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Rising Childhood ADHD, Anxiety, ASD Linked to Caregiver Mental Health

In 2022, caregivers with “poor” mental health had 4.6 times higher odds of having a child with severe ADD/ADHD.

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Childhood mental, behavioral and developmental disorders include conditions like anxiety, autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and depression, which can affect a child’s well-being, starting as early as preschool.

A study from �鶹Ů��’s Schmidt College of Medicine provides updated estimates on changes in U.S. childhood behavioral, mental and developmental disorders in children ages 6 to 11 from 2019 to 2022. Using data from the National Survey of Children’s Health, the study links the prevalence of these disorders with caregiver mental health, highlighting the significant impact of caregiver well-being on children’s health.

Results, published in the journal , reveal that from 2019 to 2022, several of these childhood disorders saw significant trends in increased prevalence and severity. Researchers found substantial associations between severe childhood anxiety and “fair” or “poor” caregiver rankings of mental and emotional health for both the 2020 and 2022 survey years.

The study also found that caregiver mental and emotional health may play a role in childhood attention deficit disorder (ADD) and ADHD prevalence rates as caregivers who ranked their mental health as “fair” or “good” had significantly higher odds of having a child with severe ADD or ADHD than caregivers who reported “excellent” mental and emotional health.

“Our study highlights the lasting impact of caregiver mental health on childhood disorders, particularly anxiety, behavioral problems and ADD/ADHD,” said Lea Sacca, Ph.D., senior author and an assistant professor in the Department of Population Health and Social Medicine, �鶹Ů�� Schmidt College of Medicine. “The COVID-19 pandemic, which increased the time children spent with caregivers, revealed a strong connection between severe childhood anxiety and lower caregiver mental health, suggesting that these effects may be long-term rather than temporary.” 

Among the study findings of childhood mental, behavioral and development disorders show:

• Anxiety in children increased from 9.5% in 2020 to more than 11% in 2022.
• Severe anxiety peaked at 8% in 2020, then stabilized around 7.7% in 2021 and 2022.
• There was a slight increase in depression in children from 2.3% in 2019 to 2.4% in 2022.
• Depression severity fluctuated between 5-7%, peaking at 6.8% in 2021. 
• Behavioral and conduct problems increased from 9.2% in 2019 to 10.3% in 2022. 
• The prevalence of ASD increased from 3% in 2019 to 2020 to 4.25% in 2022. 
• Severity of ASD fluctuated from 9.8% in 2019 to 14.5% in 2021, dropping to 11.8% in 2022. 
• Prevalence of ADD/ADHD steadily increased, reaching 12.8% in 2022. 
• Severity of ADD/ADHD ranged from 13.7% to 14.4% throughout the years.

Among the key findings related to caregiver mental health and children’s disorders show:

• In 2019, caregivers with “fair” mental health had 2.5 times higher odds of having a child with severe behavioral issues.
• In 2020, caregivers with “poor” mental health had 3.7 times higher odds of having a child with severe behavioral issues.
• In 2019, caregivers with “fair” mental health had 4.1 times higher odds of having a child with severe ADD/ADHD.
• In 2022, caregivers with “good,” “fair,” or “poor” mental health had 2.3, 4.6 and 4.4, times higher odds of having a child with severe ADD/ADHD compared to those with “excellent” mental health.
• No significant associations were found between caregiver mental health and childhood depression or ASD.

“While we did not find any significant links between caregiver mental health and childhood autism or depression, our findings support the need for a holistic approach to addressing childhood mental, behavioral and developmental disorders, one that includes caregiver well-being as a key factor,” said Sacca.

To reduce the socioeconomic impact of childhood mental and developmental issues, the researchers say evidence-based programs should focus on strengthening family dynamics, promoting healthy caregiver-child relationships, and supporting caregivers’ emotional well-being through trauma-informed, multidisciplinary care. Additionally, given the lingering effects of the COVID-19 pandemic on children’s mental health, policymakers must consider external factors when creating public health strategies to effectively address childhood mental and behavioral problems.

Study primary author, Austin Lent, and co-authors Ayden Dunn; Nada Eldawy; Vama Jhumkhawala; Meera Rao; and Joshua Sohmer, are all medical students in �鶹Ů��’s Schmidt College of Medicine.

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