Twin Study Helps Scientists Link Relationship Among ADHD, Reading, Math

Posted on: Saturday, 11 December 2010, 00:01 CST

A new study published in Psychological Science used twins to look at the genetic and environmental influences underlying ADHD behaviors, reading, and math skills in children in an attempt to better understand the relationship among them.

Washington, DC (Vocus) December 9, 2010

Washington, D.C. (Vocus) Children with ADHD can sometimes have more difficulties on math and reading tests compared to their peers. A new study published in Psychological Science, a journal of the Association for Psychological Science, used identical and fraternal twins to look at the genetic and environmental influences underlying ADHD behaviors, reading, and math skills in children in an attempt to better understand the relationship among them.

Sara Hart, of the Florida State University, and her colleagues used twins enrolled in a long-term study of reading and math. Hart says by focusing on twins specifically, psychological scientists are able to tease out the difference between nature and nurture.

To do this, scientists compare identical twins, who have nearly the same DNA, with fraternal twins, who generally only share about half of their DNA. If identical twins are generally more alike on a trait?say, their eye color or reading ability?and fraternal twins are much less alike on the same trait, you can presume the trait is inherited. On the other hand, if pairs of identical twins are alike on a trait to the same extent that pairs of fraternal twins are alike on that trait?like how outgoing they are?you know the trait is probably influenced by their environment. Most traits fall somewhere in between, and twin studies can show that, too.

In this case, Hart and her colleagues were interested in how twins matched up on symptoms of ADHD, reading achievement, and math achievement. At about age 10, every pair of twins was tested on their reading and math ability. Their mothers also filled out surveys on any problems the children have with attention or hyperactivity.

The researchers found that ADHD behaviors, reading achievement, and math achievement were all influenced by the same genetic influences; this doesn't prove anything about what causes what, but some psychological scientists think that all three might be linked through the working memory system.

Although common genetic influences is a typical result from twin studies, the exciting aspect of this work was that that ADHD behaviors, reading achievement, and math achievement are also associated by common environmental influences.

Although it is not known what the actual environmental influences are, Hart and her colleagues suggest that it could be related to aspects of the classroom and homework environment. If researchers can figure out what these environmental influences really are, they may be able to help children with ADHD do better in school.

For more information about this study, please contact Sara Hart at shart(at)fcrr(dot)org.

The APS journal Psychological Science is the highest ranked empirical journal in psychology. For a copy of the article "Exploring How Symptoms of Attention-Deficit/Hyperactivity Disorder Are Related to Reading and Mathematics Performance: General Genes, General Environments" and access to other Psychological Science research findings, please contact Keri Chiodo at 202-293-9300 or kchiodo(at)psychologicalscience(dot)org.

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Twin study helps scientists link relationship among ADHD, reading, math

ScienceDaily (Dec. 10, 2010) ? Children with ADHD can sometimes have more difficulties on math and reading tests compared to their peers. A new study published in Psychological Science, a journal of the Association for Psychological Science, used identical and fraternal twins to look at the genetic and environmental influences underlying ADHD behaviors, reading, and math skills in children in an attempt to better understand the relationship among them.

Sara Hart, of the Florida State University, and her colleagues used twins enrolled in a long-term study of reading and math. Hart says by focusing on twins specifically, psychological scientists are able to tease out the difference between nature and nurture.

To do this, scientists compare identical twins, who have nearly the same DNA, with fraternal twins, who generally only share about half of their DNA. If identical twins are generally more alike on a trait -- say, their eye color or reading ability -- and fraternal twins are much less alike on the same trait, you can presume the trait is inherited. On the other hand, if pairs of identical twins are alike on a trait to the same extent that pairs of fraternal twins are alike on that trait -- like how outgoing they are -- you know the trait is probably influenced by their environment. Most traits fall somewhere in between, and twin studies can show that, too.

In this case, Hart and her colleagues were interested in how twins matched up on symptoms of ADHD, reading achievement, and math achievement. At about age 10, every pair of twins was tested on their reading and math ability. Their mothers also filled out surveys on any problems the children have with attention or hyperactivity.

The researchers found that ADHD behaviors, reading achievement, and math achievement were all influenced by the same genetic influences; this doesn't prove anything about what causes what, but some psychological scientists think that all three might be linked through the working memory system.

Although common genetic influences is a typical result from twin studies, the exciting aspect of this work was that that ADHD behaviors, reading achievement, and math achievement are also associated by common environmental influences.

Although it is not known what the actual environmental influences are, Hart and her colleagues suggest that it could be related to aspects of the classroom and homework environment. If researchers can figure out what these environmental influences really are, they may be able to help children with ADHD do better in school.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Association for Psychological Science.

Journal Reference:

Sara Hart et al. Exploring How Symptoms of Attention-Deficit/Hyperactivity Disorder Are Related to Reading and Mathematics Performance: General Genes, General Environments. Psychological Science, (in press)

Note: If no author is given, the source is cited instead.

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Mixed-handed children more likely to have mental health, language and scholastic problems, study finds

ScienceDaily (Jan. 27, 2010) ? Children who are mixed-handed, or ambidextrous, are more likely to have mental health, language and scholastic problems in childhood than right- or left-handed children, according to a new study published in the journal Pediatrics.

The researchers behind the study, from Imperial College London and other European institutions, suggest that their findings may help teachers and health professionals to identify children who are particularly at risk of developing certain problems.

Around one in every 100 people is mixed-handed. The study looked at nearly 8,000 children, 87 of whom were mixed-handed, and found that mixed-handed 7 and 8-year old children were twice as likely as their right-handed peers to have difficulties with language and to perform poorly in school.

When they reached 15 or 16, mixed-handed adolescents were also at twice the risk of having symptoms of attention deficit/hyperactivity disorder (ADHD). They were also likely to have more severe symptoms of ADHD than their right-handed counterparts. It is estimated that ADHD affects between 3 to 9 percent of school-aged children and young people.

The adolescents also reported having greater difficulties with language than those who were left- or right-handed. This is in line with earlier studies that have linked mixed-handedness with dyslexia.

Little is known about what makes people mixed-handed but it is known that handedness is linked to the hemispheres in the brain. Previous research has shown that where a person's natural preference is for using their right hand, the left hemisphere of their brain is more dominant.

Some researchers have suggested that mixed-handedness indicates that the pattern of dominance is not that which is typically seen in most people, i.e. it is less clear that one hemisphere is dominant over the other. One study has suggested that ADHD is linked to having a weaker function in the right hemisphere of the brain, which could help explain why some of the mixed-handed students in the study had symptoms of ADHD.

Dr Alina Rodriguez, the lead researcher on the study from the School of Public Health at Imperial College London, said: "Mixed-handedness is intriguing -- we don't know why some people prefer to make use of both hands when most people use only one. Our study is interesting because it suggests that some children who are mixed handed experience greater difficulties in school than their left- and right-handed friends. We think that there are differences in the brain that might explain these difficulties, but there needs to be more research.

"Because mixed-handedness is such a rare condition, the number of mixed-handed children we were able to study was relatively small, but our results are statistically and clinically significant. That said, our results should not be taken to mean that all children who are mixed-handed will have problems at school or develop ADHD. We found that mixed-handed children and adolescents were at a higher risk of having certain problems, but we'd like to stress that most of the mixed-handed children we followed didn't have any of these difficulties," added Dr Rodriguez.

To study the effects of mixed-handedness, Dr Rodriguez and her colleagues looked at prospective data from a cohort of 7,871 children from Northern Finland. Using questionnaires, the researchers assessed the children when they reached 7 to 8 years of age and again at 15 to 16 years of age.

When the children were aged 8, the researchers asked parents and teachers to assess their linguistic abilities, scholastic performance and behaviour. The teachers reported whether children had difficulties in reading, writing or mathematics and rated the children's academic performance as below average, average or above average.

The adolescents' parents and the adolescents themselves completed follow-up questionnaires when they were 15-16 years of age, with the children evaluating their school performance in relation to their peers and the parents assessing their children's behaviour, on a questionnaire that is widely used to identify ADHD symptoms.

The research was funded by the Academy of Finland; Sigrid Juselius Foundation, Finland; Thule Institute, University of Oulu, Finland; and the National Institute of Mental Health. Dr Rodriguez received support from VINNMER.

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Imperial College London.

Journal Reference:

Alina Rodriguez, Marika Kaakinen, Irma Moilanen, Anja Taanila, James J. McGough, Sandra Loo, and Marjo-Riitta Jarvelin. Mixed-Handedness Is Linked to Mental Health Problems in Children and Adolescents. Pediatrics, 2010 (in press)

Note: If no author is given, the source is cited instead.

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Transcendental Meditation Reduces ADHD Symptoms Among Students - New Study

The Transcendental Meditation technique may be an effective and safe non-pharmaceutical aid for treating ADHD, according to a promising new study published this month in the peer-reviewed online journal Current Issues in Education.

The pilot study followed a group of middle school students with ADHD who were meditating twice a day in school. After three months, researchers found over 50 percent reduction in stress and anxiety and improvements in ADHD symptoms.

Effect exceeds expectations

"The effect was much greater than we expected," said Sarina J. Grosswald, Ed.D., a George Washington University-trained cognitive learning specialist and lead researcher on the study. "The children also showed improvements in attention, working memory, organization, and behavior regulation."

Grosswald said that after the in-school meditation routine began, "teachers reported they were able to teach more, and students were able to learn more because they were less stressed and anxious."

Stress interferes with the ability to learn

Prior research shows ADHD children have slower brain development and a reduced ability to cope with stress. "Stress interferes with the ability to learn-it shuts down the brain," said William Stixrud, Ph.D., a Silver Spring, Maryland, clinical neuropsychologist and co-author of the study.

"Medication for ADHD is very effective for some children, but it is marginally or not effective for others. Even for those children who show improved symptoms with the medication, the improvement is often insufficient or accompanied by troubling side effects," Stixrud said. "Virtually everyone finds it difficult to pay attention, organize themselves and get things done when they're under stress. So it stands to reason that the TM technique which reduces stress and organizes brain function would reduce ADHD symptoms."

While in some cases a child cannot function without medication, there is growing concern about the health risks and side effects associated with the common ADHD medications, including mood swings, insomnia, tics, slowed growth, and heart problems. In 2006 the FDA required manufacturers to place warning labels on ADHD medications, listing the potential serious health risks.

These high risks and growing concerns are fueling parents' search for alternatives that may be safer for their kids.

The study was conducted in a private K-12 school for children with language-based learning disabilities. Participation was restricted to 10 students, ages 11-14, who had pre-existing diagnoses of ADHD. About half of the students were on medication. The students meditated at school in a group for 10 minutes, morning and afternoon.

To determine the influence of the TM technique, at the beginning and end of the three-month period, parents, teachers and students completed standard ADHD assessment inventories measuring stress and anxiety, behavior and social competency, and executive function. Students were also given a battery of performance tests to measure cognitive functioning.

"The results were quite remarkable"

Andy and Daryl Schoenbach's daughter was diagnosed with ADHD in second grade. Like most ADHD children she was taking medication. "The medication helped but had mixed results-she still lost focus, had meltdowns, and the medications affected her sleep and appetite," said Andy, who lives with Daryl in Washington D.C. "She was not performing close to her potential and we didn't see the situation improving. So at the end of seventh grade when her doctor recommended increasing the medication, we decided it was time to take a different course-stopping the medication and using Transcendental Meditation."

"The results were quite remarkable," Daryl said. "The twice daily meditations smoothed things out, gave her perspective, and enabled her to be in greater control of her own life when things started falling apart. It took some time, but it gradually changed the way she handled crises and enabled her to feel confident that she could take on greater challenges -in her own words, 'climb a mountain.'"

"Everyone noticed the change," Andy added.

Grosswald explained that there is substantial research showing the effectiveness of the TM technique for reducing stress and anxiety, and improving cognitive functioning among the general population. "What's significant about these new findings is that among children who have difficulty with focus and attention, we see the same results. TM doesn't require concentration, controlling the mind or disciplined focus. The fact that these children are able to do TM, and do it easily shows us that this technique may be particularly well suited for children with ADHD," she said.

This study was funded by the Abramson Family Foundation and the Institute for Community Enrichment.

A second, recently completed TM-ADHD study with a control group measured brain function using electroencephalography (EEG). Preliminary data shows that three months practice of the technique resulted in significant positive changes in brain functioning during visual-motor skills. Changes were specifically seen in the circuitry of the brain associated with attention and distractibility. After six months TM practice, measurements of distractibility moved into the normal range.

A third, $2 million TM-ADHD study, to be funded in part by a grant from The David Lynch Foundation, will more fully investigate the effects of the technique on ADHD and other learning disorders.

Facts about ADHD

Attention Deficit Hyperactivity Disorder (ADHD)

" The Center for Disease Control reports that nearly 50 percent of the 4.5 million children (ages 4-17) in the United States diagnosed with ADHD are on ADHD medication-and the majority of those on medication stay on it in adulthood.

" The rate of prescriptions for Attention Deficit Hyperactivity Disorder in the U.S. has increasing by a factor of five since 1991-with production of ADHD medicines up 2,000 percent in 9 years.

" The commonly used drugs for ADHD are stimulants (amphetamines). These drugs can cause persistent and negative side effects, including sleep disturbances, reduced appetite, weight loss, suppressed growth, and mood disorders. The side effects are frequently treated with additional medications to manage insomnia or mood swings. Almost none of the medications prescribed for insomnia or mood disturbances are approved by the Food and Drug Administration (FDA) for use with children.

" The long-term health effects of ADHD medications are not fully known, but evidence suggests risks of cardiac disorders and sudden death, liver damage and psychiatric events. It has also been found that children on long-term medication have significantly higher rates of delinquency, substance use, and stunted physical growth.

Facts about The Transcendental Meditation technique

" The Transcendental Meditation technique is an effortless technique practiced 10-20 minutes twice a day sitting comfortably with the eyes closed.

" TM is not a religion or philosophy and involves no new beliefs or change in lifestyle.

" Over 350 peer-reviewed research studies on the TM technique confirm a range of benefits for mind, body and behavior.

" Several studies have compared the effects of different meditation practices and found that Transcendental Meditation provides deeper relaxation and is more effective at reducing anxiety, depression and hypertension than other forms of meditation and relaxation. In addition, no other meditation practice shows the widespread coherence throughout all areas the brain that is seen with Transcendental Meditation.

" The Transcendental Meditation technique is taught in the United States by a non-profit, educational organization.

Tom Ball has taught the Transcendental Meditation technique for over 30 years. He earned a BA in Western Philosophy from Maharishi University of Management, an MFA in Creative Writing from Columbia University, and a PhD in Peace Studies from Maharishi European Research University. Tom has enjoyed a rich career of lecturing and teaching across the US and around the world. He is a writer and Director of the Transcendental Meditation program of Asheville, NC. For more information, please visit http://www.adhd-tm.org .

ADHD puts teen drivers at risk: study

Children with ADHD are known to go off medications like Ritalin because of side-effects, but researchers suggest that doctors stress the importance of treatment to reduce the risk of traffic crashes. (CBC)

Teenage boys with attention deficit hyperactivity disorder are twice as likely to be involved in a serious car collision compared with the general population, an Ontario study suggests.

The study in Tuesday's issue of the online journal PLoS Medicine looked at 3,421 males between the ages of 16 and 19 who were involved in serious road trauma between 2002 and 2009, compared with a control group of teens admitted for appendicitis.

The researchers suggested listing ADHD the same way as other medical disorders like epilepsy, which require drivers to show they are road worthy to keep their driver's licence.

Study author Dr. Donald Redelmeier, a professor of medicine at the University of Toronto, estimated if the crash risk for teenagers with ADHD could be reduced to that of teens without the disorder then it would prevent about 700 crashes a year in Ontario.

Teenaged girls with ADHD also showed an increased risk of crashes, but the study focused on teenaged male drivers because they have the highest incidence of road crashes, at twice the population average.

"The findings call attention to a widespread, preventable, and costly cause of death and disability," the study's authors concluded.

"Most people know that teenage males are prone to traffic injuries, but the current data show that prevailing adjustments are not sufficient."

The researchers suggested the family doctors, psychiatrists and community health workers could help by treating ADHD patients with methylphenidate or Ritalin, as well as talking to patients about ways to reduce the risk, such as abstaining from alcohol and avoiding distractions like using cellphones while driving.

The researchers acknowledged limitations of the study, including that they couldn't determine whether the teens with ADHD were taking medication when the crashes occurred.

But children with ADHD are known to go off their meds because of side-effects.

"The medicines only work if the people take them," agreed Dr. Laurence Jerome, a child and adolescent psychiatrist specializing in ADHD at the University of Western Ontario in London. "And when it's in the evening and weekends … we have a compliance problem."

Since the study also did not look at who was "at fault," it is possible that the disorders impair the ability of teens to avoid mishaps initiated by others.

"Most importantly, the observed increase in risk as pedestrians indicates that male teenagers who abstain from driving do not escape the danger of road traffic crashes," the journal's editors said.

Jerome stressed that not everyone with ADHD is a problem driver.

With files from The Canadian Press

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Nearly one million children in U.S. potentially misdiagnosed with ADHD, study finds

ScienceDaily (Aug. 17, 2010) ? Nearly 1 million children in the United States are potentially misdiagnosed with attention deficit hyperactivity disorder simply because they are the youngest -- and most immature -- in their kindergarten class, according to new research by a Michigan State University economist.

These children are significantly more likely than their older classmates to be prescribed behavior-modifying stimulants such as Ritalin, said Todd Elder, whose study will appear in a forthcoming issue of the Journal of Health Economics.

Such inappropriate treatment is particularly worrisome because of the unknown impacts of long-term stimulant use on children's health, Elder said. It also wastes an estimated $320 million-$500 million a year on unnecessary medication -- some $80 million-$90 million of it paid by Medicaid, he said.

Elder said the "smoking gun" of the study is that ADHD diagnoses depend on a child's age relative to classmates and the teacher's perceptions of whether the child has symptoms.

"If a child is behaving poorly, if he's inattentive, if he can't sit still, it may simply be because he's 5 and the other kids are 6," said Elder, assistant professor of economics. "There's a big difference between a 5-year-old and a 6-year-old, and teachers and medical practitioners need to take that into account when evaluating whether children have ADHD."

ADHD is the most commonly diagnosed behavioral disorder for kids in the United States, with at least 4.5 million diagnoses among children under age 18, according to the Centers for Disease Control and Prevention.

However, there are no neurological markers for ADHD (such as a blood test), and experts disagree on its prevalence, fueling intense public debate about whether ADHD is under-diagnosed or over-diagnosed, Elder said.

Using a sample of nearly 12,000 children, Elder examined the difference in ADHD diagnosis and medication rates between the youngest and oldest children in a grade. The data is from the Early Childhood Longitudinal Study Kindergarten Cohort, which is funded by the National Center for Education Statistics.

According to Elder's study, the youngest kindergartners were 60 percent more likely to be diagnosed with ADHD than the oldest children in the same grade. Similarly, when that group of classmates reached the fifth and eighth grades, the youngest were more than twice as likely to be prescribed stimulants.

Overall, the study found that about 20 percent -- or 900,000 -- of the 4.5 million children currently identified as having ADHD likely have been misdiagnosed.

Elder used the students' birth dates and the states' kindergarten eligibility cutoff dates to determine the youngest and oldest students in a grade. The most popular cutoff date in the nation is Sept. 1, with 15 states mandating that children must turn 5 on or before that date to attend kindergarten.

The results -- both from individual states and when compared across states -- were definitive. For instance, in Michigan -- where the kindergarten cutoff date is Dec. 1 -- students born Dec. 1 had much higher rates of ADHD than children born Dec. 2. (The students born Dec. 1 were the youngest in their grade; the students born Dec. 2 enrolled a year later and were the oldest in their grade.)

Thus, even though the students were a single day apart in age, they were assessed differently simply because they were compared against classmates of a different age set, Elder said.

In another example, August-born kindergartners in Illinois were much more likely to be diagnosed with ADHD than Michigan kindergartners born in August of the same year as their Illinois counterparts. That's because Illinois' kindergarten cutoff date is Sept. 1, meaning those August-born children were the youngest in their grade, whereas the Michigan students were not.

According to the study, a diagnosis of ADHD requires evidence of multiple symptoms of inattention or hyperactivity, with these symptoms persisting for six or more months -- and in at least two settings -- before the age of seven. The settings include home and school.

Although teachers cannot diagnose ADHD, their opinions are instrumental in decisions to send a child to be evaluated by a mental health professional, Elder said.

"Many ADHD diagnoses may be driven by teachers' perceptions of poor behavior among the youngest children in a kindergarten classroom," he said. "But these 'symptoms' may merely reflect emotional or intellectual immaturity among the youngest students."

The paper will be published in the Journal of Health Economics in conjunction with a related paper by researchers at North Carolina State University, Notre Dame and the University of Minnesota that arrives at similar conclusions as the result of a separate study.

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by Michigan State University.

Journal Reference:

Elder et al. The importance of relative standards in ADHD diagnoses: Evidence based on exact birth dates. Journal of Health Economics, 2010; DOI: 10.1016/j.jhealeco.2010.06.003

Note: If no author is given, the source is cited instead.

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Children With Fetal Alcohol Spectrum Disorders (FASD) Have More Severe Behavioral Problems Than Children With Attention Deficit Hyperactivity Disorder (ADHD), Study Finds

New Study Reveals That Coaching Helps College Students With ADHD Improve Ability To Learn, Succeed In College

Main Category: ADHD
Article Date: 13 Nov 2010 - 2:00 PST window.fbAsyncInit = function() { FB.init({ appId: 'aa16a4bf93f23f07eb33109d5f1134d3', status: true, cookie: true, xfbml: true, channelUrl: 'http://www.medicalnewstoday.com/scripts/facebooklike.html'}); }; (function() { var e = document.createElement('script'); e.async = true; e.src = document.location.protocol + '//connect.facebook.net/en_US/all.js'; document.getElementById('fb-root').appendChild(e); }()); email to a friend ? printer friendly ? opinions ?

The results of a new study being released this week at the Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD) conference in Atlanta demonstrate the effectiveness of a new model of coaching, developed exclusively for and used by the Edge Foundation, to help college students with ADHD improve executive functioning, which is their ability to organize, set and achieve goals, and self regulate -- all critical for a successful post secondary education. Additionally, students who participated in the study felt that coaching helped them feel less stress, greater empowerment, increased confidence and have more balanced lives.

Researchers from Wayne State University in Michigan conducted the study over two years in 10 universities and community colleges throughout the country and tracked the progress of 110 students with ADHD. It is the largest and most comprehensive study of ADHD coaching conducted to-date. The research team measured students' progress through both quantitative and qualitative analysis and have determined, "This study demonstrated that the Edge coaching model was highly effective in helping students improve executive functioning and related skills as measured by the Learning and Study Strategies Inventory (LASSI; Weinstein & Palmer, 2002)."

Coaching has long been used by corporations to improve performance of CEOs and executives, but little research has been done until now on the impact this kind of intervention may have on populations with learning disabilities, like ADHD. While medication has been shown to improve academic productivity (better note-taking, scores on quizzes and worksheets, and homework completion), medication alone is not associated with skills students need to meet the demands of college which they must navigate more independently than in previous schooling.

Source: Edge Foundation

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ADHD Rates Soar in U.S. Kids: Study

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, Nov. 10 (HealthDay News) -- The number of U.S. children diagnosed with attention-deficit/hyperactivity disorder (ADHD) jumped nearly 22 percent in a recent four-year period, U.S. health officials report.

"Based on our parent surveys, there has been an increase in parent-reported ADHD diagnosis among their children," said lead author Susanna Visser of the U.S Centers for Disease Control and Prevention.

"This increase was from 7.8 percent in 2003 to 9.5 percent in 2007," she said. "When we project that to the American population, that means that a million more children were diagnosed with ADHD in 2007 as compared to 2003. That's a substantial increase in four years."

About 5.4 million children have ADHD in the United States, according to their parents, and 2.7 million take medication for the condition, the CDC survey of 4- to 17-year-olds found.

"There are probably more children out there who have not received a diagnosis and we can't determine how many more children there are based on these data," added Visser, lead epidemiologist of the child development studies team at the CDC's National Center on Birth Defects and Developmental Disabilities.

ADHD, a neurobehavioral disorder, is characterized by levels of inattention and activity that are developmentally inappropriate. The condition can persist into adulthood.

Among older teens, the rate of ADHD soared 42 percent, the researchers found. This suggests that health care providers may be managing a larger and different population of children than they were four years ago.

"We don't know as well how to manage ADHD among older teens," Visser said. "Regardless of why we are seeing this, the end result is that health care providers are going to modify their care approach to consider the needs of older teens," she said.

The 53 percent increase in ADHD diagnosis since 2003 among Hispanics means providers are going to have to be sensitive to the needs of this group as well, Visser added.

Much of the increase may be driven by better screening programs and more awareness and diagnosis, Visser said.

The report is published in the Nov. 12 issue of the CDC's Morbidity and Mortality Weekly Report.

One expert isn't surprised by the numbers.

"I believe the findings are generally accurate and consistent with most research in detailing the rapid and rather disconcerting rise in the diagnosis of ADHD in U.S. children," said John D. Ranseen, an associate professor of psychiatry at the University of Kentucky College of Medicine.

The rapid rise in diagnosis, which is not necessarily equivalent to a rise in the actual condition, must be due in part to cultural factors -- a willingness to label certain symptoms as indicating ADHD, increased cultural acceptance of doing so and increased dissemination of information labeling ADHD as a "condition," he said.

Other, more vague, cultural factors may also play a role, Ranseen pointed out.

"For instance, increased stress to complete as much schooling as possible within a lousy economy," he noted.

"Another very uncomfortable issue is the role of pharmacological companies in all of this since it is very much in their interest to increase the diagnosis and treatment of this condition. The last thing they have any interest in seeing is a drop in the diagnosis and treatment," Ranseen said.

"One would hope that such findings might give the mental health field pause to wonder and worry about why we are seeing increases in virtually all psychiatric conditions -- autism, depression, ADHD, bipolar in children -- for instance, what does this say about our society?" Ranseen added.

But another ADHD expert, Dr. Jeffrey Brosco, professor of pediatrics at the University of Miami Miller School of Medicine, said parent-reported studies make it hard to ascertain true figures.

Whether the number of children with ADHD is actually increasing or whether the increase is a product of increased awareness isn't known, Brosco said.

"I don't know and I don't think anyone can really tell you based on this study," he said. "There is no doubt that over the last 30 to 40 years we have become much more sensitive to behavioral differences," Brosco said. "Whether there is truly a change -- whether kids in the 1970s are really different from kids in the '90s or the 2000s -- there's not any way to tell that."

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