NCHS Data Brief ■ No. 70 ■ August 2011

Attention Deficit Hyperactivity Disorder Among Children 

Aged 5–17 Years in the United States, 1998–2009

Lara J. Akinbami, M.D.; Xiang Liu, M.Sc.; Patricia N. Pastor, Ph.D.; and Cynthia A. Reuben, M.A.

Key findings

Data from the National 

Health Interview Survey, 

1998–2009

• The percentage of children 

ever diagnosed with attention 

deficit hyperactivity disorder 

(ADHD) increased from 7% to 

9% from 1998–2000 through 

2007–2009.

• ADHD prevalence trends 

varied by race and ethnicity. 

Differences between groups 

narrowed from 1998 through 

2009; however, Mexican 

children had consistently lower 

ADHD prevalence than other 

racial or ethnic groups.

• From 1998 through 2009, 

ADHD prevalence increased to 

10% for children with family 

income less than 100% of 

the poverty level and to 11% 

for those with family income 

between 100% and 199% of the 

poverty level.

• From 1998 through 2009, 

ADHD prevalence rose to 

10% in the Midwest and South 

regions of the United States.

Attention deficit hyperactivity disorder (ADHD) is one of the most common 

mental health disorders of childhood (1). The symptoms of ADHD (inattention, 

impulsive behavior, and hyperactivity) begin in childhood and often persist 

into adulthood. These symptoms frequently lead to functional impairment in 

academic, family, and social settings (2,3). The causes and risk factors for 

ADHD are unknown, but genetic factors likely play a role (4). Diagnosis 

of ADHD involves several steps, including a medical exam; a checklist 

for rating ADHD symptoms based on reports from parents, teachers, and 

sometimes the child; and an evaluation for coexisting conditions (5). Recent 

national surveys have documented an increase in the prevalence of ADHD 

during the past decade (6,7). This report presents recent trends in prevalence 

and differences between population subgroups of children aged 5–17 years.

Keywords: race • ethnicity • poverty status • National Health Interview Survey

The percentage of children ever diagnosed with ADHD 

increased from 1998 through 2009 among both boys and girls.

NOTE: Access data table for Figure 1 at: http://www.cdc.gov/nchs/data/databriefs/db70_tables.pdf#1.

SOURCES: CDC/NCHS, Health Data Interactive and National Health Interview Survey. Percent

3-year period

0

2

4

6

8

10

12

14

Female

Male

All

1998–2000 2001–2003 2004–2006 2007–2009

Figure 1. Percentage of children aged 5–17 years ever diagnosed with attention deficit 

hyperactivity disorder, by sex: United States, 1998–2009

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics
NCHS Data Brief ■ No. 70 ■ August 2011

■  2  ■

• For the 2007–2009 period, an annual average of 9.0% of children aged 5–17 years had ever 

been diagnosed with ADHD—an increase from 6.9% in 1998–2000 (Figure 1).

• From 1998 through 2009, ADHD prevalence was higher among boys than girls: For boys, 

ADHD prevalence increased from 9.9% in 1998–2000 to 12.3% in 2007–2009, and for girls, 

from 3.6% to 5.5% during the same period.

ADHD prevalence varied by race and ethnicity, but differences between 

most groups narrowed from 1998 through 2009.

• ADHD prevalence increased from 1998–2000 to 2007–2009 for non-Hispanic white 

children (from 8.2% to 10.6%) and for non-Hispanic black children (from 5.1% to 9.5%) 

(Figure 2).

• In 1998–2000, non-Hispanic white children had higher ADHD prevalence compared with all 

other race groups, and Mexican children had the lowest prevalence.

• In 2007–2009, ADHD prevalence was similar among non-Hispanic white, non-Hispanic 

black, and Puerto Rican children. ADHD was lower among Mexican children compared 

with children in the three other racial and ethnic groups.

NOTE: Access data table for Figure 2 at: http://www.cdc.gov/nchs/data/databriefs/db70_tables.pdf#2.

SOURCES: CDC/NCHS, Health Data Interactive and National Health Interview Survey. Percent

3-year period

Figure 2. Percentage of children aged 5–17 years ever diagnosed with attention deficit hyperactivity disorder, by race 

and ethnicity: United States, 1998–2009

0

2

4

6

8

10

12

14

1998–2000 2001–2003 2004–2006 2007–2009

Puerto Rican

Non-Hispanic white

Non-Hispanic black

Mexican
NCHS Data Brief ■ No. 70 ■ August 2011

■  3  ■

From 1998 through 2009, ADHD prevalence increased for children with 

family income less than 100% of the poverty level and for those with family 

income between 100% and 199% of the poverty level.

• From 1998–2000 to 2007–2009, ADHD prevalence increased from 7.5% to 10.3% for 

children with family income less than 100% of the poverty level, and from 7% to 10.6% for 

children with family income between 100% and 199% of the poverty level (Figure 3). 

• In 1998–2000, ADHD prevalence was similar among all income groups, but in 2007–2009 

the prevalence was higher among children with family income less than 100% or between 

100% and 199% of the poverty level, compared with those with income greater than or 

equal to 200% of the poverty level.

NOTE: Access data table for Figure 3 at: http://www.cdc.gov/nchs/data/databriefs/db70_tables.pdf#3.

SOURCES: CDC/NCHS, Health Data Interactive and National Health Interview Survey. Percent

3-year period

Figure 3. Percentage of children aged 5–17 years ever diagnosed with attention deficit hyperactivity disorder, by poverty 

status: United States, 1998–2009

0

2

4

6

8

10

12

14

200% or more of poverty level

100%–199% of poverty level

Less than 100% of poverty level

1998–2000 2001–2003 2004–2006 2007–2009
NCHS Data Brief ■ No. 70 ■ August 2011

■  4  ■

ADHD prevalence rose in the Midwest and South regions of the United 

States from 1998 through 2009.

• ADHD prevalence rose from 1998–2000 to 2007–2009 in the Midwest region (from 7.1% to 

10.2%) and in the South region (from 8.1% to 10.3%) (Figure 4).

• In 1998–2000, ADHD prevalence was higher in the South region than in all other regions. In 

2007–2009, ADHD prevalence was similar in the South and Midwest regions; prevalence in 

these two regions was higher than in the Northeast and West regions.

NOTES: For a listing of states in each of the four U.S. Census regions, visit http://www.census.gov/geo/www/us_regdiv.pdf. Access data table for Figure 4 at: 

http://www.cdc.gov/nchs/data/databriefs/db70_tables.pdf#4.

SOURCES: CDC/NCHS, Health Data Interactive and National Health Interview Survey. Percent

3-year period

Figure 4. Percentage of children aged 5–17 years ever diagnosed with attention deficit hyperactivity disorder, by 

U.S. Census region: United States, 1998–2009

0

2

4

6

8

10

12

14

West

South

Midwest

Northeast

1998–2000 2001–2003 2004–2006 2007–2009
NCHS Data Brief ■ No. 70 ■ August 2011

■  5  ■

Summary

From 1998–2000 through 2007–2009, the prevalence of ADHD increased among children aged 

5–17 years, from 6.9% to 9.0%. These increases were seen among both boys and girls, among 

children in most racial and ethnic groups except Mexican children, and among children with 

family income less than 200% of the poverty level. By geographic region, ADHD was more 

prevalent in the South and Midwest regions of the United States than in the Northeast and West 

regions during 2007–2009. Prevalence estimates in this report are based on parental report of the 

child ever receiving a diagnosis, and thus may be affected by the accuracy of parental memory 

(including recall bias), by differential access to health care between groups (diagnostic bias), 

or by willingness to report an ADHD diagnosis. One study that included clinical assessment 

of children for ADHD symptoms (8) found that only one-half of children meeting the criteria 

for ADHD had received a diagnosis of ADHD or regular medication treatment. For the present 

report, it was not possible to discern whether growing prevalence indicates a true change in 

prevalence or increased detection and diagnosis of ADHD. Nevertheless, the societal costs of 

ADHD—including those associated with medical, educational, and criminal justice resources—

are large (8). 

Definitions

ADHD prevalence: Estimated based on the number of adults responding “yes” to the question, 

“Has a doctor or health professional ever told you that your child had Attention Deficit 

Hyperactivity Disorder (ADHD) or Attention Deficit Disorder (ADD)?” This question is included 

in the standard National Health Interview Survey (NHIS) Sample Child questionnaire.

Poverty status or percentage of poverty level: Based on family income, family size, the number 

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

the family. The poverty level is based on a set of income thresholds that vary by family size and 

composition. Families or individuals with income below their appropriate thresholds are classified 

as below the poverty level. These thresholds are updated annually by the U.S. Census Bureau to 

reflect changes in the Consumer Price Index for all urban consumers (9). Estimates by poverty 

status from NHIS are based on both reported and imputed family income (10).

Data source and methods

All ADHD prevalence estimates were obtained from the Health Data Interactive (HDI) table, 

“Attention deficit hyperactivity disorder, learning disability, behavior difficulty, ages 5–17: U.S., 

1998–2009” (available from: http://www.cdc.gov/nchs/hdi.htm). NHIS data were used to estimate 

ADHD prevalence for this HDI table. 

NHIS data are collected continuously throughout the year for the Centers for Disease Control 

and Prevention’s (CDC) National Center for Health Statistics (NCHS) by interviewers from the 

U.S. Census Bureau. NHIS collects information about the health and health care of the civilian 

noninstitutionalized U.S. population. Interviews are conducted in respondents’ homes, but followups to complete interviews may be conducted over the telephone. The Sample Child component 

collects detailed data on health conditions for a randomly selected child in households with at 

least one child. A responsible adult, usually a parent, responds to the survey questions as proxy 
NCHS Data Brief ■ No. 70 ■ August 2011

■  6  ■

for the sample child. For further information about NHIS and the questionnaire, visit the NHIS 

website at http://www.cdc.gov/nchs/nhis.htm.

NHIS is designed to yield a sample that is representative of the civilian noninstitutionalized 

population of the United States, and the survey uses weighting to produce national estimates. 

Data weighting procedures are described in more detail elsewhere (11). Point estimates and 

estimates of corresponding variances for the HDI estimates were calculated using SUDAAN 

software (12) to account for the complex sample design of NHIS. The Taylor series linearization 

method was chosen for variance estimation. 

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

level. Terms such as “higher than” and “less than” indicate statistically significant differences. 

Terms such as “similar” and “no difference” indicate that the statistics being compared were not 

significantly different. Lack of comment regarding the difference between any two statistics does 

not necessarily suggest that the difference was tested and found to be not significant. 

All estimates shown in this report have a relative standard error less than or equal to 30%. The 

significance of trends was tested using weighted least squares regression models of the log of 

each outcome and Joinpoint software (13) to determine whether an apparent change over time 

was statistically significant, taking into account the standard error for each data point. 

About the authors

Lara Akinbami, Xiang Liu, Patricia Pastor, and Cynthia Reuben are with the Centers for 

Disease Control and Prevention’s National Center for Health Statistics, Office of Analysis 

and Epidemiology.
NCHS Data Brief ■ No. 70 ■ August 2011

■  7  ■

References

1. Fulton BD, Scheffler RM, Hinshaw SP, Levine P, Stone S, Brown TT, Modrek S. National 

variation of ADHD diagnostic prevalence and medication use: Health care providers and 

education policies. Psychiatr Serv 60(8):1075–83. 2009.

2. Barkley RA. Associated cognitive, developmental, and health problems. In: Barkley RA, 

Murhpy KR, eds. Attention-deficit hyperactivity disorder: A clinical workbook. 3rd ed. New York, 

NY: Guilford Press 122–83. 2006.

3. Yoshimasu K, Barbaresi WJ, Colligan RC, Killian JM, Voigt RG, Weaver AL, Katusic SK. 

Gender, attention-deficit/hyperactivity disorder, and reading disability in a population-based birth 

cohort. Pediatrics 126(4):e788–95. 2010.

4. Khan SA, Faraone SV. The genetics of ADHD: A literature review of 2005. Curr Psychiatry 

Rep 8(5):393–7. 2006.

5. American Academy of Pediatrics. Clinical practice guideline: Diagnosis and evaluation of 

the child with attention-deficit/hyperactivity disorder. Pediatrics 105(5):1158–70. 2000.

6. CDC. Increasing prevalence of parent-reported attention-deficit/hyperactivity disorder among 

children—United States, 2003 and 2007. MMWR 59(44):1439–43. 2010. Available from: 

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5944a3.htm?s_cid=mm5944a3_w.

7. Boyle CA, Boulet S, Schieve LA, Cohen RA, Blumberg SJ, Yeargin-Allsopp M, et al. 

Trends in the prevalence of developmental disabilities in U.S. children, 1997–2008. Pediatrics 

127(6):1034–42. 2011.

8. Pelham WE, Foster EM, Robb JA. The economic impact of attention-deficit/hyperactivity 

disorder in children and adolescents. J Pediatr Psychol 32(6):711–27. 2007.

9. U.S. Census Bureau: Poverty. 2011. Available from: http://www.census.gov/hhes/www/

poverty/index.html.

10. Schenker N, Raghunathan TE, Chiu P-L, Makuc DM, Zhang G, Cohen AJ. Multiple 

imputation of family income and personal earnings in the National Health Interview Survey: 

Methods and examples. Hyattsville, MD: National Center for Health Statistics. 2008. Available 

from: http://www.cdc.gov/nchs/data/nhis/tecdoc.pdf.

11. Botman SL, Moore TF, Moriarity CL, Parsons VL. Design and estimation for the National 

Health Interview Survey, 1995–2004. National Center for Health Statistics. Vital Health Stat 

2(130). 2000. Available from: http://www.cdc.gov/nchs/data/series/sr_02/sr02_130.pdf.

12. SUDAAN, release 9.1 [computer software]. Research Triangle Park, NC: RTI International. 

2004.

13. Joinpoint Regression Program, version 3.4 [computer software]. Bethesda, MD: National 

Cancer Institute, National Institutes of Health. 2010. Available from: http://surveillance.cancer.

gov/joinpoint/.
NCHS Data Brief ■ No. 70 ■ August 2011

U.S. DEPARTMENT OF

HEALTH & HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

3311 Toledo Road

Hyattsville, MD 20782

OFFICIAL BUSINESS 

PENALTY FOR PRIVATE USE, $300

Suggested citation

Akinbami LJ, Liu X, Pastor PN, Reuben 

CA. Attention deficit hyperactivity disorder 

among children aged 5–17 years in the 

United States, 1998–2009. NCHS data brief, 

no 70. Hyattsville, MD: National Center for 

Health Statistics. 2011.

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

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Office of Analysis and Epidemiology

Linda T. Bilheimer, Ph.D., Director

To receive this publication regularly, contact 

the National Center for Health Statistics by

calling 1–800–232–4636

E-mail: cdcinfo@cdc.gov

Internet: http://www.cdc.gov/nchs 

ISSN 1941–4927 (Print ed.)

ISSN 1941–4935 (Online ed.)

CS225279

DHHS Publication No. (PHS) 2011–1209

FIRST CLASS MAIL 

POSTAGE & FEES PAID 

CDC/NCHS 

PERMIT NO. G-284