Fact-checking the MAHA report’s claims about ADHD

On May 22, the Make America Healthy Again Commission, led by Robert F. Kennedy Jr., released its Make America Healthy Again Report.¹ The report focuses on investigating what it terms “the childhood chronic disease crisis.” It identifies four primary drivers: low-quality diets, environmental pollutants, high stress and low physical activity levels, and overmedicalization.^1,2

Scientists and doctors were skeptical of many claims in the report. Even more so when media investigations found that a number of the citations were incorrect. In some cases, the cited research didn’t even exist.³

The report mentions ADHD and other neurodevelopmental disorders nearly 30 times. And the way they’re discussed in the report differs from the way health care professionals typically discuss ADHD. Understood’s Ecosystem Research team decided to review the MAHA report to determine what’s scientifically supported — and what is not.

The Ecosystem Research team is an interdisciplinary team that specializes in reviewing secondary sources, like peer-reviewed research, white paper reports, and policy briefs. We reviewed the MAHA report and identified more than 20 claims related to ADHD. 

We wanted to see if the statements in the report were truthful and accurate. To evaluate this,  we asked:

1. Does the report cite the correct study and author? 

2. Is the claim in the MAHA report supported by the research it cites?

3. Do other experts in the field agree or disagree with the claim?

We grouped the ADHD references into major themes and picked seven claims to investigate. The results? Two were false, while the other five were only partly true.

What the MAHA report says: “Over 10% of children have been diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), with approximately 1 million more children diagnosed in 2022 compared to 2016.” “Rates of other neurodevelopmental disorders and learning impairments are also increasing. Over 7.5 million K-12 students received special education services in 2023-24.” 

This is somewhat true, but misleading. The study cited by the MAHA report does find an increase in ADHD diagnoses between 2016 and 2022.⁴ When we look at additional research, we also see a surge in ADHD diagnoses in girls and in people of color during this same period. This surge is due to a greater understanding of how these conditions show up in people who are not white boys.^5,6

A large study from California shows the work that clinicians are doing to close the diagnosis gap for people of color. This study included over 8 million children ages 5–17 from 2010 through 2021. The study found that among all children, ADHD diagnoses increased from 3.5% in 2010 to 4.0% in 2021. When the study authors examined changes in specific groups of children, the data showed that the largest increases in ADHD diagnoses were in Black (4.2% to 5.1%), Hispanic (2.8% to 3.6%), and Asian (1.5% to 2.0%) children. The diagnosis rate stayed the same for white children (6.2% to 6.1%).⁶

In other words, when we look at what’s contributing to the increase in diagnoses, we see that overlooked groups are receiving care they didn’t get before. It’s not that people are being overdiagnosed. 

What the MAHA report says: “Stimulant prescriptions for ADHD in the U.S. increased 250% from 2006 to 2016, despite evidence they did not improve outcomes long-term.” 

This is somewhat true, but very misleading. The authors of the study cited by the MAHA report are hesitant to conclude that stimulants are not effective for long-term health.⁷ This is a feeling shared by other experts in the field who looked at larger populations when studying stimulants and ADHD.⁸ 

There aren’t many long-term studies of stimulant use for ADHD. You’d need to compare people who are on stimulants to those who don’t take stimulants. And you’d need to compare them over a very long period. Because stimulants are so effective for managing ADHD, it would be unethical to force those in the alternative treatment groups to deny themselves medication for years.⁸

The MAHA report looked at follow-up studies to an earlier study known as “The Multimodal Treatment Study of Children With ADHD (MTA).” MTA was designed to examine the benefits of different ADHD treatment groups: 

1. Medication and therapy

2. Medication

3. Therapy

4. Community care

For the first 14 months of this study, children in the first three groups could only access the treatment available to the group they were in. Kids placed in the therapy group would only get therapy. Kids in the medication group would only get medication. Parents of children in the fourth group, community care, could decide which treatments their kids would receive after an initial assessment and recommendation by a licensed professional. 

After 14 months, parents in all four groups were free to choose any treatment for their child. 

Researchers checked in with the families again at 24 and 36 months and saw some changes in the types of treatment parents choose for their kids. At the start of the study, 91% of children in the medication treatment groups were on medicine. At the end, 71% in those groups were on medicine. In the therapy group, 14% started on medicine. By the end of the follow-up period, nearly half (45%) of the children in the therapy group were also taking medicine. And in the community care group, the percentage of kids taking medicine remained steady at 62%.⁷

Since so many families chose stimulants over other forms of treatments, this study may actually provide evidence of how effective stimulants are. 

What the MAHA report says: “Single-parent family homes are associated with worse mental health outcomes in teens: 

• Double the rate of internalizing disorders (i.e., Anxiety & Depression). 

• Triple the rates of externalizing disorders (i.e., ADHD, conduct disorder).”

This is false. The authors of the study cited by the MAHA report only examined anxiety and depression in 154 people in a clinic in Illinois.⁹ This very small sample is not representative of the broader U.S. In a clinical sample, we expect to see higher rates of mental health conditions because these are people actively receiving care. Additionally, our team could not verify the textbook citations referenced about rates of internalizing and externalizing disorders.

The number of people in a study is called the sample size. In most studies, we want this number to be very large. Without a large sample size, you could end up with one person representing an entire group. It’s not possible for one person to represent an entire group of people.

A study that wants to make claims about the U.S. should have a large sample size that includes the different types of people found in the U.S. A strong study would include people of different races, genders, sexualities, income and education levels, geographic regions, and more. 

What the MAHA report says: “Studies find that more than 35% (equivalent to more than 15 million prescriptions) of childhood antibiotics are unnecessary and that infants exposed to antibiotics in the first 2 years of life are more likely to develop asthma, allergic rhinitis, atopic dermatitis, celiac disease, obesity, and ADHD.” 

This is somewhat true, but misleading. The authors of the study cited in the MAHA report did find an association between antibiotics and ADHD. However, this study only included people born in one county in Minnesota.¹⁰ Looking beyond this study, we found several other studies that found a small association between antibiotic use and childhood ADHD. Researchers in these studies noted that the association could also be due to genetics or the environment.^11,12

Several scientists from around the globe have looked into early childhood antibiotic use and childhood ADHD. One study conducted in Taiwan of over 2 million children born between 2003 and 2025 found that the association between antibiotics and ADHD is very small. The researchers noted that this small association is not a reason to skip antibiotics.¹¹ Another study of twins in Sweden found that the environment and shared genetics is more likely to explain the relationship between antibiotics and ADHD.¹²

So, while one study of children in one area of Minnesota found a connection between ADHD and antibiotics, global studies looking at larger populations found that the association is small¹³ and doesn’t outweigh the benefits of using antibiotics.

What the MAHA report says: “These time trends significantly outpace more moderate increases seen in other developed countries. Psychotropics for ADHD are one example, prescribed 2.5 times more in the US than in British children, and 19 times more than in Japanese youth. The crisis of overdiagnosis and overtreatment in children is therefore both empirically evident and proportionally specific to American youth.” 

This is false. The studies cited by the MAHA report do not perform any mathematical calculations to evaluate whether the United States prescribes stimulants at a rate higher than Japan and the UK. 

It might seem simple to look at the number of prescriptions across countries. But to make this claim in a scientifically valid way, you need to do a more complex mathematical analysis. You can’t compare populations at face value. The mix of people, cultures, and environment aren’t the same. The authors of the study from Japan do note that prescriptions for stimulants are higher in the U.S. and Norway. But they hypothesize that this difference may be partially explained by clinician preferences for navigating prescription regulations in Japan.¹⁴

Over in the UK, the authors of the study cited by the MAHA report are adamant that the increase in stimulant prescriptions is due to more people getting diagnosed with ADHD. The increase in prescriptions in the UK is consistent with global trends seen in countries including the U.S. and the Netherlands.¹⁵

What the MAHA report says: “According to best trial data available, these widely used ADHD drugs cause long-term height loss averaging an inch; of note, the only long-term trial found exclusively short-term (14-month) behavior benefits, which were not found at 3 years. Indeed, at 3, 5, 8, and 14 years, no benefits were seen in grades, relationships, achievement, behavior, or any other measure.”

This is somewhat true, but misleading. An editorial published by several ADHD experts looked at over 100 studies examining the relationship between ADHD and height. The majority of those studies found that people with ADHD who used stimulants were shorter. But the reason for their shorter height is not well understood.¹⁶ Major studies have found that people with ADHD may already be shorter before starting stimulants.¹⁷ Research also suggests they may regain the lost height by temporarily stopping the medication.¹⁸ 

What the MAHA report says: “Over 2,500 food additives—including emulsifiers, binders, sweeteners, colorings, and preservatives—may be used to mimic the taste and texture of conventional food and increase its shelf life. Studies have linked certain food additives to increased risks of mental disorders, ADHD, cardiovascular disease, metabolic syndromes and even carcinogenic effects.” 

“Certain food colorings, such as red 40, which is present in widely-consumed products have been associated with behavioral issues in children, such as increased hyperactivity and symptoms consistent with ADHD.” 

This is somewhat true, but misleading. Over the past decades, there have been FDA commissions and congressional hearings to investigate an association between artificial food coloring and ADHD.¹⁹ Given the high interest in the topic, our team wrote a full-length article on food dyes. 

Our quick take, though, is this: We agree with the assessment in scientific papers that artificial food dyes are a public health concern, not an ADHD concern.^20,21,22

From our review of the MAHA report, it’s clear that the causes of ADHD as well as its diagnosis, treatment, and management were not described accurately. These misrepresentations can result in stigma that stops people from seeking accommodations and treatment for their kids or for themselves. 

The research is clear: Proper support helps people with ADHD have the best outcomes in life. This should be the goal of all public health professionals.

Additional contributions by Andrew Khan, PsyD, and Jennifer Spindler, MSEd, MPhil.