Mental Health Weekly 12(21):6-7, 2002. © 2002 Manisses Communications
Group, Inc
About one-half of the 1.6 million elementary school-aged children
diagnosed with attention-deficit/hyperactivity disorder (ADHD), a
condition also known as attention-deficit disorder (ADD), have also been
identified as having a learning disability (LD), according to a new study
by the Centers for Disease Control and Prevention (CDC).
The report, Prevalence of Attention-Deficit Disorder and Learning
Disability: United States, 1997-1998, is based on data from the CDC's
National Health Interview Survey (NHIS), which focused on children ages 6
to 11. The NHIS was a national household survey that collected health
status and sociodemographic information on the civilian
noninstitutionalized population of the United States.
According to the report, from 1997-1998, more than 2.6 million children
ages 6-11 were reported to have ever had a diagnosis of either ADD or LD.
Three percent of the children had been diagnosed with only ADD, 4 percent
with only LD, and 4 percent with both conditions, according to the NHIS.
The NHIS is the first national survey to include questions on the
prevalence of both diagnosed ADD and LD in school-aged children. According
to the study, the differences in the way in which ADD and LD were measured
in other national and community-based studies makes it difficult to
compare these estimates with the NHIS results.
"This report serves as a snapshot of a condition that has important
consequences for the development of school-age children," said David
Fleming, M.D., acting CDC director. "However, much more needs to be
learned about ADHD and about the spectrum of impairments associated with
ADHD."
The advocacy organization CHADD (Children and Adults with
Attention-Deficit/Hyperactivity Disorder) applauded the CDC for
highlighting the significance of ADHD and learning disabilities.
"This report reinforces what the leading scientific institutions have
been telling us all along," said Clarke Ross, chief executive of CHADD.
"Individuals affected by ADHD rarely have ADHD alone. Nearly 70 percent of
those with ADHD simultaneously cope with other conditions such as learning
disabilities, mood disorders, anxiety and more."
Ross said the complexity of the disorders combined with the challenge
of appropriate treatment for individuals with ADHD points to the need for
additional research, early intervention and appropriate assessment.
The report found that among children with the LD diagnosis, 54 percent
were in special education. This was nearly five times greater than the
percent observed for children with ADD and no LD and over 23 times the
percent reported for children with neither ADD nor LD.
Among children with LD and no ADD, 46 percent attended special
education, and among those with both ADD and LD, 65 percent were in
special education. Among children with LD, the percent of boys and girls
in special education was similar.
According to the report, the percent of boys with only ADD was almost
three times greater than the percent of girls with ADD, and the percent of
boys with both diagnoses was over two times greater than the percent of
girls with both diagnoses. The percent of boys and girls with only LD was
similar.
The findings also indicated that white non-Hispanic children were more
often diagnosed with only ADD than black non-Hispanic or Hispanic
children. However, the percent of children with only LD did not vary
significantly by race or ethnicity.
The report found that in the last 30 years, behavioral and learning
disorders in school-aged children have become major health concerns in the
U.S. The study authors noted, however, that lack of health care insurance
and limited access to mental health services have left some children
undiagnosed and untreated.
"There has been concern in some circles that ADHD has been
overdiagnosed among those with regular access to health care," said
Fleming. "And there is equal concern that the problem may be
underdiagnosed among those who have limited or no access to care. It's
clearly important to accurately identify children with ADHD and ensure
that they have appropriate health care."
Many adults have identified underachievement and failure in school as
serious problems facing youth. At the same time, said the report,
educators have reported a rise in the number of school-aged children with
disabling behavioral and learning disorders.
The report found that health problems, including impaired vision and
hearing, allergies, and chronic health conditions other than asthma, were
reported more frequently for children with LD than for children with
neither ADD nor LD.
The percent of children with four or more health care visits during the
past 12 months was 34 percent for children with only LD, 45 percent for
children with only ADD, and 51 percent for children with both diagnoses.
Among children with neither ADD nor LD, 23 percent had four or more health
care visits during the past 12 months.
Children with ADD more often had contact with a mental health
professional, used prescription medication regularly, and had frequent
health care visits, said the report.
The study noted that the regular use of prescription medication was
highest among children with ADD: 54 percent for children with only ADD and
61 percent for children with both ADD and LD. Prescription medication use
for children without ADD was lower: 14 percent for children with only LD
and 6 percent for children with neither ADD nor LD.
The full report is available at www.cdc.gov.
