Parents Don’t Overestimate ADHD

ADHD rates reported by parents in a national survey reflected true rates of diagnoses

(RxWiki News) There has been some debate about whether parents tend to think their kids have ADHD when that's not actually the case. To settle the matter, the CDC double-checked their stats to see if parental bias played a role in reported rates of ADHD.

Two groups of scientists challenged each other's research results on the rates of ADHD in children compared to the rates of ADHD reported by the kid's parents.

The results of the challenge showed that ADHD rates might be different in particular geographic regions, but not due to parents over-reporting rates of ADHD.

"Seek a specialist for help with ADHD."

Susanna N. Visser, MS, from the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention (CDC), worked with a team of CDC scientists to study the rates of attention deficit-hyperactivity disorder (ADHD) in US children.

In a recent study, led by Dr. Darios Getahun, researchers used medical records from the Kaiser Permanente Southern California health system to show that the rates of ADHD in children were lower than the CDC had claimed in a previous study because parents had a tendency to overestimate the existence of ADHD in their children when they were surveyed.

The original CDC research found that parents of children between the ages of 4 and 17 reported that ADHD was present in 6 percent of kids in California.

To test the claims in Dr. Getahun’s study, the CDC research team revisited the data they had collected for the 2007 National Survey of Children’s Health.

The survey collected data on 73,123 children between the ages of 4 and 17 living all across the US.

Visser’s team found that 10 percent of the parents involved in the survey reported that they had a child with a diagnosis of ADHD.

Since Dr. Getahun’s study only included data on children between 5 and 11 years of age who lived in the state of California and were covered by insurance, Visser’s team took a second look at data from the survey results to more closely match Dr. Getahun’s methods.

The results of this second look showed that 8 percent of children between the ages of 5 and 11 with insurance coverage had a diagnosis for ADHD.

When Visser’s team only looked at kids in the state of California between the ages of 5 and 11 with insurance coverage, they found that only 5 percent had a diagnosis of ADHD.

According to Visser, the claims made by Dr. Getahun’s study were correct until they were put into context. That is to say, the CDC found that 10 percent of US children between the ages of 4 and 17 had ADHD. Dr. Getahun’s study claimed that only 5 percent of kids actually had ADHD.

But Dr. Getahun’s research only included kids that were between the ages of 5 and 11 with insurance coverage and living in the state of California.  

Visser’s team concluded that parents' reports of ADHD in the national survey were very closely aligned with the medical records for ADHD diagnoses used by Dr. Getahun and did not overestimate the prevalence of ADHD.

“Studies of psychiatric disorders such as ADHD can rise and fall on the validity of the sample. With large survey studies, expense and practicality make it infeasible to have an expert clinician interview each subject and family to affirm the diagnosis,” Glen R. Elliott, PhD, MD, told dailyRx.  

“This paper both nicely illustrates the way factors such as geography, insurance status, and age can affect estimated prevalence; in addition, it suggests that, at least for ADHD, parent report may be closely correlated with more complicated and expensive methods of determining whether a subject has ADHD or not,” said Dr. Elliott, who was not involved with this research.

This research letter was published in May in JAMA Pediatrics.

No outside funding was used to support this research. No conflicts of interest were declared.

Review Date: 
May 22, 2013