NATCHEZ — Natchez Pediatrician Dr. Jennifer Russ is treating more children for ADHD now than she did 13 years ago, but it’s not easy to zero in on the cause of that statistic.

“I don’t think there’s any one reason for that,” Russ said. “I think we’re seeing more of it because we’re more demanding of kids nowadays and sometimes because they’re missing that true structure in their households.”

Attention deficit hyperactivity disorder is one of the most common neurobehavioral disorders of childhood and results in children having trouble paying attention or being overly active, among other things.

The exact cause of ADHD is still unknown, but research conducted by the Centers for Disease Control and Prevention show that genes might play a role.

ADHD is usually first diagnosed in childhood and often lasts into adulthood. An estimated 4.1 million school-aged children have a current ADHD diagnosis, according to a study by the CDC.

In Mississippi, the study estimates 7.3 percent of children ages 4 to 17 have a current ADHD diagnosis. The national average is 7.2 percent.

The high number of children diagnosed with the disorder ultimately impacts the educators who spend roughly half the day teaching and supervising those children.

Cathedral Assistant Administrator Shannon Bland said the advances in modern science and educational methods, though, have given teachers better ways of helping those children in the classroom.

“Before people really weren’t educated on what to look for and just thought that they were very active or didn’t understand the rules,” Bland said. “Now, we understand so much more.”

ADHD is often treated with medication, behavior therapy or a combination of both, said Dr. Susan Buttross, division chief for Child Development and Behavioral Pediatrics at Blair E. Batson Hospital for Children at the University Medical Center in Jackson.

In Mississippi, 5.8 percent of children ages 4 to 17 take medication for ADHD — a higher percentage than the national average of 4.8 percent.

But the road from when a child begins exhibiting signs of ADHD to prescription medicine is longer than most people think, Russ said.

“One of the biggest misconceptions is that there’s one test for ADHD, because there is not,” she said. “It’s more like putting the pieces of a puzzle together and looking at that child’s history, symptoms and different testing.”

And while some parents are against putting their children on medication for fear of its addictive qualities, Russ said the long-term affects of the medication can’t yet be proven.

“Some of my patients I treated when they were younger are now in college and still on the medication, but I don’t think we’ve seen the full circle and can determine if they will ever be able to get off the medication,” Russ said. “There are also a lot of misconceptions about the medications that we dispel because when (parents) were growing up it was just one pill.

“Now we have different medications, and if their child is not themselves on the medication, we’re not on the right medicine or the right dose.”

Buttross said the high number of children on medication can be alarming, though.

“ADHD occurs, we think, in about 5 to 7 percent of the population of children, so if you have a school where you’re seeing 20 percent or more kids on medication, really a red flag should go up,” Buttross said. “That’s when you need to start looking at different things going on in the classroom to see if maybe we’re too restrictive with the children and just expecting them to sit down and shut up instead of encouraging interactive learning.

“All of that needs to be looked at when you start seeing big numbers.”

Educators, parents and doctors also need to be sure the diagnosis is the right one, Buttross said.

“ADHD involves a diagnosis of exclusions, so there are lots of things that can make someone inattentive including vision, hearing loss or even a learning disability, where the material is so far over the children’s head they don’t understand it,” Buttross said. “So it’s really important before a diagnosis is made and medication is prescribed that all of those things are ruled out and a good physical exam is conducted.”

Diagnosis generally begins, Russ said, with a list of symptoms and parents filling out a questionnaire that helps in the evaluation, diagnosis and treatment of ADHD and other disorders.

A sample question includes, “How often does your child have trouble going to sleep at night?”

Russ said the results of the questionnaire, along with a proper physical exam and a psychological evaluation, are paired together to determine if the child has ADHD.

“The next steps are discussing the results with the parents and seeing what they want to do next,” Russ said.

“There are some parents that do not want the medicine at all and others who say they want to try everything else possible before they go with the medicine.”