https://www.nytimes.com/2025/04/13/briefing/adhd-cases-us.html
NEWSLETTER
The Morning
Understanding A.D.H.D.
What’s behind the surge in cases in the U.S.?
By Adam B. Kushner
April 13, 2025
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This morning, my colleagues at The Times Magazine published a remarkable cover
story by Paul Tough about a surge of A.D.H.D. cases in the United States — and the
way we treat them. Today, 23 percent of 17-year-old boys have received a diagnosis
of attention deficit hyperactivity disorder. The number of prescriptions rose nearly
60 percent in a decade. You almost certainly know people who take these
stimulants.
Why is this happening? One thing I love about Paul’s story is that it’s partly a tale
about how science is made and changed. Researchers in the 1930s saw immediate
benefits when they treated jumpy kids with amphetamines. Eventually, doctors
crafted a diagnosis that could explain distracted and excitable personalities, and a
consensus formed about how to treat them. Paul’s story describes how a few
scientists have come to challenge that consensus — and some of the fundamental
ideas behind A.D.H.D.
For today’s newsletter, I spoke to Paul about his reporting.
What got you interested in this story?
I’ve been writing for decades about education and children, and I now have two
boys of my own. A few years ago, I began to notice how many families I met were
struggling with their kids’ attention issues. Attention was something I worried
about in my own children — and in myself, too. But I didn’t know much about the
science behind attention. So I started talking to scientists. When I did, I discovered
they had a lot of big unresolved questions.
What is A.D.H.D., and why is it so tricky to define?
There is no biological test for A.D.H.D. So it has to be diagnosed by its symptoms,
and those symptoms are sometimes hard to pin down. One patient’s behavior can
look quite different from another’s, and certain A.D.H.D. symptoms can also be
signs of other things — depression or childhood trauma or autism. Take a child who
is constantly distracted by her anxiety. Does she have A.D.H.D., an anxiety
disorder or both?
So A.D.H.D. may not be a clear, distinct medical disorder with defined boundaries
— something you either have or don’t have?
Increasingly, the science shows that the condition exists on a continuum, and there
is no clear dividing line between people who have A.D.H.D. and people who don’t.
For many kids, A.D.H.D. symptoms fluctuate over time — worse one year, better
the next — and those fluctuations may depend on their external environment as
much as their internal wiring.
Traditionally A.D.H.D. is treated with stimulants like Adderall and Ritalin. Now a
few researchers are raising questions about them. Why?
Most researchers I spoke with believe that stimulant medications are, on the
whole, a positive thing for children with A.D.H.D. But some feel that their benefits
have been oversold. One big study found that stimulants were more effective than
other interventions only for the first 14 months of treatment. By 36 months, their
relative benefit had disappeared. And even when these medications improve
children’s behavior in the short term, they don’t seem to boost their learning or
academic achievement. As a result, some scientists — and some families — are
looking for other approaches.
What other approaches work?
That’s another challenge for the field: At this point, there isn’t much solid evidence
for any treatment other than stimulant medication. What I found encouraging,
though, was research suggesting that changes in children’s environments — a
more stimulating classroom, a calmer home life, or, as they get older, an interesting
job — can often have a positive effect on their symptoms. My guess is that a lot of
the field is heading in that direction.
It’s tough because parents can’t always pick their kids’ classroom or work fewer
hours. Do you think the way we diagnose and treat A.D.H.D. in this country is
likely to change?
I hope so! For many families, stimulant medication has been, and will continue to
be, a lifesaver. But there are plenty of other children who would benefit from a new
and different approach. My hope is that the research I’ve written about will lead to
a new way to treat A.D.H.D. and a new way to think about it.
I recommend you read Paul’s story here.
THE LATEST NEWS
Trump Tariffs
The Trump administration exempted smartphones, computers and other
electronics from some of the tariffs it had placed on China. Nonetheless, the U.S.
and China’s trade war shows few signs of abating.
Before President Trump paused some tariffs, he posted on social media that it
was a “great time to buy.” Was this market manipulation? Our reporter explains
in this video.
Trump’s trade war has added risk to the surest bet in global finance: U.S.
government bonds.
After the fall of its textile industry, the Upstate region of South Carolina was
saved by foreign investors. Now, tariffs are bringing another round of
uncertainty.
Brexit, described by critics as a startling act of economic self-harm,
foreshadowed the president’s tariffs, Mark Landler writes.
More on the Administration
Elon Musk at a cabinet meeting. Eric Lee/The New York Times
Elon Musk told the cabinet that DOGE would fall short — by 85 percent — of its
goal to cut $1 trillion from the federal budget. But even that revised estimate may
be overstated.
Musk’s trillion-dollar goal was always out of reach: The part of the budget DOGE
has been mining was expected to total only $950 billion.
The Trump administration ignored a federal judge’s orders to provide a plan to
return a Maryland man who had been wrongfully deported to El Salvador.
Harvard professors sued the administration, saying that the government’s threat
to cut the university’s funding violates free speech.
More on Politics
Gavin Newsom, California’s Democratic governor, is using his podcast to explore
how Democrats could win back young men.
Meta will face the U.S. government tomorrow in a landmark antitrust trial over
its acquisitions of Instagram and WhatsApp.
An Idaho judge slightly broadened access to abortion there, ruling that an
exception to the state’s ban does not require a woman to face impending death.
International
A Passover Seder in Tel Aviv. Sergey Ponomarev for The New York Times
Passover, a festival of freedom, is a time for celebration. For many Israelis, the
continued captivity of hostages in Gaza is tempering the joy.
The U.S. and Iran held preliminary diplomatic talks over Tehran’s nuclear
program in Oman. The next round of discussions is set for the coming week.
The Democratic Party in Hong Kong, once the city’s largest opposition force, has
disbanded following a crackdown by Beijing.
Paramilitaries in Sudan killed all the staff of the last medical clinic in a faminestricken camp in the western region of Darfur.
Other Big Stories
“I worry they could take my mom”: America’s tougher stance on immigration has
caused anxiety among children whose parents are vulnerable to deportation.
The helicopter that came apart in the sky and crashed into the Hudson River on
Thursday had flown tourists in New York City thousands of times. Read about its
final flight.
THE SUNDAY DEBATE
Is free trade free?
Yes. Markets are at their best when they’re allowed to work without central
government planning. “I have money, my grocer has food. The grocer doesn’t need
to buy anything from me for it to be a mutually-beneficial relationship,” The Orange
County Register’s Matt Fleming writes.
No. What we call free trade works well for goods, but for the last five years, the
European Union has been able to tax online services at the United States’ expense,
only to cry foul at Trump’s tariffs. “If the EU has its way, on net, protectionism will
increase,” Bloomberg’s Tyler Cowen writes.
FROM OPINION
The U.S. cannot afford to wait for Trump to take back his tariffs. Congress should
act by itself and limit the presidency’s trade powers, the Editorial Board writes.
Here are columns by Ezra Klein on speed in politics and Nicholas Kristof on animal
welfare.
MORNING READS
Paige Bueckers Clement Pascal for The New York Times
Ascendant: Paige Bueckers became a college sensation. Now she’s about to join
the W.N.B.A.’s growing constellation of stars.
Lofoten, Norway: Travel above the Arctic Circle for an adventurer’s paradise,
complete with skiing, climbing and sailing.
Look out below: The Times’s resident meteorologist explains how avalanches
actually happen — and how experts are trying to make them less deadly.
Most clicked yesterday: A couple scoured the Northeast for a space they could live
and work in. Which home did they choose? Play our game.
Vows: They met as teens. Both love dogs, but it would be years before they loved
each other.
Lives Lived: Max Kozloff was a leading art critic who wrote extensively about the
New York art scene in the 1960s and ’70s. He later became a well-regarded
photographer. He died at 91.
BOOK OF THE WEEK
By Elisabeth Egan
“Everything is Tuberculosis,” by John Green: It doesn’t have the catchiest title. It
covers a subject that might seem long ago and far away, but it’s not. As John Green
demonstrates in his heart-tugging best seller, tuberculosis is a modern problem,
killing over a million people a year worldwide, more than any other infectious
disease. What’s more, Green tells us, in the simple, straightforward language that
made him a folk hero to young adult readers — yes, this is the same John Green
who brought us “The Fault in Our Stars” — “We know how to live in a world
without tuberculosis. But we choose not to live in that world.” His slim, timely book
is an examination of the history of this scourge and our maddening failure to
eradicate it. (“The problem,” Green writes, is that “the cure is where the disease is
not, and the disease is where the cure is not.”) But this is also the story of Henry
Reider, a magnetic 17-year-old boy whom Green crossed paths with while on an
advocacy mission in Sierra Leone. His fight against tuberculosis forms the spine of
this book. His spirit is its soul.
More on books
Read our review of “Everything is Tuberculosis.”
Looking for your next thriller? See our editors’ recommendations.
THE INTERVIEW
By Lulu Garcia-Navarro
This week’s subject for The Interview is Ramy Youssef, whose new animated show,
“#1 Happy Family USA,” tells the story of the fictional Hussein family as they try to
fit into a changing America after the Sept. 11 attacks. We spoke about the show,
Adam Sandler’s influence and how he thinks about politics in his work.
There’s this little title card at the top of every episode that warns that the
characters should not be taken as representation. Why are you so uncomfortable
with representation?
When we put out “Ramy” on Hulu, I remember seeing a headline that was like,
“Muslims, Here’s the Show for You,” and my heart sinking and going, “No, no, we
are two billion people, and a lot of them are not gonna like what I’m doing, and they
shouldn’t, because I am a guy from New Jersey who thinks this type of thing is
funny.” Putting the representation warning was a cathartic thing of being like: “I
know you guys didn’t elect me.”
I know from some of my Muslim American friends that because their community
has suffered so much scrutiny, they are wary of opening themselves up to the eyes
of broader culture. Are you worrying about perception when you’re writing?
I think my way of handling that goes back to the work being self-reflective above
all. I’m not satirizing the culture so much as I am looking at the way people behave.
The father in our show is a lot of people’s fathers. We open up our pilot with him
handing out to his family these small electrical bills that show the output that
everyone is spending in the house, how much GameCube is being played. He’s so
worried about getting his family through, under budget. The things that hit on the
sensitivities that you’re talking about, I try to take a more tender approach toward.
Read more of the interview here.
THE NEW YORK TIMES MAGAZINE
Illustration by Chan Yu Chen
Click to read this week’s magazine.
THE MORNING RECOMMENDS …
Get lost in a good murder mystery book.
Clean a patio with the best pressure washer.
Brew coffee in a French press.
MEAL PLAN
Armando Rafael for The New York Times
Chances are you probably have a can or two of tuna in your pantry right now. In
this week’s Five Weeknight Dishes newsletter, Emily Weinstein suggests using
them to make spicy tuna and avocado tostadas, a five-star recipe from Kristina
Felix. Emily also recommends some other (non-tuna) dishes, including miso-honey
chicken and asparagus, and crispy gnocchi with sausage and broccoli.
NOW TIME TO PLAY
Here is today’s Spelling Bee. Yesterday’s pangram was lifeblood.
Can you put eight historical events — including the first stock markets, the
domestication of sheep and the creation of the zodiac — in chronological order?
Take this week’s Flashback quiz.
And here are today’s Mini Crossword, Wordle, Connections, Sports Connections
and Strands.
Thanks for spending part of your weekend with The Times.
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Adam B. Kushner edits The Morning newsletter. You can subscribe here.