Attention Deficit Disorder In Children Essay

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Attention deficit hyperactivity disorder  (ADHD), or attention deficit disorder,  as it is perhaps  more commonly  known,  is a psychiatric  disorder characterized by pervasive  difficulties  with  tasks that   require   sustained   attention  and   impulse control, such as focusing  on important life tasks, fulfilling responsibilities, staying organized, listening  to  others,  remaining  still  in  one’s  seat, and keeping appropriately quiet. Prevalence of ADHD  is estimated  at 9 percent  among  children aged between 13 and 18 years, with boys affected in significantly greater numbers  than  girls. ADHD leads to problems in social, economic, and psychological   adjustment that  frequently   persist into adulthood.

A diagnosis  of ADHD  is made  based  on  the criteria set out in the Diagnostic and Statistical Manual  of  Mental  Disorders  (DSM),  now  in  its fifth edition. Six out of 18 possible symptoms must be present for a diagnosis, five of which must have been evident before the child was 12 years of age. Symptoms  must cut across the contexts  of school, home, and elsewhere and lead to more  severe difficulties  than  would  be expected  for  a child  of a similar  age and  developmental phase.  Depending on a child’s particular presentation of ADHD symptoms, professionals may specify that  a child exhibits  primarily  inattentive, hyperactive-impulsive, or combined  symptoms.

Economics  is a  key contextual clue  to  under- standing  the  diagnosis  and  treatment of ADHD. The lower a child’s socioeconomic  status (SES), the greater  the likelihood  that  he or she will be diagnosed  with  the disorder.  The reasons  are unclear; both   low  SES and  ADHD  may  share  common causes, or the stresses of living in economically disadvantageous  circumstances may  give  rise  to the  symptoms. Social  services  intended   to  help families adjust to the disorder  require considerable public  expenditures in  the  areas  of  health  care, education, and  the  justice  system.  Moreover, the research,  development, and marketing of drug treatments have led to sizeable profits for the pharmaceutical industry.

Health Care Costs

Children  with ADHD  have more emergency room visits  than  other  children  on  average.  They  also have twice as much contact with mental health providers  and visit outpatient mental health clinics 10  times more  often  than  those  who  are  undiagnosed. This creates  higher  costs within  the health care system and greater out-of-pocket expenses for families with children diagnosed  with ADHD.

Adolescents with ADHD who are of driving age have  significantly  higher  traffic-related incidents. They also show higher rates  of risky or impulsive driving behaviors, speeding, and crashes. These drivers  are more  easily distracted when  a secondary stimulus is present, increasing traffic-related health  care and insurance  costs.

Diagnosis  of ADHD  is determined by qualified health  care  professionals, including  primary  care physicians, psychiatrists, psychologists,  social workers, counselors, and family therapists. Families receive mental health services most commonly through their  primary   care  physician.  Diagnosis and  treatment can  be  costly.  In an  average  year, health  care for ADHD in children and adolescents may cost each family struggling  with  the disorder between  $621  and  $2,720. Nationally, estimates for these costs range from $4.12  billion to $18.04 billion.

Education  Costs

ADHD displays itself within the classroom through impulsivity,  lack  of  sustained  attention, and  disruption. There  are  multiple  ways  in  which  this disorder  affects  educational costs. Many  children with   ADHD   have   an   individualized  education plan,  which  involves  a team  of people,  including teachers,  parents,  and mental  health  professionals.

Preschool-age   children   who   have  been  diagnosed with ADHD use specialized educational resources at a rate four times greater than their undiagnosed peers. These resources  include speech therapy, occupational therapy, special  education, and physiotherapy. Children  with ADHD in elementary, middle,  and  high  school  have  higher utilization of  school  counseling.  Fifty  percent  of those  who  are  using  special  education have  an ADHD diagnosis, and 77 percent of these students use additional educational resources  that  include tutoring, counseling,  special  class placement, and additional monitoring.

ADHD  in children  may have a negative impact on educational achievement.  In the United  States, a  study  showed  that  boys  who  were  diagnosed with  ADHD  completed  2.5  years  less of  school than other children. Throughout adolescence, ADHD can have a negative impact on self-efficacy and choosing  a career path. There is evidence that adolescents  with a diagnosis  of ADHD  may be at greater risk of struggling academically and psychologically. Children  with  ADHD  have  lower  levels of achievement,  are less productive, and score somewhat lower  on  intelligence  tests  and  other measures   of  intellectual   development.  At  least 40  percent   receive  special  educational  services. Costs of educational services for children and adolescents with ADHD may average between $2,222 and  $4,690 per  person  annually,  with  a  nationwide cost of $9.36  billion to $19.75 billion.


Adolescents  who are diagnosed  with ADHD  show significantly  higher rates  of injury on the job. This leads to economic  loss due to missed work,  workman’s compensation claims, and health care costs. A Canadian study shows that workers diagnosed with ADHD are twice more likely to have an accident on the job than  workers  without such a diagnosis. An increased  report  of somatic  symptoms  within  this population can also burden  the system through absenteeism  and  health  care costs. Problems  relating to ADHD in children each year cause families to lose between  $142  and  $339  annually  because  of productivity losses. Nationally, productivity losses total $1.03  billion to $2.45  billion annually.

Justice System

ADHD has an impact on the justice system with an estimated  annual  expenditure of $3  billion  to  $6 billion annually. This cost accrues from criminal offenses committed by individuals with ADHD, expenditures related  to juvenile detention centers, arrests, burglaries, robberies, drug charges, and convictions. There is a significant correlation between  bullying and behavior  deemed as violent, and hyperactivity.

Pharmaceutical Industry

Medications to  treat  ADHD  in children  are  commonly  stimulants that  increase  the  activity  of the central  nervous  system. These medications usually work by increasing the activity of dopamine, a neurotransmitter that reinforces pleasurable behaviors. The activity of dopamine in individuals with ADHD may be generally lower than normal. Increasing this activity has a paradoxically calming effect on children with the disorder. Although  the best treatment outcomes are frequently seen in patients using a combination of drugs  and  behavioral psychotherapy,  psychiatric  medications alone  continue  to  be the most common way of treating ADHD. Increased demand  for  these  medications over  the  past  few decades has led to an explosion of research and marketing by the pharmaceutical industry.

Globally,    ADHD    medication   expenditures increased  from $332  million in 1994  to $2.26  billion in 2003,  with the vast majority  of such medications  consumed  in the United  States. Over  that period, the sales volume experienced a 104-percent increase. The United States remains the most important market  for ADHD medications, perhaps because  of the higher  prevalence  rates  due to the use of the DSM, which is chiefly used in the United States and has diagnostic  criteria that are generally more  relaxed  than  those  used in European countries and elsewhere.

Many  parents  use the Internet  to find information regarding their children’s impulsive and disruptive    behavior.  One   study   suggests   that 37 percent  of popular search  engine responses  to searches for information about  the causes and treatment of ADHD  lead to sites that  are funded by drug  companies.  These sites tend  to favor  biological  and  genetic  explanations for  what  causes ADHD, supporting the use of pharmaceutical interventions rather than psychosocial ones (counseling, behavior  modification). If the number of children who are prescribed ADHD medications continues to increase, these companies are well positioned to reap the financial  rewards.


  1. American Psychiatric Association. Diagnostic  and Statistical Manual  of Mental Disorders,  5th ed. Arlington,  VA: American Psychiatric  Publishing, 2013.
  2. Doshi, Jalpa A., Paul Hodgkins, Jennifer Kahle, Vanja Sikirica, Michael J. Cangelosi, Juliana Setyawan, M. Haim  Erder, and Peter J. Neumann. “Economic Impact of Childhood and Adult Attention-Deficit/ Hyperactivity Disorder  in the United States.” Journal of the American  Academy of Child & Adolescent Psychiatry,  51/10  (2012).
  3. Marks, David J., Agnieszka Mlodnicka, Melissa Bernstein, Anil Chacko, Scott Rose, and Jeffrey M. Halperin. “Profiles  of Service Utilization  and the Resultant Economic Impact  in Preschoolers  With Attention Deficit/Hyperactivity Disorder.” Journal of Pediatric Psychology,  34/6 (2009).
  4. Mitchell, Jessica and John Read. “Attention-Deficit Hyperactivity Disorder, Drug Companies and the Internet.” Clinical Child Psychology  and Psychiatry, v.17/1 (2012).
  5. Pelham, William E., E. Michael Foster, and Jessica A. Robb. “The  Economic Impact  of Attention-Deficit/ Hyperactivity Disorder  in Children  and Adolescents.” Ambulatory Pediatrics, v.7/1 (2007).

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