Critically Discuss the Implications of Adhd Prevalence Rate Differences Between Countries and Within Countries

Attention deficit hyperactivity disorder (ADHD) is one of the most common disorders of childhood that is characterised by symptoms of inattention, impulsivity and hyperactivity (Singh, 2008). ADHD has received significant attention with the rising worldwide prevalence rates in the past decade, especially due to the disorder’s prominent educational aspect and use of stimulant medication (Mayes, Bagwell & Erkulwater, 2008). While ADHD affects children worldwide, the prevalence differs between countries. Specifically, ADHD was suggested to be much more prevalent in the USA than in other countries, such as the UK and France (Faraone, Sergeant, Gillberg & Biederman, 2003). Significant variation has even been found within countries, where prevalence rates varied from 2% to 18% in the USA (Singh, 2008). The uncertain cause of the prevalence differences has fuelled debate over the aetiology and validity of ADHD. The first perspective holds that the varied prevalence rates reflect true differences in behaviour, advocating that environmental factors are primary in causing ADHD. The second position explains the disparity by the different diagnostic systems used, such that there are no actual differences in the prevalence. However, the above positions have limited value in explaining the prevalence differences within countries. The third perspective views ADHD as a social construct, rather than a real disorder. Owing to the evidence of a biological basis for ADHD, this essay concludes the relative strength of the middle ground that social influences play a critical role in the recognition, rather than the presence, of ADHD.

The first possible explanation to the international variation in ADHD prevalence is that there are true differences in children’s behaviours due to their varied environment. Harkness and Super (2006) identified major differences between Dutch and American parenting practices that may influence children’s environment. Dutch parents were found to emphasise the importance of regularity and non-overstimulating environments in children’s development than American parents. This cultural difference in terms of stimulation and discipline might explain the higher ADHD prevalence rates in American children (Sung, Beijers, Gartstein, De Weerth & Putnam, 2015). Firstly, the role of overstimulation in ADHD aetiology has been supported by the positive association found between exposure to electronic media and ADHD symptomatology (Cheng, Maeda, Yoichi, Yamagata & Tomiwa, 2010; Swing, Gentile, Anderson & Walsh, 2010). Correspondingly, Dutch children are less likely to exhibit ADHD symptoms compared to American children, as they are less likely to be overly exposed to electronic media due to their parenting. On the other hand, Dutch children, being brought up with regularity, are less likely to display weak self-regulation that was found in children with ADHD (Ellis & Nigg, 2009). However, with the heritability