ADHD Medication Shortages and the increasing rise of Attention Deficient Hyperactivity Disorder Diagnoses in Kids and Adults.

As schools are back in session and parents are clamoring to get their children's medications, they have noticed a shortage in ADHD medications. This has impacted their ability to support their children with their neurodevelopmental disorder. ADHD impacts approximate 5% of the population in children and 2.5 % in adults, so why is there a shortage?  Learn about what is ADHD, symptoms, treatment options and next steps.

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What is ADHD?

Attention Deficit Hyperactivity Disorder or ADHD is a Neurodevelopmental disorder that is impacted by the development process of the brain. It often impacts children and extends into adulthood. Approximately 5% of children are diagnosed with ADHD and 2.5 % of adults are diagnosed with ADHD. Unlike other mental health diagnoses, ADHD involves brain development.  Boys are twice as likely to be diagnosed with ADHD than girls, however this may be due to girls ability to mask symptoms more easily.   ADHD operates on a spectrum from inattentiveness to hyperactive and impulsivity. Often ADHD can be present with both inattentive and hyperactivity. The type of ADHD is coded towards what is most present for the child (or adult). Often children are diagnosed as a result of symptoms being present in both the home and school and not better explained by another mental health diagnosis. It is important to have other diagnoses ruled out before assuming ADHD is the problem. Anecdotally, there may be periods of time where a child or adult is having attention issues but may not be due ADHD diagnosis.

How is ADHD Diagnosed?

ADHD requires a medical provider or a licensed mental health provider to diagnose the disorder. The diagnosis requires observations from parents, teachers and others in the child’s life to capture if the behaviors (symptoms) are present in multiple life domains. Providers may utilize assessments, interviews with parents, and in office observations to assess for ADHD.  ADHD symptoms require 6 symptoms to be present for 6 months or more. This aids the provider to rule out other neurodevelopmental disabilities or can be explained by development in general. It should be noted that there are other mental health diagnoses that should be ruled out first and can be done by having a psychological evaluation done on the child to rule out trauma, anxiety, life stressors, other learning disabilities, autism spectrum disorder, behavioral disorders or mood disorders.

​What are the Symptoms?

Inattentive Type:

• Fails to give close attention to details or makes careless mistakes in schoolwork, work or during other activities. (more than a one-time occurrence)
• Difficulty sustaining attention in task or play.
• Selective hearing (not hearing when spoken to).
• Not following through on instructions or completing homework.
• Difficulty organizing tasks.
• Avoids, dislikes or reluctant in tasks that requires sustained mental effort.
• Loses things necessary for tasks or activities.
• Easily distracted by external stimuli or unrelated thoughts (for older children/and adults)

Hyperactive/Impulsivity:

• Fidgets with or taps hands or feet or squirms in seat.
• Leaves seat in situations where remaining seated is necessary
• Often runs about or climbs in situations where it is inappropriate.
• Unable to play or engage in activities or leisure quietly.
• Acts as if they are driven by a motor or always on the go.
• Talks excessively.
• Blurts out an answer before a question has been completely asked.
• Difficulty waiting their turn while waiting in lines.
• Interrupts or intrudes on others.

Symptoms must have been present before age of 12, be present in 2 more or settings such as home, school, play, after school programs or activities.
Clear evidence the symptoms interfere with their social, academic or occupational functioning must be present.

Could it be something else?

Yes! Absolutely it could be something else. Many children are experiencing issues of delayed developmental issues due to having been isolated and learning virtually during the COVID Pandemic. This impacts their ability to be up to speed with the life phase developmental levels. Teachers and counselors are supporting students to catch up developmentally, but also helps that parents also support their developmental growth at home.
            Many children, teens and adults were utilizing short videos online and have almost created an increase in attention problems. Attentions spans where they use to last 10-15 minutes may be down to 2-3 minutes.  If your child is heavily relying on tablets, phones, or tv for entertainment or education, it is important to remember their brain development actually needs less screen time. Please consult with your medical provider for current recommendations for limited screen time. You might be surprised at the limited screen time recommendations for adults too!

Why is there a Medication Shortage?

Supply and demand. Since the Covid pandemic, we saw a shortage in a lot of things. Delayed shipments, and manufacturing of different medications often are outsourced and has taken longer for them be available in the United States. You can find out more information regarding medication shortages on the FDA website.

What Can We do about it?

As for medications, not much. The recommended treatment for ADHD is a three prong approach.

1. Medication management,
2. Cognitive and Behavioral Therapies
3. Parent training and education.

There are many different behavioral strategies that can be utilized to address the issues of executive functioning such as forgetfulness, inattentiveness, time management, etc. Things like the pomodoro method for task adherence can be greatly useful to get things done and building tolerance to doing time consuming tasks. Creating check lists, having family calendars for everyone to see in advance, or even just having a tidy area can take off the mental load for someone with ADHD.

Parents, please give your child with ADHD 1 task to complete at a time. The more specific you are about the task the more likely you will avoid fights about what needs to get done in the home.  So don’t say clean your room.  Try something like “Please put your clothes in the hamper” or “Put your toys in the toybox”. 

Dietary Suggestions
Something to consider is limiting processed foods and processed sugars from the child’s diet, when possible, limit food dyes. A well rounded meal with protein, vegetables, complex starches, and fruit are a great way for a kid to get nutrition they need. 

Activity Suggestions
Get your child involved in sports such as running, basketball, karate, baseball, volleyball, or other activities that require physical movement and focus. Often these types of activities will teach your child self control, how to socialize, build skills through playing often helps them learn faster.

Additional treatments

Since ADHD, often comes with comorbidities such as depression and anxiety, it is imperative we are supportive to our kids and help them learn to regulate their emotions and demonstrate we do the same thing. They often learn best by seeing and doing what you are doing.  Seeking counseling to address depression or anxiety disorders, will also support the individual to build self-esteem, self-worth, reduce anxiety response and build healthy coping mechanisms to cope with their neurodiversity. In the end we all learn in different ways and have to figure out what works for all of us.

Conclusion
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When in doubt, please seek testing for your child whether through a private psychologist or through a diagnostician at school. You are your child’s best advocate. If they are found to have a diagnosis, schools can create an individualized education plan (IEP) or if they qualify for a 504 plan that aids in helping them in getting longer testing times, individualized space to test, or other supports that the school can provide to help your child to adapt.  To request this, please speak to your school administrators such as the principals or school counselors who can get the ball rolling. You might even ask if they will accept an external psychological evaluation to get your child help faster.
 
If we can be of help to you in parenting a child with ADHD, or help your child or teen with ADHD, Please give us a call 210-201-4578 or reach out to us on our contact page.

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Author- Aimee Rhodes, MS, LPC-S

Aimee is a co-founder and owner of Transform & Renew, PLLC, a Doctoral Candidate, Trainer, and enjoys working with adults and teens in a variety of issues.