Introduction
In 1936, Benzedrine was first used to treat children displaying symptoms of Attention Deficit and Hyperactivity Disorder ADHD. At that time, the condition was referred to as hyperkinetic impulse disorder. In 1955, Ritalin was introduced as a treatment. In 1980, two types of disorders were listed: Attention Deficit Disorder with hyperactivity and without. Hyperactivity was considered a fairly rare side effect of the disorder. In 1987, the current symptoms of ADHD were defined. By the 1990s, because of parental awareness and the improved ability to diagnose the symptoms, the number of diagnoses increased significantly.
Diagnosis of ADHD is difficult, as it often relies upon subjective reports of the symptoms. Very often, the diagnosis consists of eliminating other causes of the troubling behavior. Usually, a pediatrician and a psychologist will carry out an assessment. The child’s academic, social, and emotional functioning will be evaluated. Rick Nauert, PhD, points this out, “Nevertheless, the current study shows that in order to avoid a misdiagnosis of ADHD and premature treatment, it is crucial for therapists not to rely on intuition but strictly adhere to well-defined, established diagnostic criteria.”
Overdiagnosis is a concern as unnecessary treatment of children burdens them with avoidable side effects. According to psychiatrists, Ritalin is overprescribed.
The argument for misdiagnosis
Data collected by researchers at the Ruhr-Universitat Bochum RUB and the University of Basle confirm that ADHD is over-diagnosed, with boys being over-diagnosed substantially more often than girls. The researchers studied 473 German child and adolescent psychologists and psychiatrists. These medical practitioners supplied files that contained the signs and symptoms that had been used as the basis for the diagnosis of ADHD. The researchers found that there was insufficient information in three out of four of the cases to make a diagnosis of ADHD. Despite this lack of information, between 9% and 13% of girls were diagnosed, and between 19% and 30 % of the boys. They also missed the diagnosis that should have been made in 23% of the girls and 20% of the boys. “In other words, the rate of diagnostic error among these same clinicians is at least 20 percent,” John M. Grohol, Psy.D. explains.
Also pointing to the high incidence of misdiagnosed ADHD are large differences in ADHD prevalence in the various states in the USA. For example, 14.8% of children in Kentucky have been diagnosed with ADHD, but only 5.6% in Colorado. This does not make sense since ADHD is physical in origin.
Increases in the number of children diagnosed
The Centre for Disease Control and Prevention reported in 2011 that 11% of children in the United States had been diagnosed with ADHD. Of the 6.4 million children diagnosed, 4.2 million were taking stimulant drugs. Thirty years ago, the rate was estimated at between 3% and 5%. “Experts estimate that 5% is a realistic upper limit of children with the disorder, but in many areas of the country, as Watson found in Virginia, up to 33% of white boys are diagnosed with ADHD,” Pieter Cohen, M.D., and co-authors say.
This increase could be through misdiagnosis. The diagnosis of ADHD is time-consuming and must be done through the process of elimination since so many other disorders have similar symptoms. The diagnosis has to include interviews with parents and teachers. Despite the need for a careful diagnosis, medical professionals are being put under pressure by parents, who, in turn, are being pressured by teachers to put their children on stimulants. Many of the medical professionals simply don’t have sufficient time to do a proper evaluation. The cost and time required to do the extensive evaluation required to diagnose ADHD have resulted in children being diagnosed on the anecdotal information supplied by parents and teachers.
A huge study was carried out in North Carolina by two epidemiologists at Duke University. They interviewed thousands of parents and children and found that between 1% and 2% of the children had ADHD. Many children taking stimulants were not sick, and others who were had not been identified. The results of this study were confirmed by several follow-up sessions.
Is Immaturity being diagnosed as ADHD?
Some believe that the increase in diagnoses could be related to the push for early childhood education. In 2010, the Journal of Health Economics reported that preschoolers born in August were twice as likely to be diagnosed with ADHD as those born in September. Those born in August are the youngest in the class and those born in September are the oldest in the class. This difference would account for 900,000 incorrect diagnoses. This suggests that there is overdiagnosis of children who are too young to cope with the demands they face. Children born one month prior to the September grade cutoff were 122% more likely to be diagnosed than those who were 11 months older. There were also similar findings of school age from studies in Taiwan, Iceland, Australia, and Canada.
The Father of ADHD supports the notion that the condition is overdiagnosed
Keith Connors, the father of ADHD, started studying the condition 50 years ago. He analyzed the data on the first Ritalin trials. He developed the impact scales and is largely responsible for ADHD becoming widely accepted as a disorder. He is convinced that the condition is being widely overdiagnosed.
He believes that drug companies have caused the false epidemic. In a bid to sell new and expensive drugs, they have used misleading advertising to convince parents and teachers that children might have undiagnosed ADHD. A National Institute of Health study also made people believe that drugs were more effective than therapy.
In his view, between 2% and 3% of children and adolescents have ADHD and should be treated. Children should never be treated without a full and thorough clinical history, including interviews with the child, parents, and teachers.
Conclusion
Parents of children diagnosed with ADHD should be aware of the difficulty of diagnosing this disorder and should be satisfied that all other conditions have been ruled out and that all environmental conditions have been analyzed. They should not allow themselves to be pressured into allowing their child to carry the burden of misdiagnosed ADHD.
www.madinamerica.com/2016/06/the-overdiagnosis-of-adhd/
http://www.health24.com/Medical/ADHD/About-ADHD/adhd-a-timeline-20170328
http://www.health24.com/Medical/ADHD/Overview/How-is-ADHD-diagnosed-20130205
http://www.medicalnewstoday.com/articles/315391.php
http://www.health24.com/Medical/ADHD/About-ADHD/adhd-a-timeline-20170328
