Director of Child Health at Royal Children’s Hospital says Australia should be more cautious about ADHD diagnoses

It’s one of the most prevalent disorders in the country and growing at alarming speeds. But one doctor says there’s a dark side to the ADHD “crisis”.

The discourse surrounding ADHD has rapidly evolved in recent years, but some doctors are hesitant about the state of diagnoses in children as millions seek medical answers to their quirks.

New figures released in 2025 reveal attention deficit hyperactive disorder – a syndrome characterised by prolonged patterns of concentration, attention and impulse control difficulties – could now affect 366 million adults worldwide.

Professor Frank Oberklaid, Director of Child Health at the Royal Children’s Hospital, has raised the alarm on what he sees as a “crisis” of over-diagnosing children in Australia.

ADHD is now one of the most commonly diagnosed conditions in Australia, affecting about 8 per cent of children and adolescents, with boys twice as likely to receive a diagnosis. Among adults, 6.7 per cent show symptoms, with diagnoses among women rising as awareness improves.

Professor Oberklaid says he has observed an over-eagerness amongst Australians to get a diagnosis on their child, even for ones as young as three. He argues that every child goes through landmark moments of stress throughout their development and that the mental health sector should take this into account when observing behaviour.

He agrees that diagnosis can be very beneficial for some people, but questions whether the culture around normalising ADHD to the levels of prevalence it has today is a good thing.

“There’s no question about that. A lot of kids benefit from diagnosis and treatment,” he told 2GB on Wednesday.

The discourse surrounding ADHD has rapidly evolved in recent years, but some doctors are hesitant about the state of diagnoses in children as millions seek answers to their personal quirks.

“But lots of them don’t. Kids go through developmental stages. Stressors in their lives like starting school, moving house. It’s normal for kids to be a bit anxious and a little bit depressed.

“There’s a lot to be anxious about. There’s a lot of uncertainty, there’s stress, there’s house security and cost of living. There’s climate change, there’s pressure at school … so we’d expect kids to be a little anxious, that’s the way they cope.

“It doesn’t mean they’ve got a disorder, it just means they’re going through a phase where they need extra support or parents need more guidance.

“Putting a label on them at three or five or six years of age sometimes can be beneficial, but it sometimes can be distressing for them as well because it focuses just on the negatives and what’s ‘wrong’ with them. It doesn’t focus on strengths, it sort of disempowers children and says ‘you’ve got a disorder and need treatment’, rather than encouraging them to build some resilience and get over it themselves.

“There are pluses (to diagnosis) but there are a lot of negatives as well.”

There is also the issue of identity. Professor Oberklaid says some children might be relieved to finally have answers, but others may feel as if their disorder, whether accurately diagnosed or not, is a weakness.

Professor Frank Oberklaid, Director of Child Health at the Royal Children’s Hospital, says there are better ways to approach the issue.

“Diagnoses tend to stick. If you label them at the age of eight, it tends to stick with them,” he continued.

“Some people don’t mind a diagnosis because it helps them understand what’s happening to them and why they have difficulty concentrating.

“Some parents also like a diagnosis because it helps them and the school deal with issues the child has.

“I’m not saying to never make a diagnosis -- I’m saying I think we rush to make mental health diagnoses a bit too often in lots of kids.”

The Critical Psychiatry Network Australasia also argues that ADHD is being over-identified and over-medicated, with behaviours previously seen as part of the normal spectrum of childhood now pathologised.

However, there are those in the medical field who disagree and say the widespread use of powerful, behavioural modifying medications in young children is a positive.

Head of Pearson Clinical Assessment ANZ and cognitive scientist Mimma Mason puts this rise in formal diagnoses – both at home and abroad – down to “a correction of decades of under diagnosis, rather than a sign of an actual increase in the prevalence of ADHD”.

In either case, the surge in ADHD cases has, unsurprisingly, been very beneficial to pharmaceutical company profits.

The boom has seen a massive boost in sales for medication, with prescriptions for ADHD medication have surged nearly 300 per cent in the past decade. Some 470,000 Australians received scripts in 2022-2023 alone.

While this number doesn’t directly translate to diagnoses — since one patient may have multiple prescriptions — it’s estimated around one million Australians now carry an ADHD diagnosis.

Research by Deloitte Access Economics suggests the condition costs the country more than $20 billion per year in healthcare, productivity loss, and other associated expenses.

It’s also a costly process once you decide to journey down the road of diagnosis.

Some clinics charge up to $2,000 for an assessment, while others offer a fast-track option for those willing to pay $3,000 to skip the queue.

With waitlists stretching months or even years, demand is outpacing supply, leading to a surge in private providers cashing in on the trend.

Some 470,000 Australians received scripts in 2022-2023 alone.

Why is ADHD on the rise?

The surge in ADHD cases can’t be pinned on a single factor.

Increased awareness and better recognition of symptoms play a role, with both individuals and doctors more tuned in to spot the condition. But there are also cultural and systemic factors at play.

In Australia and the US, the DSM-5 criteria are used, which classify even mild or moderate behavioural traits as potential ADHD indicators.

In Europe, the International Classification of Diseases (ICD) is the standard, which only diagnoses ADHD in children with severe behavioural symptoms.

While some argue that rising numbers signal better diagnosis and treatment, others worry that the bar for what constitutes ADHD has been lowered too far.

Clinical psychologist Mariane Power believes Australia’s figures reflect greater awareness and accessibility rather than an over-diagnosis problem.

“Diagnosis remains inaccessible for many, especially women and people of colour, due to systemic barriers and longstanding biases in research and healthcare,” Power told the ABC.

“Continued awareness and improved diagnosis are critical to unlocking the potential those with ADHD have to maximise their out-the-box thinking, creativity, problem-solving, and justice sensitivity—qualities essential for driving innovation in our rapidly changing world.”

‘Kids go through developmental stages. Stressors in their lives like starting school, moving house. It’s normal for kids to be a bit anxious and a little bit depressed.’

ADHD presents in three recognised subtypes:

Impulsive/Hyperactive:

The stereotypical “can’t sit still” presentation is often linked to emotional dysregulation and hyper-focus on certain interests—sometimes labelled a “superpower.”

Inattentive/Distractible: Characterised by difficulty maintaining focus, staying organised, and following through on tasks, often seen in a calmer demeanour.

Combined Type: A mix of inattentive and hyperactive symptoms.

Originally published as Director of Child Health at Royal Children’s Hospital says Australia should be more cautious about ADHD diagnoses