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Prevalence of diagnosis and medication treatment for attention-deficit/ hyperactivity disorder--United States, 2003.

Article Excerpt
Attention-deficit/hyperactivity disorder (ADHD), previously known as attention deficit disorder, is a neurobehavioral disorder characterized by pervasive inattention and hyperactivity-impulsivity that often results in substantial functional impairment (Box). Prevalence estimates of ADHD in school-aged children have ranged from 2% to 18% in community samples (1). Although stimulant medications are an effective first-line treatment for ADHD (2), concern persists regarding the possible side effects and long-term health outcomes associated with stimulant consumption (1). Estimating the number of children who have had ADHD diagnosed and are currently taking medication for the disorder is an important step toward understanding the overall burden of ADHD in the United States. Previously, population-based estimates of medication treatment for ADHD were not available or were limited by their lack of generalizability (3-5). To estimate rates of parent-reported ADHD diagnosis and medication treatment for ADHD, CDC analyzed data from the 2003 National Survey of Children's Health (NSCH). This report describes the results of that analysis, which indicated that, in 2003, approximately 4.4 million children aged 4-17 years were reported to have a history of ADHD diagnosis; of these, 2.5 million (56%) were reported to be taking medication for the disorder. Because both substantial health risks and benefits might be associated with medication treatment for ADHD, further study of this population of children with ADHD is needed.

NSCH is a survey about the physical and emotional health of civilian, noninstitutionalized, U.S. children aged [less than or equal to] 17 years (6). CDC conducted the 2003 NSCH during January 2003-July 2004 by using the State and Local Area Integrated Telephone Survey (SLAITS). SLAITS allows for sampling from the National Immunization Survey sampling frame. One child was randomly selected from households with at least one child aged [less than or equal to] 17 years. Parents or guardians responded to survey items on behalf of 102,353 sample children (completion rate: 68.8%). NSCH data were weighted to estimate national and state-specific rates of ADHD diagnosis and medication treatment among children aged 4-17 years.

As a proxy for ADHD diagnosis, respondents were asked, "Has a doctor or health professional ever told you that [child] has attention-deficit disorder or attention-deficit/hyperactivity disorder, that is, ADD or ADHD?" If an ADHD diagnosis was indicated, respondents were asked, "Is [child] currently taking medication for ADD or ADHD?" Estimates of reported ADHD diagnosis, current medication treatment among those with ADHD, and current medication treatment for ADHD among all children aged 4-17 years were calculated. Rates of medication treatment for ADHD among all children aged 4-17 years were calculated by using the number of children currently receiving medication as the numerator and all families who responded to the ADHD diagnosis question (affirmatively or...

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