The number of children in the U.S. who have been diagnosed with attention deficit hyperactivity disorder (ADHD) has increased by 43% since 2003. This reflects a significant surge in recent years, particularly among girls and minority groups, according to a new study.

The research, published in The Journal of Clinical Psychiatry, suggests that 5.8 million children ages 5 to 17 in the U.S. are now diagnosed with the disorder, which is characterized by difficulty paying attention, hyperactivity, and impulsiveness. In 2011, about 12 percent of children and teens in the United States had an ADHD diagnosis. The study also showed especially large increases in ADHD among girls, adolescents, and Hispanic youth.

Sean D. Cleary, PhD, MPH, an associate professor of epidemiology and biostatistics at Milken Institute School of Public Health at the George Washington University, told CBS News:

The driving force behind this study was that we wanted update the data to have the most recent information on trends ADHD and up until this point there has been very little research on racial and ethnic disparities in ADHD.

The study found that diagnosis among girls jumped 55 percent from 4.7 percent in 2003 to 7.3 percent in 2011, although the prevalence remained higher among boys. Experts found this surprising, because boys are traditionally more likely to receive an ADHD diagnosis. They say it may mean that parents, teachers, and doctors are paying more attention to the gender differences in how symptoms appear in young children.

Michael Manos, PhD, head of the Center for Pediatric Behavioral Health at Cleveland Clinic Children’s (who was not involved in the study), told CBS:

ADHD is 3-to-1 boys to girls in childhood. When you consider what makes little boys stand out, it’s hyperactivity and impulsive behavior, which is easy to recognize. But it’s inattention that tends to be higher in little girls. A child in preschool or kindergarten or even up until fifth grade who’s very bright can pay attention for 15 minutes out of the hour and still get what they need to do well in school. So the tendency was to recognize the disruptive behavior more typical in boys over the inattention in little girls. So what’s good about these numbers is that now inattention is also being recognized.

Diagnosis for boys rose 40 percent during the study period to 16.5 percent by 2011.

Age also played a role in diagnosis rate gains, with the a 33 percent increase among kids aged five to nine years old, a 47 percent climb for those 10 to 14 years, and a 52 percent surge for teens 15 to 17 years.

White children still made up the majority of cases, but diagnosis rates climbed much more for black and Hispanic youth. Diagnosis among Hispanic children spiked 83 percent over the study period, and in blacks, diagnoses rose 58 percent.

Some experts say the rising diagnosis rates aren’t surprising, and are consistent with trends U.S. clinicians have been seeing for years. Quyen Epstein-Ngo, a psychology researcher at the University of Michigan in Ann Arbor (who wasn’t involved in the study) told Reuters that it is possible that some of the increase in diagnosis could be due to some children having avoided diagnosis in the past as a result of having less severe symptoms, more coping strategies, or a stronger support system to help them deal with the demands of school:

It could be that the last several years have seen an increased ability, or willingness, to recognize that older adolescents who are still struggling could require more formal help and support. Alternatively, it could be that increased pressures on adolescents to perform and achieve are leading to a push for more ADHD assessments.

Manos told CBS he attributes the uptick in diagnoses to both an increase in awareness of symptoms and a culture with ever-increasing demands on high school students:

Almost essentially, it’s associated with a child’s ability to manage themselves in school. We now have placed such an emphasis on academic success as being almost critical, it’s no longer good enough for a child to have a high IQ and good grades. They have to have great grades. So you have an increase in the prevalence of ADHD in adolescents primarily because we’re recognizing a less than optimal response.

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