About 2 million more children and adolescents were diagnosed in 2011, compared with 2003 according to an interesting article by Luis Fabregas And Megan Harris.

Experts attribute the surge to better tools to identify the disorder and recognition by pediatricians that tell-tale symptoms — risk-taking, hyperactivity and distraction — are much more than “kids being kids.”

“In the past, parents were more likely to attribute problems to just laziness or being ‘bad,’ and not even bring this up to the physician,” said Dr. Oscar Bukstein, medical director of DePelchin Children’s Center in Houston and former director of the ADHD program at the University of Pittsburgh. “Behavioral and emotional problems as disease or disorder just was not considered.”

Dr. Kristin Hannibal, a pediatrician, said standards set in the past decade allow physicians to determine who should be diagnosed with ADHD.

“These kids were in the classroom when we were growing up, but they were not diagnosed,” said Hannibal, clinical director of the Child Development Unit at Children’s Hospital of Pittsburgh.

More than medication

The surge in cases prompted doctors nationwide to prescribe drugs to control the disorder. More than two-thirds of people with ADHD take stimulant medications such as Ritalin, according to the Centers for Disease Control and Prevention.

The drugs address core symptoms, but most children need other treatments, said Bukstein.

“The story that medication is all you need is absolutely a false one,” he said.

Marsha Zaleski of Franklin Park said medication plays an important part in the treatment of her son Mark, 14. Without it, the high school freshman can’t finish a chore, do homework or control his anger, she said.

“Without medication, he is loud, clumsy and distracted,” Zaleski said. “Sometimes he talks so fast, we don’t understand one word he says.”

Other factors helped his improvement, including support from North Allegheny School District, where administrators and teachers pay attention to his needs, she said. He gets good grades and has learned to play the guitar.

“Ninth grade has been a dream,” she said.

Such an experience is not the norm. Families often struggle for years to find behavioral therapy, experts said.

“We have a huge problem with access to behavioral therapy,” said Brooke Molina, a professor of psychiatry and psychology at Pitt. “Medications don’t teach coping skills. Medications don’t help parents manage the symptoms of ADHD.”

Making accommodations

Advocates say families often clash with school districts about the best way to help their children.

Trea Graham, who owns a company called ADVOKID that advocates for children with ADHD, said schools often put resources toward children with the most intense disabilities. Once a school pegs a child as a behavior problem, they might see him as a burden and stop trying to help, Graham said.

“Some teachers tell these kids to try harder,” she said. “It’s not like they’re choosing to misbehave. For a child who needs glasses, you wouldn’t tell them to try harder to see.”

Tom Menditto of Squirrel Hill said some school districts make more accommodations than when he was diagnosed 15 years ago.

“You can take tests that aren’t timed. They offer support therapists — different things,” said Menditto, 27. “With the right help, it’s easier for an ADHD student to blend in.”

School districts rely on teachers to monitor children thought to have ADHD, according to the Diagnostic and Statistical Manual of The American Psychiatric Association. School officials typically monitor students for at least six months to determine the extent of symptoms.

School administrators urged Julie Costa-Malcolm to medicate and control her son Quinn. The boy behaved well in class but learned nothing, she said.

Quinn, 15, attends Three Rivers Village School, a charter school in Stanton Heights, where he has thrived.

“I was told repeatedly, ‘There’s something wrong with your child,’ ” said Costa-Malcolm, 37, of Highland Park. “But there wasn’t. He just couldn’t absorb the information the way his teachers presented it. I dragged my feet with the doctors because I didn’t want him to be medicated.”