the U.S.
Prevalence of ADHD in U.S.: Changes from 2017-2022
Spoiler alert: ADHD rates remained relatively stable over the study period, with an overall increase of under three percent.
Here are the details:
ADHD in Children and Teens: The Latest Data
2017-2018:
Total: 10.2%
- By Age:
- 4-11: 7.9%
- 12-17: 13.4%
- By Gender:
- Female: 6.6%
- Male: 13.7%
2019-2020:
Total: 10.1%
- By Age:
- 4-11: 7.7%
- 12-17: 13.1%
- By Gender:
- Female: 6.9%
- Male: 13.1%
2021-2022:
Total: 10.5%
- By Age:
- 4-11: 7.5%
- 12-17: 14.2%
- By Gender:
- Female: 7.4%
- Male: 13.4%
We can see the categories with the largest differences: adolescents 12-17 received ADHD diagnoses at almost twice the rate as children 4-11, while males received ADHD diagnoses at close to twice the rate of females. Other notable demographic differences in data include:
- Hispanic children and adolescents received ADHD diagnoses at a rate 38% below non-Hispanic white and black children and adolescents
- Children and adolescents from families with income below the federal poverty level received ADHD diagnoses at a rate 27% families with income significantly above the federal poverty level.
One thing we’ll note about this report is that the COVID-19 pandemic appears to have had little to no effect on rates of ADHD among children and adolescents, with the data showing a minor decrease for children and a minor increase for adolescents between 2019-2020 and 2021-2022.
How Do You Know If Your Child or Teen Has ADHD?
The Diagnostic and Statistical Manual of Behavioral Disorders, Volume Five (DSM-5), which mental health professionals use as a reference for diagnosing mental health disorders, indicates there are two types of symptoms that contribute to a clinical ADHD diagnosis: symptoms of inattention and symptoms of hyperactivity.
To meet clinical criteria for diagnosis, kids below age 16 need to show more than six of the symptoms below, while teens 17 and over need to show at least five symptoms. In addition, the symptoms must persist for over six months, be inappropriate for age, and cause significant disruption in two or more life domains/settings, such as home, work, school, sports teams, clubs, visiting relatives, or social situations with peers.
Symptoms of Inattention:
- Persistent inability to focus on details
- Repeated careless mistakes at school and home
- Persistent problems trouble focusing on tasks
- Persistent problems listening to instruction
- Repeated inability to complete tasks as school or home
- Problems with personal organization
- Repeated avoidance of tasks requiring sustained attention/focus
- Repeated loss of personal possessions
- Frequent forgetfulness/distraction
Symptoms of Hyperactivity/Impulsivity:
- Persistent fidgeting
- Persistent moving while seated
- Inability to remain seated
- Inappropriate running/jumping/climbing
- Inability to remain quiet during play
- Constant energy, all the time
- Constant talking
- Frequent interruption while others are talking
- Inability to wait
- Frequent interruption of the activities of others
When an individual meets the criteria we list about, they may receive a diagnosis for one of the following three types of ADHD:
- Combined ADHD: individual shows both types of symptoms for six months or longer
- Predominantly Inattentive ADHD: presence of inattentive symptoms more than hyperactive symptoms for six months or longer
- Predominantly Hyperactive-Impulsive ADHD: presence of hyperactive-impulsive symptoms more than inattentive symptoms for six months or longer
If your child or teen receives a diagnosis for ADHD, the diagnosing clinician may classify the diagnosis as mild, moderate, or severe, depending on the frequency, intensity, and level of disruption the symptoms cause. In most cases, the diagnosing clinician will also offer a referral for professional treatment and support.
Treatment for Children and Teens With ADHD
Leading experts on ADHD indicate that the most effective approach to supporting children and teens with ADHD is with a combination of therapy, medication, and various forms of specialized support at school and home.
First, we’ll share the most effective behavioral therapies for ADHD, which include:
- Cognitive behavioral therapy (CBT)
- Mindfulness-based cognitive behavioral therapy (MBCBT)
- Dialectical behavior therapy (DBT)
Those three approaches resemble traditional psychotherapy. CBT helps patients understand the connection between thought and behavior. A trained CBT therapist gives children and teens the tools to identify the patterns of thought that lead to counterproductive/maladaptive behavior. MBCT takes the foundation of CBT and combines it with evidence-based practices such as mindful meditation, which helps children and teens with ADHD reduce stress and manage difficult emotions. Finally, DBT combines both CBT and mindfulness in a systematic approach to helping people with severe ADHD symptoms reduce emotional reactivity, tolerate distressing situations, and manage symptoms of inattention and hyperactivity.
In addition to those behavioral therapies, children and teens with ADHD benefit from support at school that includes help with organizational skills, time management, tutoring, and various accommodations that promote classroom success without diluting the educational content. Evidence also indicates that family participation in treatment improves outcome. Family participation may mean parent training in parenting skills, psychotherapy for parents, and/or education about ADHD and treatment for ADHD.
Finally, in some cases, children and teens with ADHD can benefit from prescription medication, including simulant and/or non-stimulant medication.
Additional Support: The Role of Diet, Sleep, and Exercise
We’ll take a moment to mention the role of a healthy diet for children and teens with ADHD. A study published in 2012 showed that people diagnosed with ADHD should avoid the following foods:
- Fast food
- Red meat
- Processed meat products
- Potato chips
- High-fat dairy
- Sodas
The researchers found the following foods help people with ADHD:
- Fish
- Vegetables
- Tomatoes
- Fruits
- Whole grains
- Low fat dairy
To be clear, changing diet is not treatment, but rather supports treatment. A healthy diet – as well as plenty of sleep, exercise, and outdoor activity – increases the likelihood a person with ADHD will have a successful treatment experience. And while physical activity/exercise is not officially considered treatment for ADHD, a study published in 2014 indicates that an intervention involving 30 minutes of exercise a day yields superior outcomes to a classroom-based, sedentary intervention for the following ADHD symptoms:
- Inattention
- Hyperactivity
- Impulsivity
- Moodiness
We’ll reiterate that these lifestyle changes – diet, exercise, activity – are not treatment per se, but rather improve outcomes for traditional treatments in clinical settings. It’s important for parents of children and teens with ADHD to understand that when they participate in treatment, either by attending psychotherapy or educational sessions themselves, or by ensuring their child or teen eats a healthy diet, gets plenty of rest, and gets plenty of exercise, overall treatment outcomes improve.
How to Find Treatment and Support: Online Resources for Families
- The American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors in your area. Their treatment finder is convenient and easy to use.
- The National Institute of Mental Health (NIMH) maintains a page for youth, adolescent, and family mental health.
- The National Alliance on Mental Illness maintains excellent resources for families.
