Data & Statistics
New Data: Medication and Psychological Services Among Children Ages 2-5 Years (Healthcare Claims Data)
American Academy of Pediatrics (AAP) guidelines (2011) state that behavior therapy is the recommended first line treatment for Attention-Deficit/Hyperactivity Disorder (ADHD) in young children, and should be tried before medication is prescribed. To understand treatment patterns for children ages 2-5 years receiving clinical care for ADHD, healthcare claims for psychological services and ADHD medication were compared for patients covered by MarketScan commercial employer-sponsored insurance (ESI, 2008–2014) or by Medicaid (2008–2011).
- In both ESI and Medicaid populations, the percentage of children ages 2–5 years receiving clinical care for ADHD increased over time.
- In both populations, about 3 in 4 children ages 2-5 years with ADHD received ADHD medicine, and only about half or fewer received any form of psychological services.
- During 2008–2011, 2–5 year-old children covered by Medicaid were twice as likely to receive clinical care for ADHD compared with similar-aged children covered by ESI.
- Among 2-5 year-old children with ESI, the percentage in clinical care for ADHD that received psychological services did not increase after the release of the 2011 AAP guidelines; a similar analysis was not done for children with Medicaid since data past 2011 were not available.
The data from a national sample of children with special health care needs, ages 4-17 years, collected in 2009-10, showed that most children with ADHD received either medication treatment or behavior therapy; however, many were not receiving treatment as described in the best practice guidelines from 2011.
- Less than 1 in 3 children with ADHD received both medication treatment and behavior therapy, the preferred treatment approach for children ages 6 and older.
- Only half of preschoolers (4-5 years of age) with ADHD received behavior therapy, which is now the recommended first-line treatment for this group.
- About half of preschoolers with ADHD were taking medication for ADHD, and about 1 in 4 were treated only with medication.
ADHD medication and behavior therapy among children with ADHD (ages 4-17) with special health care needs
Data are from the National Survey of Children with Special Health Care Needs, collected in 2009-2010. Parents were asked about their child’s ADHD medication use in the previous week and about behavior therapy in the previous year.
Visser, S. N., Bitsko, R. H., Danielson, M. L., Gandhour, R., Blumberg, S. J., Schieve, L., Holbrook, J., Wolraich, M., Cuffe, S. (2015). Treatment of attention-deficit/hyperactivity disorder among children with special health care needs. Journal of Pediatrics, published online April 1, 2015
- The American Psychiatric Association states in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) that 5% of children have ADHD1. However, studies in the US have estimated higher rates in community samples.
- ADHD Throughout the Years
- The percent of children estimated to have ADHD has changed over time. A historical view provides the necessary context to understand changes in what we know about ADHD, including estimates of the rates of ADHD across time, changes in diagnostic criteria, and medication treatment.
- Recent surveys asked parents whether their child received an ADHD diagnosis from a health care provider. The results show that:
- Approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of 2011.
- The percentage of children with an ADHD diagnosis continues to increase, from 7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011.
- Rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 [Read article] and an average of approximately 5% per year from 2003 to 2011.
- Boys (13.2%) were more likely than girls (5.6%) to have ever been diagnosed with ADHD.
- The average age of ADHD diagnosis was 7 years of age, but children reported by their parents as having more severe ADHD were diagnosed earlier.
- Prevalence of ADHD diagnosis varied substantially by state, from a low of 5.6% in Nevada to a high of 18.7% in Kentucky.
Parents were also asked about whether their child was taking medication for ADHD. The results show that:
- The prevalence of children 4-17 years of age taking ADHD medication increased from 4.8% in 2007 to 6.1% in 2011
- More US children were receiving ADHD treatment in 2011 compared to 2007; however, as many as 17.5% of children with current ADHD were not receiving either medication for ADHD or mental health counseling in 2011.
- In 2011, geographic variability in the percent of children taking medication for ADHD ranged from a low of 2% in Nevada to a high of 10.4% in Louisiana.
State-based Prevalence Data of Children with a Current ADHD Diagnosis Receiving Medication Treatment (2011-2012)
- Parents of children with a history of ADHD report almost 3 times as many peer problems as those without a history of ADHD (21.1% vs. 7.3%).
- Parents report that children with a history of ADHD are almost 10 times as likely to have difficulties that interfere with friendships (20.6% vs. 2.0%).
- A higher percentage of parents of children with attention-deficit/hyperactivity disorder reported non-fatal injuries (4.5% vs. 2.5% for healthy children). [Read abstract]
- Children with ADHD, compared to children without ADHD, were more likely to have major injuries (59% vs. 49%), hospital inpatient (26% vs. 18%), hospital outpatient (41% vs. 33%), or emergency department admission (81% vs. 74%). [Read abstract]
- Data from international samples suggest that young people with high levels of attentional difficulties are at greater risk of involvement in a motor vehicle crash, drinking and driving, and traffic violations. [Read abstract]
- Using a prevalence rate of 5%, the annual societal ‘‘cost of illness’’ for ADHD is estimated to be between $36 and $52 billion, in 2005 dollars. It is estimated to be between $12,005 and $17,458 annually per individual. [Read abstract]
- There were an estimated 7 million ambulatory care visits for ADHD in 2006. [Read article]
- The total excess cost of ADHD in the US in 2000 was $31.6 billion. Of this total, $1.6 billion was for the treatment of patients, $12.1 billion was for all other health care costs of persons with ADHD, $14.2 billion was for all other health care costs of family members with ADHD, and $3.7 billion was for the work loss cost of adults with ADHD and adult family members of persons with ADHD. [Read abstract]
- ADHD creates a significant financial burden regarding the cost of medical care and work loss for patients and family members. The annual average direct cost for each per ADHD patient was $1,574, compared to $541 among matched controls. The annual average payment (direct plus indirect cost) per family member was $2,728 for non-ADHD family members of ADHD patients versus $1,440 for family members of matched controls. [Read abstract]
- Across 10 countries, it was projected that ADHD was associated with 143.8 million lost days of productivity each year. Most of this loss can be attributed to ADHD and not co-occurring conditions. [Read abstract]
- Workers with ADHD were more likely to have at least one sick day in the past month compared to workers without ADHD. [Read abstract]
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth edition: DSM-5. Washington: American Psychiatric Association, 2013.
Impact of ADHD and Other Mental Conditions
Data from a community study show that children with ADHD and other conditions are more likely to have problems with friendships and to get into trouble in school or with the police.
(Published November 25, 2015)
How US Children are Diagnosed with Attention-Deficit/Hyperactivity Disorder
The first national study presenting greater detail on how ADHD diagnoses take place among a representative sample of children who have ADHD, as described by their parents.
(Published September 3, 2015)
Medication and Behavioral Therapy for ADHD
Patterns of ADHD treatment among children with special health care needs, 2009-10.
(Published April 1, 2015)
Estimates of ADHD Change Depending on Which ADHD Criteria Are Applied
Using more criteria for ADHD decreases the percentage of children who fit the diagnosis.
(Published November 11, 2014)
Persistence of Attention-Deficit/Hyperactivity Disorder Symptoms
Data from a community sample show that certain ADHD symptoms can often last into adolescence.
(Published July 3, 2014)
Trends in ADHD Diagnosis and Medication Treatment 2003-2011
Data on trends and age of diagnosis across 3 survey time points.
(Published November 22, 2013)
Parent report is a valid measure of attention-deficit/hyperactivity disorder diagnosis.
(Published: May 14, 2013)
ADHD Prevalence in Two Communities
ADHD diagnosis and treatment in a study of children in two school-based samples.
(Published: September 11, 2012)
Vital Signs: ADHD in Young Children
Use recommended treatment first.
(Published: May 3, 2016)
Behavior Therapy First for Young Children with ADHD
Learn about using parent behavior therapy first to help young children with ADHD.
(Published: October 12, 2015)
Smoking in Pregnancy: A Possible Risk for ADHD
CDC looked at any association between smoking during pregnancy and ADHD.
(Published: October 10, 2014)
ADHD: Keeping Track of the Numbers
Discover how CDC’s latest research helps us all understand how ADHD impacts children and families.
(Published: November 22, 2013)
ADHD: Current Research
Project to Learn About ADHD in Youth (PLAY)
(Published: October 9, 2012)
ADHD is Increasing
Nearly one in ten school-age children have an ADHD diagnosis.
(Published: August 14, 2012)
- Page last reviewed: May 4, 2016
- Page last updated: May 4, 2016
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