Increasing Prevalence of ADHD

Attention Deficit Hyperactivity Disorder (ADHD) has been a hot topic in education, pediatric medicine, and parenting for decades. The condition has been known in various forms by various names for at least a hundred years, but the current definition was crystallized in the year 2000 by the American Psychiatric Association (APA) in their definitive publication “The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition” (DSM-IV) and most recently updated 2013 in the most recent version of the same manual (DSM-V):

“…a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with development, has symptoms persisting in two or more settings (e.g. at home, school, or work), and negatively impacts directly on social, academic or occupational functioning.”

The prevailing notion among health professionals is that ADHD is a neurological disorder of quantitative, material physiological origin. This is a matter of intense debate, though. Diet, food additives, environmental contaminants, and other factors have all been presented as possible causes of ADHD. Addressing and attempting to answer questions of origin is beyond the scope of this article. However, and regardless of its causes, the diagnosis of ADHD in the U.S is clearly on the rise.  The Centers for Disease Control (CDC) offers the following statistics on the upward trend in ADHD diagnosis in the U.S.:

• In 2016, over 6 million children between the ages of 2 and 17 in the U.S. had an ADHD diagnosis.
  • 388,000 between 2-5
  • 2.4 million between 6-11
  • 3.3 million between 12-17
• The percentage of children receiving an ADHD diagnosis in 2003 was 7.8%, 9.5% in 2007, and 11% in 2011-12.
• The rate of increase averaged 3% each year between 1997-2006, and an average of 5% each year between 2003-2011.

Current ADHD Treatment Options

The most common treatments for ADHD in the U.S. are: 1) A course of prescription medication such as Ritalin or Adderall, or 2) Intensive behavioral intervention. Research has also shown that in addition to medication, changes in diet can also help alleviate symptoms of ADHD. Evidence indicates that cutting down on fast foods, high-fat dairy products, processed meats, and sugary snacks and drinks, while increasing whole grains, fish, fruits and vegetables all help children manage their ADHD symptoms. In an article published in the Journal of Abnormal Child Psychology (JACP) new data indicates that there is another option that parents, school personnel, parents, and pediatricians can add to their ADHD treatment toolbox: daily doses of moderate to intense aerobic activity before school.

Daily Exercise Benefits Children with ADHD

For many parents and teachers working with children who show symptoms of ADHD, there’s an enormous white elephant in the room. Young children have lots of energy. And they need to express that energy in some way. Of course, some children have more energy than others. Some are fine sitting in classrooms, listening to teachers and doing their worksheets. Fifteen minutes of recess plus thirty minutes of P.E. a day suffice in getting all that excess energy out. Other kids, though, seem to need more. They need to be outside, running around, playing active games for more than forty-five minutes a day. Parents and teachers don’t need science or a peer-reviewed journal article to teach them that these children need regular exercise. Experience is teacher enough, and for these kids, an ADHD diagnosis seems unfair and possibly unnecessary. They’re just super-active kids.

At the same time, a subset of children exists who are in a different category altogether. For these children, medication can change everything. It can mean the difference between being able to sit still for thirty seconds and being able to sit still for a fifteen-minute lesson. It can mean the difference between finishing an entire worksheet and barely being able to finish writing their name.

For these children, medication or intensive behavioral intervention can mean the difference between learning and not learning. The study above is a game-changer for these children and families. The data shows that neither medication nor behavioral is 100% effective, and both come with a wide range of complicating factors. Some parents simply won’t put their kids on medication. In many cases, an intensive behavioral intervention is so burdensome to implement that it’s nearly impossible for parents and schools.

An Hour A Day: It’s Do-Able

What the study in the Journal of Abnormal Child Psychology shows is that an intervention strategy of regular exercise – thirty-one minutes a day of moderate to intense exercise before school – reduces the reported occurrence of ADHD symptoms. It decreases inattention, hyperactivity, impulsivity, and moodiness more effectively than a sedentary intervention strategy of the same length. The relevance of this data cannot be overstated. Not only is this intervention inexpensive and simple to implement, but it also may appeal to parents for whom medication is off the table. It may also appeal to schools who simply don’t have the staffing to offer direct behavioral intervention to children dealing with the challenges of ADHD.

According to Alan Smith, one of the researchers who conducted the study, “…physical activity appears to be a promising intervention method for ADHD with well-known benefits to health overall…” If more research backs up the encouraging data offered by this study, before long we may see doctors prescribing exercise as a course of treatment for the symptoms of ADHD. In the meantime, parents and schools now have one more research-based method to help children with ADHD learn, grow, and live full and productive lives.