NCHS Data Brief ■ No. 201 ■ May 2015

Association Between Diagnosed ADHD and Selected 

Characteristics Among Children Aged 4–17 Years:

United States, 2011–2013

Patricia N. Pastor, Ph.D.; Cynthia A. Reuben, M.A.; Catherine R. Duran, B.S.; and 

LaJeana D. Hawkins, M.P.H., C.H.E.S.

Key findings 

● In 2011–2013, 9.5% of 

children aged 4–17 years were 

ever diagnosed with attention 

deficit hyperactivity disorder 

(ADHD). For those aged 4–5, 

prevalence was 2.7%, 9.5% for 

those aged 6–11, and 11.8% for 

those aged 12–17.

● Among all age groups, 

prevalence of ever diagnosed 

ADHD was more than twice as 

high in boys as girls.

● Among those aged 6–17, 

prevalence was highest among 

non-Hispanic white children 

and lowest among Hispanic 

children. 

● Among all age groups, 

prevalence was higher among 

children with public insurance 

compared with children with 

private insurance.

● Among children aged 4–11, 

prevalence was higher for 

children with family income 

less than 200% of the federal 

poverty threshold than for 

children with family income at 

200% or more of the poverty 

threshold.

Attention deficit hyperactivity disorder (ADHD) is the most common 

neurobehavioral disorder diagnosed in U.S. children (1). While this disorder 

is most often diagnosed in children when they are in elementary school, it is 

increasingly being identified in preschool children (2–5). This report describes 

the prevalence of diagnosed ADHD among children aged 4–17 years using 

parent-reported data collected in a large, nationally representative health 

survey. Differences in the prevalence of diagnosed ADHD are examined by 

selected demographic and socioeconomic variables: the child’s sex, race 

and Hispanic ethnicity, health insurance coverage, and poverty status for all 

children aged 4–17 and among age groups 4–5, 6–11, and 12–17.

Keywords: child mental health • behavioral disorders • National Health 

Interview Survey

In 2011–2013, 13.3% of boys and 5.6% of girls aged 4–17 had 

ever been diagnosed with ADHD.

Figure 1. Children aged 4–17 years with diagnosed ADHD, by age and sex: United States, 

2011–2013 Percent

1

Significantly different from girls within the same age group (p < 0.05). 2

Significantly different from all children aged 6–11 (p < 0.05). 3

Significantly different from all children aged 12–17 (p < 0.05). 4

Significantly different from children of the same sex aged 6–11 (p < 0.05). 5

Significantly different from children of the same sex aged 12–17 (p < 0.05).

NOTES: Data are based on household interviews of a sample of the civilian noninstitutionalized U.S. population. ADHD is attention 

deficit hyperactivity disorder. 

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2013.

0

5

10

15

20 All children Boys Girls

6–11 12–17

Age (years)

4–17 4–5

9.5

1

13.3

5.6

2,32.7

1,4,54.3

4,51.2

3

9.5

5

5.6

11.8

1

16.3

7.1

1,513.2

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
NCHS Data Brief ■ No. 201 ■ May 2015

■  2  ■

In 2011–2013, the overall prevalence of ever diagnosed ADHD in children aged 4–17 was 9.5% 

(Figure 1). The prevalence of diagnosed ADHD was higher among older children than younger 

children: 2.7% among children aged 4–5, 9.5% among children aged 6–11, and 11.8% among 

children aged 12–17.

Among all children aged 4–17 and within each age group, boys were more than two times as 

likely to have ever been diagnosed with ADHD compared with girls. Boys and girls aged 4–5 

were less likely to have ever been diagnosed with ADHD compared with older boys and girls.

The prevalence of diagnosed ADHD among boys aged 6–11 was lower than the prevalence 

among boys aged 12–17 (13.2% compared with 16.3%). The prevalence of diagnosed ADHD 

among girls aged 6–11 was also lower than the prevalence among girls aged 12–17 (5.6% 

compared with 7.1%).

In 2011–2013, the prevalence of diagnosed ADHD among children aged 

4–17 was 11.5% among non-Hispanic white children, 8.9% among 

non-Hispanic black children, and 6.3% among Hispanic children. Percent

Figure 2. Children aged 4–17 years with diagnosed ADHD, by age and race and Hispanic ethnicity: United States, 

2011–2013

1

Significantly different from non-Hispanic black children within the same age group (p < 0.05).

2

Significantly different from Hispanic children within the same age group (p < 0.05).

3

Significantly different from children aged 6–11 and 12–17 (p < 0.05).

4

Significantly different from non-Hispanic white children aged 12–17 (p < 0.05).

NOTES: Data are based on household interviews of a sample of the civilian noninstitutionalized U.S. population. ADHD is attention deficit hyperactivity disorder. 

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2013.

0

5

10

15

20 Non-Hispanic white Non-Hispanic black Hispanic

4–5 6–11 12–17

Age (years)

4–17

2

8.9

1,211.5

6.3

3

3.2 3

2.2

2,411.1

2

9.3

7.1

1,214.6

2

10.4

7.1

3

2.8

In each racial and ethnic group, the prevalence of diagnosed ADHD among children aged 4–5 

was lower than the prevalence among older children. There were no statistically significant 

differences in the prevalence of diagnosed ADHD among non-Hispanic white, non-Hispanic 

black, and Hispanic children in this age group. 
NCHS Data Brief ■ No. 201 ■ May 2015

■  3  ■

Among children aged 6–11, non-Hispanic white (11.1%) and non-Hispanic black (9.3%) children 

were more likely than Hispanic children (7.1%) to have ever been diagnosed with ADHD 

(Figure 2). The prevalence of diagnosed ADHD among non-Hispanic white and non-Hispanic 

black children did not differ significantly.

Among children aged 12–17, non-Hispanic white (14.6%) and non-Hispanic black (10.4%) 

children were more likely than Hispanic children (7.1%) to have ever been diagnosed with 

ADHD. In this age group, non-Hispanic white children were more likely than non-Hispanic black 

children to have ever been diagnosed with ADHD.

Among non-Hispanic white children, the prevalence of diagnosed ADHD was higher among 

those aged 12–17 than among those aged 6–11: 14.6% compared with 11.1%. However, the 

prevalence of diagnosed ADHD among non-Hispanic black and Hispanic children did not differ 

significantly between those aged 6–11 and 12–17. 

In 2011–2013, the prevalence of diagnosed ADHD among children aged 

4–17 was highest among children with public insurance (11.7%) and lowest 

among uninsured children (5.7%). Among children with private insurance, 

the prevalence of diagnosed ADHD was 8.6%. Percent

Figure 3. Children aged 4–17 years with diagnosed ADHD, by age and health insurance coverage: United States, 

2011–2013

* Estimate does not meet standards of reliability or precision (relative standard error is greater than 30%).

1

Significantly different from children with public insurance within the same age group (p < 0.05).

2

Significantly different from uninsured children within the same age group (p < 0.05).

NOTES: Data are based on household interviews of a sample of the civilian noninstitutionalized U.S. population. ADHD is attention deficit hyperactivity disorder.

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2013.

0

5

10

15

20

4–5 6–11 12–17

Age (years)

4–17

2

11.7

1,28.6

5.7

4.3

*

1

8.0

2

12.2

6.7

1,211.1

2

14.9

5.7

1

1.4

Private insurance Public insurance Uninsured

Among children in each age group, the prevalence of diagnosed ADHD was higher among 

children with public insurance than among children with private insurance. Among those aged 

4–5, 4.3% of children with public insurance had ever been diagnosed with ADHD compared with 
NCHS Data Brief ■ No. 201 ■ May 2015

■  4  ■

1.4% of children with private insurance (Figure 3). Among children aged 6–11, 12.2% of children 

with public insurance had ever been diagnosed with ADHD compared with 8.0% of children with 

private insurance. And among children aged 12–17, 14.9% of children with public insurance had 

ever been diagnosed with ADHD compared with 11.1% of children with private insurance.

Among children aged 6–11 and 12–17, the prevalence of diagnosed ADHD was lower among 

uninsured children than among children with public health insurance. Among those aged 6–11, 

12.2% of children with public insurance had ever been diagnosed with ADHD compared with 

6.7% of uninsured children. Among those aged 12–17, 14.9% of children with public insurance 

had ever been diagnosed with ADHD compared with 5.7% of uninsured children.

Among children aged 6–11, the prevalence of diagnosed ADHD was similar between uninsured 

children (6.7%) and children with private insurance (8.0%). However, among those aged 12–17, 

prevalence among uninsured children (5.7%) was lower than among children with private 

insurance (11.1%).

In 2011–2013, 10.4% of children aged 4–17 in families with incomes less 

than 200% of the federal poverty threshold had ever been diagnosed with 

ADHD compared with 8.8% of children in families with incomes at 200% or 

more of the poverty threshold. Percent

Figure 4. Children aged 4–17 years with diagnosed ADHD, by age and poverty status: United States, 2011–2013

1

Significantly different from children at 200% or more of the federal poverty level within the same age group (p < 0.05). 

NOTES: Data are based on household interviews of a sample of the civilian noninstitutionalized U.S. population. Poverty status is defined by family income as a 

percentage of the federal poverty threshold. ADHD is attention deficit hyperactivity disorder. 

SOURCE: CDC/NCHS, National Health Interview Survey, 2011–2013.

Age (years)

0

5

10

15

20

Less than 200% 200% or more

4–17 4–5 6–11 12–17

1

10.4

8.8

1

3.7

1.9

1

11.1

8.1

12.3

11.5
NCHS Data Brief ■ No. 201 ■ May 2015

■  5  ■

Among those aged 4–5, 3.7% of children in families with incomes less than 200% of the federal 

poverty threshold had ever been diagnosed with ADHD compared with 1.9% of children in 

families with incomes at 200% or more of the poverty threshold (Figure 4). 

For those aged 6–11, 11.1% of children in families with incomes less than 200% of the federal 

poverty threshold had ever been diagnosed with ADHD compared with 8.1% of children in 

families with incomes at 200% or more of the poverty threshold. 

Among children aged 12–17, there was no statistically significant difference in the prevalence 

of diagnosed ADHD by federal poverty status: 12.3% among those in families with incomes less 

than 200% of the poverty threshold and 11.5% among those in families with incomes at 200% or 

more of the poverty threshold.

Summary

In 2011–2013, 9.5% of U.S. children aged 4–17 had ever been diagnosed with ADHD. This 

report adds to existing research by examining the relationship between selected demographic 

and socioeconomic characteristics and diagnosed ADHD for all children aged 4–17 and children 

in three age groups: 4–5, 6–11, and 12–17. In all three age groups, the prevalence of diagnosed 

ADHD for boys was greater than the prevalence reported for girls. In contrast, the prevalence of 

diagnosed ADHD by race and Hispanic ethnicity indicates that differences among these groups 

varied depending on a child’s age group. Among children aged 4–5, there were no significant 

racial and ethnic differences in the prevalence of diagnosed ADHD. But among children aged 

6–11, the prevalence of diagnosed ADHD was significantly higher among non-Hispanic white 

children compared with Hispanic children. And among children aged 12–17, prevalence was 

significantly higher among non-Hispanic white children compared with both non-Hispanic black 

and Hispanic children. 

The scope of this report is limited because the data only describe differences in the prevalence of 

ever diagnosed ADHD and do not indicate variations in the prevalence of undiagnosed ADHD. 

A previous study that included parent reports of ADHD symptoms as well as previous diagnoses 

estimated that slightly less than one-half of children meeting the DSM-IV ADHD criteria had 

been diagnosed by a health care professional (5). Also, the higher prevalence among older 

children reflects the longer exposure of older children to the possibility of ever being diagnosed 

with ADHD. 

Another limitation of this study was the use of parent reports to estimate the prevalence of 

diagnosed ADHD. British and U.S. research, however, has shown parent reports to be valid and 

reliable when compared with service records (6,7). Data from the National Health Interview 

Survey (NHIS) provide consistently collected information about diagnosed ADHD that can 

be used to describe important demographic and socioeconomic differences in this frequently 

diagnosed health condition among children. In view of the economic and social costs associated 

with ADHD and the potential benefits of treatment, the continued surveillance of diagnosed 

ADHD is warranted (8).
NCHS Data Brief ■ No. 201 ■ May 2015

■  6  ■

Definitions

Diagnosed attention deficit hyperactivity disorder (ADHD): Respondents were asked, “Has a 

doctor or health professional ever told you that [sample child] had attention deficit hyperactivity 

disorder (ADHD) or attention deficit disorder (ADD)?” The condition of diagnosed ADHD does 

not include children with the symptoms of ADHD who have not received a diagnosis of ADHD 

from a doctor or health professional.

Health insurance: Respondents were asked about the sample child’s health insurance coverage at 

the time of the interview. Respondents reported whether the child was covered by private health 

insurance (obtained through the employer or workplace, purchased directly, or purchased through 

a local or community program); Medicare; Medicaid; Children’s Health Insurance Program 

(CHIP); Indian Health Service (IHS); military insurance (including TRICARE); a state-sponsored 

health plan; another government program; or any single-service plan. This information was 

used to form three mutually exclusive categories: children with private health insurance, which 

includes children with TRICARE or other military coverage (some children with private health 

insurance coverage may also have public health insurance like Medicare); children with only 

public health insurance, which primarily includes children with Medicaid or CHIP; and children 

who are uninsured. Children who only had IHS or a single-service plan were considered to be 

uninsured.

Poverty status: Family income as a percentage of the federal poverty threshold. The federal 

poverty threshold is based on a set of income thresholds that vary by family size and composition 

(the number of children in the family, and, for families with two or fewer adults, the age of the 

adults in the family). The income thresholds are updated annually by the U.S. Census Bureau 

to reflect changes in the Consumer Price Index for all urban consumers (9). Both reported and 

imputed income are used to calculate poverty status (10). 

Race and Hispanic ethnicity: The revised 1997 Office of Management and Budget standards for 

race were used for the classification of race and Hispanic ethnicity. A person’s race is described 

by one or more of five racial groups: white, black or African American, American Indian or 

Alaska Native, Asian, and Native Hawaiian or Other Pacific Islander. Data on race and Hispanic 

ethnicity are collected separately but combined for reporting. Not shown separately are data for 

American Indian or Alaska Native, Asian, Native Hawaiian or Other Pacific Islander, and persons 

of two or more races. Persons of Hispanic origin may be of any race.

Data source and methods

This analysis used data from the 2011–2013 NHIS. Interviewers from the U.S. Census Bureau 

collect NHIS data continuously throughout the year for the Centers for Disease Control and 

Prevention’s National Center for Health Statistics. NHIS includes questions about the health 

and health care of the civilian noninstitutionalized U.S. population. Interviews are conducted in 

respondents’ homes. In some instances, follow ups to complete interviews may be conducted over 

the telephone. Questions for this analysis are from the household composition section and the 

Family Core and Sample Child components of the 2011–2013 NHIS. A sample child is randomly 

selected from each family in NHIS, and information about the sample child is obtained from 

an adult residing in the household who is knowledgeable about the child’s health. From 2011 

through 2013, information on the sample child was collected for 29,968 children aged 4–17. For 
NCHS Data Brief ■ No. 201 ■ May 2015

■  7  ■

more information about NHIS, visit http://www.cdc.gov/nchs/nhis.htm.

NHIS is designed to yield a nationally representative sample, and this analysis uses weights to 

produce nationally representative estimates. Data weighting procedures are described in more 

detail elsewhere (11). Point estimates and estimates of corresponding variances for this analysis 

were calculated using the SUDAAN software package (12) to account for the complex sample 

design of the survey. The Taylor series linearization method was chosen for variance estimation. 

Estimates shown in this report that do not meet the current NHIS standard of statistical reliability 

(relative standard error less than or equal to 30%) are indicated by an asterisk (*). Differences 

between percentages were evaluated using two-sided significance tests at the 0.05 level. 

About the authors 

Patricia N. Pastor, Cynthia A. Reuben, Catherine R. Duran, and LaJeana D. Hawkins are with 

CDC’s National Center for Health Statistics, Office of Analysis and Epidemiology.

References

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surveillance among children—United States, 2005–2011. MMWR Surveill Summ 62(Suppl 

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of childhood and adult attention-deficit/hyperactivity disorder in the United States. J Am Acad 

Child Adolesc Psychiatry 51(10):990–1002. 2012. 
NCHS Data Brief ■ No. 201 ■ May 2015

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For more NCHS Data Briefs, visit:

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9. U.S. Census Bureau. How the Census Bureau measures poverty. 

Available from: http://www.census.gov/hhes/www/poverty/about/overview/

measure.html. 

10. Schenker N, Raghunathan TE, Chiu PL, Makuc DM, Zhang G, Cohen 

AJ. Multiple imputation of missing income data in the National Health 

Interview Survey. J Am Stat Assoc 101(475):924–33. 2006.

11. Parsons VL, Moriarity C, Jonas K, et al. Design and estimation for the 

National Health Interview Survey, 2006–2015. National Center for Health 

Statistics. Vital Health Stat 2(165). 2014. 

12. RTI International. SUDAAN (Release 11.0) [computer software]. 2012.

Suggested citation

Pastor PN, Reuben CA, Duran CR, Hawkins 

LD. Association between diagnosed ADHD 

and selected characteristics among children 

aged 4–17 years: United States, 2011–2013. 

NCHS data brief, no 201. Hyattsville, MD: 

National Center for Health Statistics. 2015.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Nathaniel Schenker, Ph.D., Deputy Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Office of Analysis and Epidemiology

Irma E. Arispe, Ph.D., Director

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ISSN 1941–4927 Print ed.

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DHHS Publication No. 2015–1209

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