Young children are prone to causing a ruckus or getting fidgety every now and then, but more children displaying serious problems with inattentiveness and hyperactivity are being diagnosed with attention deficit hyperactivity disorder (ADHD).
"The issue is not whether [ADHD] occurs, but how much it occurs," says Dr. Jack McClellan, medical director of the Child Study and Treatment Center at the Seattle Children's Hospital.
And according to a recent Kaiser Permanente report, ADHD diagnoses for children age 5 to 11 is on its way up -- a 25-percent increase from 2.5 percent in 2001 to 3 percent in 2010 in Kaiser Permanente's Southern California system.
Yet the increased percentages do not necessarily indicate an increased prevalence of the developmental issue. Instead, Dr. McClellan cites increased ADHD awareness among parents and health-care organizations as influencing Kaiser Permanente's statistics.
Parents may be wary of ADHD diagnoses among young children, particularly when it comes to medicating them with stimulants such as Adderall and Ritalin. Yet considering the significant medical research on stimulants and amphetamines, medicine should not be the primary concern, says Dr. McClellan.
"Medicines are simple, kids are complicated. The question is which kids [have ADHD]," says Dr. McClellan.
According to health experts such as Dr. McClellan, the larger issue is the wide variability of care -- the under diagnosis of children living with ADHD and the over diagnosis and medication of those who do not qualify.
The Kaiser Permanente study was significant in its stride toward more accurate ADHD diagnoses among children, utilizing defined protocols and largely reliant on medical specialists' records, in comparison to reports from primary-care providers or parents.
From this clearer definition of ADHD, Kaiser Permanente researchers found that white boys from high-income families making over $70,000 a year were still the most common demographic with increased risk of diagnosis.
However, the study also found increased diagnoses for black children - going from 2.6 percent in 2001 to 4.1 percent in 2010 -- and Hispanic children - which rose from 1.7 percent in 2001 to 2.5 percent in 2010. Although the sex gap of higher ADHD diagnoses prevalence among boys remained stable among whites, Hispanics and Asians, black girls showed significant increase of ADHD diagnoses.
While more awareness of ADHD and better access to health care have contributed to increased ADHD diagnoses across most racial groups, the statistics speak to unequal distribution of quality and access to health care.
"Too often things operate merely out of crisis before an expertise is obtained," says Dr. McClellan. "For most kids with significant psychiatric problems, they need more than medicine."