Reports on the incidence of ADHD in the United States have variedfrom 2 to 20 percent of grade-school children. A conservative figure is about3 to 5 percent of prepubertal elementary school children. In Great Britain theincidence is reported to be lower than in the United States, less than 1percent. Boys have a greater incidence than do girls, with the ratio beingfrom 3 to 1 to as much as 5 to 1. The disorder is most common in first bornboys. The parents of children with ADHD show an increased incidence of hyper kinesis, sociopathy, alcohol use disorder. Although the onset is usuallyby the age of 3, the diagnosis is generally not made until the child is inelementary school and the formal learning situation requires structuredbehavior patterns, including developmentally appropriate attention span andconcentration.
The causes of attention-deficit / hyperactivity disorders are not known. The majority of children with ADHD do not show evidence of gross structuraldamage in the central nervous system (CNS). Conversely, most children withknown neurological disorders caused by brain injuries do not displayattention deficit and hyperactivity. Despite the lack of a specificneurophysiologic or neurochemical basis for the disorder, it is predictablyassociated with a variety of other disorders that affects brain function, suchas learning disorders. The suggested contributing factors for ADHD includeprenatal toxic exposures, prematurely, and prenatal mechanical insult to thefetal nervous system.Food additives, colorings, preservatives, and sugar have also beensuggested as possible causes of hyperactive behavior. No scientific evidenceindicates that those factors cause attention-deficit / hyperactivity disorder.
Evidence for a genetic basis for attention-deficit / hyperactivitydisorder includes the greater concordance in monozygotic twins than indizygotic twins. Also, siblings of hyperactive children have about twice therisk of having the disorder as does the general population. One sibling mayhave predominantly inattention.