Upward of 6.4 million children in the United States suffer from attention deficit hyperactivity disorder (ADHD), making it the most common neurodevelopmental disorder in childhood. A recent study presented at the Pediatric Academic Societies (PAS) annual meeting in Vancouver, Canada, has revealed that children diagnosed with ADHD are also likely to be affected by adverse family and environmental challenges, such as poverty, divorce, neighborhood violence, and a family history of substance abuse.

"Our findings suggest that children with ADHD experience significantly higher rates of trauma than those without ADHD," Dr. Nicole M. Brown, assistant professor of pediatrics, Division of General Pediatrics, Children's Hospital at Montefiore, Albert Einstein College of Medicine, said in a statement. "Providers may focus on ADHD as the primary diagnosis and overlook the possible presence of a trauma history, which may impact treatment."

Using data from the 2011 National Survey of Children’s Health, the research team, led by Brown, identified 65,680 children between the ages of 6 and 17 whose parents filled out questionnaires regarding if and when their child was diagnosed with ADHD, the severity of the condition, and any medication use. The parents also answered questions pertaining to nine adverse childhood experiences, including poverty, divorce, death of a parent or guardian, domestic violence, neighborhood violence, substance abuse, incarceration, familial mental illness, and discrimination.

Approximately 12 percent of the children included in the study were diagnosed with ADHD. Parents of children diagnosed with ADHD reported a higher prevalence of adverse childhood experiences compared to children who had not been diagnosed with ADHD. Seventeen percent of children with ADHD were exposed to four or more adverse experiences compared to six percent of children without ADHD. Children who were exposed to four or more adverse experiences were also more likely to use ADHD medication and have their parents rate the severity of their condition as moderate to severe.

"Knowledge about the prevalence and types of adverse experiences among children diagnosed with ADHD may guide efforts to address trauma in this population and improve ADHD screening, diagnostic accuracy and management," Brown added. “Pediatric providers should consider screening for adverse childhood experiences in children who they suspect may have ADHD and/or those who carry the diagnosis, and initiate evidence-based treatment/intervention plans for children who screen positive for ACEs.”

According to the Centers for Disease Control and Prevention, around 11 percent of children between the ages of 4 and 17 have been diagnosed with ADHD as of 2011. Children who struggle with focusing on one task at a time, staying organized, controlling their behavior, and sitting still tend to be diagnosed with ADHD. A child’s risk of developing ADHD increases due to a traumatic brain injury, environmental exposures, alcohol, and tobacco use during pregnancy, premature birth, low birth weight, and genetic factors.

Source: Brown N, Brown S, German M, Balamarich P, Briggs R. Associations Between Adverse Childhood Experiences and ADHD: Analysis of the 2011 National Survey of Children's Health. Pediatric Academic Societies (PAS) annual meeting. 2014.