Every survey of attention deficit-hyperactivity disorder seems to point to the same trend: rising rates of diagnoses. That shouldn’t be a surprise, given that education and awareness about the condition among children has exploded in recent years. In fact, researchers say most of the increase isn’t due to some biological or clinical change in children but because of this heightened recognition, which means that parents, teachers and doctors are all more aware of the signs of symptoms of ADHD.

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In the latest study, published in the Journal of Clinical Psychiatry, it’s likewise not a shock that scientists found a 43% increase in the rates of ADHD, as reported by parents, when they analyzed national data involving 190,000 children between 2000 and 2011. What was novel, however, was that the group, led by senior author Sean Cleary, an associate professor of epidemiology and biostatistics at the Milken Institute School of Public Health at George Washington University, also broke down the data by race and ethnicity. While all racial and ethnic subgroups experienced a rise in ADHD prevalence, and the prevalence was still highest among whites, the rate of increase was greatest among Hispanics at 83%. Girls also showed a bigger rate of increase at 55% than boys (40%).

MORE: The Kids Most Likely to Have ADHD In the U.S.

Cleary speculates that the surges are primarily due to more healthcare and education about ADHD reaching people other than whites, the group where most of the diagnoses occur. “Whether it’s through more awareness of the signs and symptoms of ADHD, or whether it’s through greater openness and access to health care, or whether there are more bilingual physicians or health professionals that can help diagnosis ADHD—all of these can play a role,” he says.

For example, the study found that having insurance was a strong indicator of whether parents reported ADHD diagnoses in their children; having access to doctors who are familiar with the condition and can recognize its symptoms is an important part of receiving the diagnosis, he says.

MORE: Kids on ADHD Medication Are More Likely to Be Bullied, Study Says

The data also showed an increase from 2003 to 2011 among teens ages 15 to 17 years. That’s most likely a reflection of the fact that more of the adolescents in 2011 were diagnosed about a decade earlier, in 2000, than would have been diagnosed in 1993 because of growing awareness of ADHD.

“My greater concern about ADHD is lack of diagnosis,” says Cleary. “The greater message is that now we are becoming aware of ADHD among females, and among racial-ethnic groups, so parents, teachers, social workers or whoever is in a position to advise parents if a child is exhibiting symptoms should recommend that child for an assessment.” Diagnosing ADHD during childhood, and providing the children with coping tools and ways to direct their attention and concentration, may better equip them as adults in the workforce to handle organizational tasks that might otherwise be challenging.

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