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ADHD in the U.S.: Tackling Diagnosis & Treatment Gaps with Technology

Vandana Yadav • October 15, 2024

Introduction to ADHD Prevalence 

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition affecting millions of people in the United States. Approximately 7 million (11.4%) U.S. children aged 3–17 years have ever been diagnosed with ADHD, according to a national survey of parents using data from 2022.¹ It is characterized by inattention, impulsivity, and hyperactivity, which can interfere with social, academic, and professional functioning. 

The prevalence of ADHD has steadily risen in recent years, sparking debate about the underlying causes. While some argue that overdiagnosis and overprescription of stimulant medications are to blame, others point to diagnostic disparities and increased awareness, improved techniques, and environmental factors as contributing causes.² Regardless, the need for effective treatments and monitoring tools remains critical, as ADHD often leads to long-term difficulties if left unmanaged. 

Challenges in ADHD Diagnosis and Treatment

Several major barriers hinder the diagnosis and treatment of ADHD, including overlapping symptoms with mood and anxiety disorders, substance use disorders (SUDs), learning disabilities, information and auditory processing disorders, as well as various psychosocial factors. Additionally, some individuals manage to overcome ADHD-related challenges by developing compensatory skills, which can further complicate the accuracy of an ADHD diagnosis.³

Treatment typically includes a combination of behavioral therapy and medication, but finding the right balance can be difficult. A 2022 national parent survey showed that 30% of children with ADHD aged 3–17 did not receive either medication or behavior treatment.⁴ For children, parents, and adults, tracking the effectiveness of these treatments can be frustrating and inconsistent. Current approaches rely heavily on self-reports and subjective observations, often leading to under- or overtreatment. The complexities and barriers surrounding ADHD diagnosis—such as overlapping symptoms with other disorders and inconsistencies in treatment tracking—have opened the door for innovative digital health solutions. These technologies offer a more objective, data-driven approach to managing ADHD, providing clinicians with tools that could personalize and enhance care for millions of patients. 

Digital Health Solutions for ADHD

Digital health interventions ADHD have gained significant attention due to their potential to enhance treatment accessibility and effectiveness. Various studies have demonstrated that web-based and mobile health (mHealth) solutions can facilitate behavioral changes in children with ADHD, thereby improving their management and treatment outcomes.  One of the key findings in the literature is that web-based interventions can effectively support teachers in managing ADHD symptoms in classroom settings. A randomized controlled trial indicated that such interventions could lead to significant behavioral changes among elementary students diagnosed with ADHD, suggesting that evidence-based school interventions can be successfully delivered through digital platforms.⁵ Furthermore, a systematic review highlighted the necessity for more nonpharmacological approaches, including mHealth technologies, to manage ADHD, emphasizing the importance of integrating reminders and human facilitation into these digital health interventions.⁶  

The use of technology in promoting child behavioral health has also been explored in various contexts. For instance, a scoping review identified a two-step triage strategy that utilizes digital screening questionnaires to identify students with behavioral challenges, including ADHD. This approach not only aids in the early identification of needs but also facilitates targeted interventions involving both students and teachers.⁷ Additionally, the integration of telemedicine has been shown to enhance the management of ADHD, with a meta-analysis revealing that telehealth services, including computerized training programs, are becoming increasingly prevalent in ADHD treatment.⁸ The COVID-19 pandemic has further accelerated the adoption of digital health solutions. Regular online consultations and therapy sessions have been recommended to prevent the exacerbation of ADHD symptoms during this period, highlighting the critical role of telehealth in maintaining treatment continuity.⁹

Moreover, studies have shown that digital platforms can effectively monitor and improve classroom behavior, as evidenced by the development of applications designed specifically for children with ADHD.¹⁰ These applications not only support behavior management but also engage children in their treatment process, making it more interactive and effective.  In terms of treatment efficacy, a multicenter randomized trial demonstrated the effectiveness of a home-based digital treatment for pediatric ADHD, indicating that such interventions can significantly reduce the severity of ADHD symptoms.¹¹

The potential of online cognitive behavioral therapy (CBT) has also been recognized, with studies reporting improvements in self-reported and clinician-assessed outcomes among college students with ADHD.¹² This suggests that digital platforms can provide accessible and effective therapeutic options for various age groups.  In conclusion, digital health interventions for ADHD represent a promising avenue for enhancing treatment accessibility and effectiveness. The integration of web-based and mobile technologies into ADHD management not only facilitates behavioral change but also ensures continuity of care, particularly in challenging circumstances such as the COVID-19 pandemic. Future research should continue to explore the long-term impacts of these interventions and their applicability in diverse real-world settings. 

HITLAB and iFocus Collaboration

Recognizing the urgent need for innovative approaches, HITLAB has teamed up with iFocus, a pioneering company developing an AI-powered biomarker designed to improve ADHD treatment effectiveness. This groundbreaking research project aims to revolutionize how ADHD is monitored and managed, offering clinicians new tools for more accurate diagnosis and treatment. 

Through this collaboration, HITLAB is inviting healthcare providers—especially clinicians and psychiatrists who prescribe ADHD medications—to participate in a crucial study. By joining, they will contribute to the development of cutting-edge technology that can more precisely measure ADHD symptoms, allowing for better treatment personalization and improved patient outcomes. More details about this study can be found here.  

HITLAB’s work with iFocus aims to address many of the current gaps in ADHD care, providing healthcare professionals with tools to track real-time treatment effectiveness and optimize outcomes. Together, we are set to make a significant impact on the health and quality of life of ADHD patients across the U.S. By embracing digital innovations and collaborating on initiatives like the HITLAB-iFocus project, healthcare providers can shape the future of ADHD care, ultimately transforming the lives of millions of patients.

References:

  1. Danielson ML, Claussen AH, Bitsko RH, et al. ADHD Prevalence Among U.S. Children and Adolescents in 2022: Diagnosis, Severity, Co-Occurring Disorders, and Treatment. J Clin Child Adolesc Psychol. Published online May 22, 2024
  2. Abdelnour E, Jansen MO, Gold JA. ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis? Mo Med. 2022 Sep-Oct;119(5):467-473. PMID: 36337990; PMCID: PMC9616454.
  3. ADHD Update: Diagnosis, Assessment, and Treatment Issues. Psychiatric Times. Jonathan C. Blassingame III, Nathalie V. Buitrago. June 8, 2022.
  4. Danielson ML, Holbrook JR, Bitsko RH, et al. State-Level Estimates of the Prevalence of Parent-Reported ADHD Diagnosis and Treatment Among U.S. Children and Adolescents, 2016 to 2019. J Atten Disord. 2022;26(13):1685-1697
  5. Corkum, P., Elik, N., Blotnicky-Gallant, P., McGonnell, M., & McGrath, P. (2015). Web-based intervention for teachers of elementary students with adhd: randomized controlled trial. Journal of Attention Disorders, 23(3), 257-269. https://journals.sagepub.com/doi/10.1177/1087054715603198
  6. Hollis, C., Falconer, C., Martin, J., Whittington, C., Stockton, S., Glazebrook, C., … & Davies, E. (2016). Annual research review: digital health interventions for children and young people with mental health problems – a systematic and meta‐review. Journal of Child Psychology and Psychiatry, 58(4), 474-503. https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.12663
  7. Huang, K., Douglas, L., Nakigudde, J., Cheng, S., Gouley, K., Mann, D., … & Mendelsohn, A. (2019). Use of technology to promote child behavioral health in the context of pediatric care: a scoping review and applications to low- and middle-income countries. Frontiers in Psychiatry, 10. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2019.00806/full
  8. Bemanalizadeh, M., Yazdi, M., Yaghini, O., & Kelishadi, R. (2021). A meta-analysis on the effect of telemedicine on the management of attention deficit and hyperactivity disorder in children and adolescents. Journal of Telemedicine and Telecare, 30(1), 31-43. https://journals.sagepub.com/doi/10.1177/1357633X211045186
  9. Lee, J., Hsiao, R., Tsai, C., & Yen, C. (2022). Caregivers’ difficulty in managing smartphone use of children with attention-deficit/hyperactivity disorder during the covid-19 pandemic: relationships with caregiver and children factors. International Journal of Environmental Research and Public Health, 19(9), 5194.https://www.mdpi.com/1660-4601/19/9/5194
  10. Schuck, S., Emmerson, N., Ziv, H., Collins, P., Arastoo, S., Warschauer, M., … & Lakes, K. (2016). Designing an ipad app to monitor and improve classroom behavior for children with adhd: iselfcontrol feasibility and pilot studies. Plos One, 11(10), e0164229. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0164229
  11. Kollins, S., Bower, J., Findling, R., Keefe, R., Epstein, J., Cutler, A., … & Faraone, S. (2018). 2.40 a multicenter, randomized, active-control registration trial of software treatment for actively reducing severity of adhd (stars-adhd) to assess the efficacy and safety of a novel, home-based, digital treatment for pediatric adhd. Journal of the American Academy of Child & Adolescent Psychiatry, 57(10), S172. https://linkinghub.elsevier.com/retrieve/pii/S0890856718314758
  12. López-Pinar, C. and Vicente-Gispert, A. (2022). Online cognitive behavior therapy for two college students with attention-deficit/hyperactivity disorder. Clinical Case Studies, 22(1), 18-37. https://journals.sagepub.com/doi/10.1177/15346501221090267

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