Is ADHD Overdiagnosed or Are We Diagnosing It Better?


ADHD diagnoses are increasing at a rate of 5% per year, with one-third of the diagnosed group being made up of children under the age of six. Jenna Birch, writing for Yahoo! Health, asks whether these numbers are because of medical diligence or sloppiness. According to statistics, cases of ADHD have been consistently rising for the last ten years, which is causing parents, medical professionals and policymakers to question whether ADHD is being over-diagnosed.

A new CDC report says clinicians are getting more methodical in their diagnosing approach, using practices set by the American Academy of Pediatrics, sending the youngest kids to specialists, and enlisting outside opinions on children’s behaviors. To get this data, scientists went to the 2014 National Survey of the Diagnosis and Treatment of ADHD and Tourette Syndrome, which was a follow-up on the 2011-2012 National Survey of Children’s Health that questioned about 3,000 parents about the specifics of their children’s ADHD diagnosis.

Nine out of 10 children were diagnosed using behavior rating scales. In over 80% of cases, someone outside the family gave input. Susanna N. Visser, Dr.P.H., an epidemiologist at the National Center on Birth Defects and Developmental Disabilities, says:

“We found that, of the children diagnosed, one third were diagnosed before age six. This is important, because children that young are a special group, and diagnosis is very complicated. Preschoolers have symptoms that are often very similar to what’s developmentally-appropriate. We need to be very careful when diagnosing young kids.”

Child psychiatrist Francisco X. Castellanos, MD, a professor in the Department of Child and Adolescent Psychiatry at NYU Langone’s Child Study Center, says the report is reassuring because it shows that greater care and greater expertise are being employed by healthcare professionals. Still, diagnosis of this neurobehavioral disorder is a tough call. Treatment includes behavioral therapies like goal-setting, rewards, and consequences and education for parents.

CNN’s Azadeh Ansari writes that diagnosis must include input from multiple sources close to the child, including parents and teachers.

“You can’t diagnose ADHD in a vacuum; there are a multitude of factors at play,” said Dr. Robert Doyle, child and adolescent psychiatrist at Massachusetts General Hospital. “ADHD is also a highly genetic condition, if a man and a women get together, and each of them have ADHD, their risk for having a child with ADHD is about 75%.”

In the new report, it was found that 11% of school-aged children are considered to have ADHD — a 42% increase from 2003-2004 to 2011-2012. Research has found that when a child has ADHD, there is a likelihood that he or she could also have another condition, such as a learning disability, depression, a sleep disorder, or anxiety.

The most common symptoms of the disorder are include inattention, hyperactivity, and impulsive behavior, all of which can hinder a child’s ability to learn, writes Tara Haelle of HealthDay. For children under the age of six, in three of every four cases, a family member or parent becomes concerned about the child’s behavior.

The report says that overdiagnosis can still occur, said Dr. Danelle Fisher, vice chair of pediatrics at Providence Saint John’s Health Center in Santa Monica, Calif. This can mean being improperly diagnosed, which could obfuscate other behavioral or psychiatric problems, and being over-medicated.

Castellanos, writes Gillian Mohney of ABC News, suspects that the rising diagnoses may be a reflection of increased awareness in recent years, and, if so, will probably level off soon.

“There used to be a real sense of ‘Let’s wait it out, it’s going to go away,’” Castellano said of children with ADHD behaviors. “I think that’s pretty much no longer around. That’s why we see a large increase in overall prevalence. I can’t imagine there’s going to continue to be the same increase in the future.”

09 14, 2015
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