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Cited by 29Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentAutism Spectrum Disorder Research

Addressing discrepancies between ADHD prevalence and case identification estimates among U.S. children utilizing NSCH 2007–2012

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Song, MinKyoung, Dieckmann, Nathan F., Nigg, Joel T.·2019·Journal of Attention Disorders
DOI 10.1177/1087054718799930PMC PMC6625923
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Abstract

Objective: Among U.S. children, ADHD epidemiological estimates (3%-5%) vary significantly from case identification rates (over 11%), leading to confusion about true incidence and prevalence. We investigated the extent to which this discrepancy could be resolved by definitional issues through reexamining the most cited U.S. survey of case identification, the National Survey of Children’s Health (NSCH). Method: Using NSCH 2007/2008 and 2011/2012, we stratified identification of ADHD by current status, severity, psychiatric comorbidity, and ADHD medication usage. Using those criteria, definitional strength was coded into “Definite,” “Probable,” “Doubtful,” and “No.” Results: “Definite” ADHD in caseness in 2007/2008 was 4.04%, increasing to 5.49% in 2011/2012, roughly corresponding to epidemiological estimates. “Definite” ADHD was the primary contributor to an overall increase in caseness over that period. Conclusion: This analysis strengthens understanding of discrepancies in estimated ADHD rates. When low confidence identification is considered false positives, ADHD case identification rates match epidemiological estimates more closely.

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  • Large US and Swedish studies show that ADHD has been diagnosed more often in recent years, reflecting shifts in administrative and clinical practice.

    “large studies from the US and Sweden indicate that ADHD is more likely to have been diagnosed in recent years, which reflects changes in administrative and clinical practices”

    From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Song et al., 2019

    The Introduction (page unavailable) reports rising ADHD identification among U.S. children from 2007 to 2011. The paper does not report a Swedish study, and its Discussion (page unavailable) argues against relaxed clinical diagnostic standards as the explanation for the increase during that period; it does not establish a change in administrative practice as the cause. (LLM, conf=0.88)

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  • Clinicians are more likely to diagnose ADHD now than in earlier decades because recognition has improved.

    “although due to increased recognition by clinicians, the disorder is more likely to be diagnosed today than in prior decades.”

    From The World Federation of ADHD International Consensus Statement: 208 Evidence-based conclusions about the disorder (2021) · cites this paper as Song et al., 2019

    The Discussion (page unavailable) reports increased ADHD case identification from 2007 to 2011 and suggests that greater awareness of how ADHD manifests in girls may explain part of that increase. It does not establish that improved clinician recognition generally caused ADHD to be more likely diagnosed today than in prior decades. (LLM, conf=0.82)

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2 retracted

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Research works printed but not linked: 2

  1. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
  2. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

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Authors
Song, M., Dieckmann, N. F., & Nigg, J. T.
Affiliations
Oregon Health & Science University (US)
Corresponding author
Song, MinKyoung
ORCID
Venue
Journal of Attention Disorders
Publisher
SAGE Publications
Published
2018-09-28
Volume
23
Issue
14
Pages
1691-1702
ISSN
  • 1087-0547 (ISSN-L)
  • 1557-1246
DOI
10.1177/1087054718799930
PMC
PMC6625923
OpenAlex
W2893642860
Cited by
29
References
35
Citations by year
2026: 3 · 2025: 1 · 2024: 4 · 2023: 2 · 2022: 4 · 2021: 6 · 2020: 8 · 2019: 1
FWCI
2.94
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Attention Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (R37MH059105)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
Keywords
attention deficit hyperactivity disorder, ADHD prevalence, National Survey of Children's Health, diagnostic certainty, psychiatric comorbidity, ADHD medication use, ADHD symptom severity, false positives, children
MeSH terms
Child Health, Adolescent, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Female, Humans, Male, Population Surveillance, Probability, United States, Incidence, Prevalence

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