Trends in Parent-Reported ADHD Diagnosis and Treatment Among U.S. Children, 2016-2023

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder starting in childhood, often persisting into adulthood. Diagnosis rates have risen since the first U.S. estimates in the 1990s, with variations across sex, race/ethnicity, and other factors. This study explores ADHD diagnosis and treatment among U.S. children from 2016 to 2023, with a focus on identifying differences across sociodemographic and clinical characteristics.

Data from the National Survey of Children's Health (NSCH; 2016‒2023) on parent-reported ADHD diagnoses and treatments among non-institutionalized U.S. children aged 3‒17 years were analyzed. Trends over time and across sociodemographic and clinical subgroups were assessed using logistic regression models and joinpoint regression analysis.

ADHD diagnosis prevalence estimates were stable from 2016 to 2019 (8.6% to 8.8%), rising after the onset of the COVID-19 pandemic in 2020 to 10.5% in 2023. Yet, from 2016 to 2023, overall ADHD treatment rates declined (76.9% to 70.8%), particularly for medication treatment (62.5% to 53.0%), while behavioral treatment stayed steady (47.3% to 48.2%). ADHD diagnosis trends differed by race, insurance status, and ADHD severity, increasing only for children in Asian, White, and multiracial groups; with private insurance, and with mild or moderate ADHD. Treatment prevalence differences by sex narrowed over time, as medication use decreased for males and behavioral treatment increased for females, specifically adolescent females.

With a widening gap between the prevalence of ADHD diagnosis and treatment, fewer children are receiving recommended care than in the past. These results may inform interventions to improve healthcare access and address systemic barriers to treatment for all children with ADHD.