Hidden epidemic of 33,000 ADHD children

Published on Saturday 26 April 2008 00:13

TENS of thousands of children in Scotland are suffering from hyperactivity and behavioural problems but have not been diagnosed, experts have warned.

A report by the health watchdog NHS Quality Improvement Scotland (NHS QIS) said that at least 7,000 children with the most severe form of attention deficit and hyperactivity disorder (ADHD) were currently undiagnosed and could benefit from drug treatment.

Altogether, more than 33,000 under-18s are thought to have ADHD – from mild to severe – but have not been identified.

Just 4,539 schoolchildren are diagnosed with ADHD in Scotland, the report said. Experts said undiagnosed youngsters could benefit from help, ranging from simple advice to improve their learning skills to drug therapy.

Some have criticised the increased use of drugs to tackle conditions such as ADHD, branding it the "chemical cosh". But experts yesterday said that, when used appropriately, they could dramatically improve the quality of life for families.

NHS QIS found that just 0.6 per cent of school-aged children had been diagnosed with ADHD. But international studies have suggested prevalence of severe ADHD is at least 1.5 per cent, while all forms could affect as many as 5 per cent of children – some 38,000 in Scotland.

Diagnosis rates across Scotland varied from just 0.2 per cent in Ayrshire and Arran and Lanarkshire to 0.8 per cent in Fife. The report found at least two-thirds of children with ADHD would continue to have symptoms into adolescence, and this may persist into adulthood.

But no NHS board has any protocol in place to ease the transition of young people with ADHD into adult services, and there are no established services for adults with the condition.

Stimulant medications, such as Ritalin, were recommended as the first-line treatment in 82 per cent of Scottish cases of ADHD.

Non-stimulant drugs were used in around 25 per cent of cases at some point. Dr Fiona Forbes, a consultant psychiatrist at NHS Lothian, said the under-diagnosis of ADHD was a "major concern". She added: "This means that families are not benefiting from access to appropriate help."

Jan Warner, director of performance assessment at NHS QIS, said it was reassuring that ADHD services across Scotland were generally of high quality, but added: "What is worrying is that society as a whole is failing to recognise many children with ADHD. We will now work with children, parents, carers, clinicians, social services and education services to tackle under diagnosis."

Andrea Bilbow, the chief executive of the Attention Deficit Disorder Information and Support Service, said:

"We also need to make clear that these children are not just naughty. ADHD means they are unable to control their emotions and that is all the time. It is not just a willful, one-off act of naughtiness."

TURNING HER LIFE AROUND

GRACE Mitchell knew she had serious problems with her anger and aggression. But when her mother took Grace to see a doctor, bad parenting was blamed for her behaviour.

Grace, from East Ayrshire, was not diagnosed with ADHD until she was 16.

Now 18, she has turned her life around with the help of medication and other support.

"I was always angry and just being bad," she said. "I was just fighting and being aggressive to my family all the time."

After leaving school at 15, she has now returned to complete her final year.