It’s another health statistic for which Kentucky would prefer not to be a national leader: the state tops the list of children diagnosed with attention deficit hyperactivity disorder (ADHD) at nearly 19 percent.
Renee Shaw talked with Lexington psychiatrist Timothy M. Houchin about the numbers and treatment options on a recent edition of Connections.
The Centers for Disease Control says that nearly one in five children will experience a mental disorder in a given year. Those may range from ADHD to autism spectrum disorder to mood and anxiety disorders. The CDC estimates diagnosis and treatment of these conditions costs up to $247 billion each year.
While rates of ADHD diagnosis are increasing nationally, Kentucky’s lead is nearly two percentage points ahead of the next closest state, Arkansas. Dr. Houchin indicates most states are in the 7 – 11 percent range.
Challenges to Accurate Diagnosis
ADHD is generally classified into three distinct types: a predominantly inattentive type, a predominantly hyperactive/impulsive type, and then a type that combines the first two. There is a strong genetic component to the ADHD, according to Houchin, and both adults and children can have the condition.
While he says he believes there is a general over-diagnosis of ADHD, Houchin does concede it can be difficult to accurately diagnose. He advocates for a multi-disciplinary approach that involves psychologists, counselors, teachers, and parents. In his practice, Houchin says he administers an federally approved test to the patient, and interviews care-givers before making his diagnosis.
Although many doctors don’t have the time or resources to make such a thorough review of a child’s behavior, Houchin contends it’s necessary to help differentiate between a patient who truly has ADHD and those who may be distracted or fidgety because of other issues such as abuse or bullying, problems at home, or even poor nutrition and hunger.
With proper diagnosis, Houchin says commonly prescribed drugs like Ritalin are more than 90 percent successful at giving ADHD patients a normal life. He warns that adults with cardiac problems may not be able to take the amphetamine-based drugs, but he says there are non-stimulant medications that are effective alternatives.
Houchin says he’s seen some cases where instead of thoroughly examining a child, a doctor will prescribe a drug treatment to see if the patient’s behavior improves. While the symptoms may well decrease under medication, Houchin says that doesn’t prove that ADHD was the cause.
Behavioral approaches can also help children with the disorder. Houchin says some of those techniques may be as simple as teaching a patient to be more organized with school assignments.