Eight reasons why ADHD diagnoses are increasing

For a long time it was assumed that this would be somewhere in between 5 and 6% of having children attention deficit hyperactivity disorder (ADHD). But in practice, the rates are often higher. The U.S. Centers for Disease Control and Prevention estimates the prevalence 11.4% in children in 2022.

The Swedish Council for Health and Welfare reports that in 2022, 10.5% of boys and 6% of girls received an ADHD diagnosis. 50% more than in 2019. And the board predicts that rates will ultimately remain at 15% for boys and 11% for girls.

What could be the reasons behind the surprising increase? Here are eight possible causes, many of which overlap and interact with each other.

1. Multiple diagnoses made for the same person

Previously, doctors were recommended by diagnostic manuals and trained to limit an individual's diagnosis to the most prominent ones, and not to make certain combinations of diagnoses at all – for example, autism and ADHD. Nowadays it is recommended and common in the mental health care to make as many diagnoses as necessary to meaningfully describe and treat a person's symptoms and challenges.

2. Increasing knowledge and awareness among professionals

Today, there is a new generation of professionals working in services with greater awareness and knowledge of ADHD. This has led to ADHD being detected earlier and ADHD being diagnosed in previously neglected groups. especially girls and women– but also inside adults, in general

3. Reduced stigma

In many societies, ADHD is far away less stigmatized than before. Doctors have fewer doubts about making the diagnosis, and those who receive the diagnosis feel less stigmatized. For more and more people, ADHD has fewer negative connotations and is becoming a natural part of people's identities.

4. Modern society places higher demands on cognitive skills

ADHD is not a disease, but a poorly functioning composite of cognitive traits that exist even in the general population at more functional levels, such as “attention control” (concentration) and organizational and self-regulatory skills. Modern societies are fast and complex and place high demands on these cognitive properties. So people with lower than average skills in these key cognitive areas begin to have difficulty coping with daily demands and may receive an ADHD diagnosis.

5. Higher expectations about health and performance

People's expectations about their own performance and health and that of others are increasing. The so-called 'social baseline' of average health and performance is higher today. Therefore, people may express concerns earlier and more often about their own performance and that of others, and they may hypothesize that ADHD could be an explanation.

6. Changes in schools have led to more students struggling

Schools have undergone substantial changes in the way they teach, such as digitalization and the introduction of more project and group-based learning, as well as much more self-directed education.

These changes have led to a less distinct learning environment, including increased demands on students' motivation and cognitive skills, factors that can make it more difficult for students with even some of the characteristics of ADHD to succeed. It has also led to schools referring more students they suspect are there ADHD for review.

7. Policymakers prioritize evaluation

Politicians in many countries have tried to address rising diagnosis rates primarily through diagnostic assessments more accessible so that people do not have to wait long for a diagnosis.

While this is understandable, it encourages diagnoses and does not focus on avoiding diagnoses, such as by improving the way children are taught, improving workplaces to make them more neurodivergist friendly, and providing support without anyone needing a diagnosis.

8. Diagnosis ensures access to support and resources

In most societies, services are constructed in such a way that only a clinical diagnosis guarantees access to support and resources. It is often the only way people and their families can get support.

In general, not much is done for people without a diagnosis, because service providers do not receive compensation and are therefore less obliged to take action. People who need support are therefore more likely to actively seek a diagnosis. And professionals are more likely to help them by making a diagnosis, even if the person doesn't quite meet the diagnostic criteria for ADHD – a phenomenon that “diagnostic upgrade.”

This article is republished from The conversation under a Creative Commons license. Read the original article.