ADHD: Misunderstood, underdiagnosed—and treatable

One in nine children in the U.S. have been diagnosed with attention-deficit/hyperactivity disorder, according to data released in May by the Centers for Disease Control and Prevention. More than 8% of college students have ADHD, too, and they often struggle in silence: distracted in lectures, unable to complete assignments on time, slow to make friends. The condition can even cause them to forget to take the ADHD meds that would help them.

Andrea Chronis-Tuscano, the Joel and Kim Feller Endowed Professor in the University of Maryland’s Department of Psychology and president of the American Psychological Association’s Society of Clinical Child and Adolescent Psychology, is an expert on this chronic neurodevelopmental disorder, characterized by symptoms of inattention, hyperactivity, impulsivity and/or emotion dysregulation.

She co-directs with Assistant Clinical Director Erin Jones UMD’s SUCCEEDS College ADHD Clinic and focuses her research on understanding early predictors of developmental outcomes for children with ADHD; she’s also working on treatments that target these early risk and protective factors to improve the lives of people with ADHD, including 4.4% of adults.

October marks Attention-Deficit/Hyperactivity Disorder Awareness Month, and Chronis-Tuscano shared a few key points about the disorder that everyone should know:

ADHD is very treatable

“We all know people with ADHD who have learned to cope with it, found their niche, and are doing very well,” she said. “That is one of the most promising things about ADHD.”

Treatments can include behavioral and cognitive-behavioral therapy, organizational skills training, and stimulant medication. Chronis-Tuscano recommended speaking with a primary care physician or a pediatrician as a first step toward diagnosis and treatment.

“We’re having conversations about ADHD and youth mental health more than ever before,” she said. “This open dialogue is really important if we want to decrease mental health stigma and increase access to treatments.”

Left untreated, ADHD can have devastating effects

Members of the public severely underestimate the impact that untreated ADHD can have on individuals, families and society, Chronis-Tuscano said.

ADHD can lead to depression, suicide, substance use, school dropout, and incarceration. Individuals with the disorder have a reduced life expectancy by 10 to 15 years, due to physical and mental health consequences, she said.

She rebutted notions that ADHD is overdiagnosed or even an excuse for being forgetful or unmotivated. “We need to take ADHD seriously, because the outcomes can be devastating.”

There are disparities and barriers to ADHD treatments

Chronis-Tuscano noted that not everyone has access to a primary care physician or pediatrician where they can take the first steps toward getting a diagnosis or treatment for themselves or their child. Many schools are under-resourced and unable to provide timely evaluation or accommodation for students who are struggling.

Socioeconomic factors, such as lack of access to transportation or insurance coverage, can also create a barrier for people seeking ADHD support and treatment programs. Another obstacle can be stigma.

“People don’t always want to tell the school or their employer—they don’t want the label,” she said. “As a result, they may not get the support they need.”

More research and flexibility are also needed when it comes to understanding ADHD in girls and women, Chronis-Tuscano said, noting that many symptoms and “red flags” clinicians look for to diagnose the disorder were described in psychiatric literature with boys and men in mind. Thus, parents, teachers, caregivers and medical practitioners are more likely to start diagnosis and treatment plans for them than for girls and women with the disorder.

“Some people don’t consider ADHD that big of a deal,” Chronis-Tuscano said. “But it is tied to so many important outcomes: mental health and wellness, educational attainment, financial independence … so many people are touched by it.”