ChildsWork News, March 20, 2012: ADHD Diagnosis and a Great Podcast on Social-Emotional Development

Happy First Day of Spring! For this morning’s CW News, I wanted to share two interesting stories. The first is news from a study conducted by Northwestern Medicine. According to this study, the diagnosis of ADHD among American children has risen a startling 66% over the past 10 years. As a frequent topic of discussion here on CW, what are your feelings about this study? Have you noticed this rising trend? The second article this morning is in two parts. The first is a summary of the podcast that accompanies it. In this podcast New America Foundation’s Lisa Gurney speaks with the director of the Institute of Human Development and Social Change, C. Cybele Raver, about her research on Chicago City Schools with focused on the social-emotional development of pre-k to third graders and how we may integrate that into our curriculum. If you have 20 minutes to listen to this presentation, it’s a great learning experience. Diagnosis of ADHD on the Rise         From Science Daily The number of American children leaving doctors' offices with an attention deficit hyperactivity disorder (ADHD) diagnosis has risen 66 percent in 10 years, according to a new Northwestern Medicine study. Over this same timeframe, specialists, instead of primary care physicians, have begun treating an increasing number of these young patients, the study found. The study, which will be published in the March/April issue of the journal Academic Pediatrics, analyzed ADHD trends from 2000 to 2010 among children under the age of 18 who were diagnosed and treated by office-based physicians. Researchers analyzed changes in the diagnosis of ADHD and treatment of the disorder over this 10-year time period. "ADHD is now a common diagnosis among children and teens," said Craig Garfield, M.D., first author of the study. "The magnitude and speed of this shift in one decade is likely due to an increased awareness of ADHD, which may have caused more physicians to recognize symptoms and diagnose the disorder." Garfield is an assistant professor in pediatrics and medical social sciences at Northwestern University Feinberg School of Medicine and a pediatrician at Children's Memorial Hospital and Northwestern Memorial Hospital. Symptoms of ADHD, such as trouble paying attention and controlling impulsive behaviors and being overly active, can affect children and teens both academically and socially, Garfield said. In the past decade several important regulatory and clinical changes regarding ADHD and the medications used to treat it have occurred, yet it was unknown how these factors have affected ADHD management, Garfield said. For the study, Garfield and his team of researchers quantified ADHD diagnosis and treatment patterns among people under 18 using the IMS Health National Disease and Therapeutic Index. This is a nationally representative sample of office-based visits and included 4,300 office-based physicians in 2010. According to the study, in 2010, 10.4 million children and teens under age 18 were diagnosed with ADHD at physician outpatient visits, versus 6.2 million in 2000. Researchers also found that psychostimulants have remained the most common medication prescribed to children with ADHD. Psychostimulants were used in 96 percent of treatments in 2000 and 87 percent in 2010. The exact reason for the decrease is unclear, but there was not an increase in treatment with other, substitute medications, Garfield said. While the majority of children and teens with ADHD are still managed by primary physicians, the study found that there has been a substantial shift away from primary doctors and towards specialists, such as pediatric psychiatrists. "Recently, there's been more public health advisories issued about problems or side effects of different ADHD medications," Garfield said. "It may be that general pediatricians are shying away from treating patients themselves and instead rely on their specialist colleagues to provide the treatment and management of these medications." Given the short supply of psychiatrists specializing in pediatric ADHD, Garfield said this trend might make it difficult for many children to receive medical treatment of ADHD in the future. This study was funded by the Agency for Healthcare Research and Quality and the Robert Wood Johnson Foundation. Focusing on Social-Emotional Development in Pre-K to 3^rd Graders Presented by The New America Foundation’s Lisa Gurney Ensuring that children receive a good education throughout their early years, from pre-kindergarten through third grade, is not just about helping them achieve academically.  It also means providing kids with teachers who can help them grow socially and emotionally year after year. Last month, the Erikson Institute in Chicago held a forum on High-Quality PreK-3rd in the Age of the Common Core that included a focus on this point.  A presentation by C. Cybele Raver, director of the Institute of Human Development and Social Change, highlighted the positive impact of teaching pre-K children how to regulate their emotions and share with their peers -- as well as the less-impressive results that derive when those strategies aren't continued in elementary school. In this podcast, we talk with Raver about her research on the Chicago School Readiness Project, which is tracking outcomes for children who attended Head Start centers in seven high-poverty areas of the city.  The research so far shows that when teachers are given training on how to help children regulate their emotions and develop their social skills, children exhibit fewer behavior problems and have better self-regulation and attention skills than those in similar classrooms without trained teachers. Those differences in behavior among the CSRP kids, however, do not appear to continue into the elementary school years if children do not attend schools in which teachers can attend to their developmental needs, Raver said. The social-emotional training program used in the CSRP was only for Head Start teachers, not for teachers in the public schools. After children turned 5, they were enrolled in some kindergarten classrooms that Raver described as "chaotic, large and less supportive" of children's social-emotional growth. In those cases, many gains that showed up at age 4 were no longer apparent in those children after kindergarten. "It takes prolonged and sustained investments in children’s emotional and behavioral development," said Raver, who is tracking outcomes through the fourth and fifth grades. "We can’t keep our foot on the gas pedal for one year and then pull it off again.”