Sie sind auf Seite 1von 9

Alexis Altvater Jane Blakelock ENG 2100 April 15, 2014 Are Children Being Over Diagnosed for

ADHD? ADHD is one of the most common over diagnosed neurodevelopmental disorders of childhood. Normally, ADHD is diagnosed in early elementary years, when teachers pick up on students behavior patterns, and usually lasts into adulthood. Each year eleven percent of school age children are diagnosed with (ADHD) (Koplewicz) Studies showed a sharp rise in the number of children being diagnosed with ADHD and the prevalences rates are increasing as well. (ADHD) In 1902, an English pediatrician, Sir George Frederick Still, was the first to describe ADHD. (Connor) There are three subtypes of ADHA: predominately hyperactive-impulsive, predominantly inattentive, and combined hyperactive-impulsive and inattentive. Scientists are not sure what causes ADHD, but they know some factors that may play a role in it. Those factors are genes, environmental factors, brain injuries, sugar, and food additives. (ADHD) Researchers are unsure if taking out food additives would be beneficial. Symptoms include: difficulty following instructions, trouble focusing on one thing, being easily distracted, talking nonstop, constantly in motion, having trouble staying seated, impatient, inappropriate comments, and interrupt conversations. It is natural for children to have trouble concentrating and behaving every now and then. However, children with ADHD do not just grow out of these behaviors. The symptoms continue and can cause difficulty at school, at home, or with friends. (ADHD) As children get older and become teenagers the ADHD can start to fade away, while others can have it for the rest of their lives.

The public believes rambunctious children have this disorder. However, the general population does not have the correct understanding of what ADHD is to just diagnose a child themselves. When parents are given the correct information, their children will be treated properly. This will help parents get a better understanding of ADHD and not assume their childs diagnosis. The medical professionals need to give the parents the accurate information about ADHD. My younger sister, Alyssa, who is ten years old, was diagnosed with ADHD two years ago. At the time I thought she was just a rambunctious child who loved to play all the time. She was taken to a psychologist who diagnosed her with ADHD. The psychologist only did an initial diagnosis and Alyssa did not have any other special testing to confirm the diagnosis. My parents didnt believe it at first. They gave Alyssa pills to take and my mother hated that she had to be put on medicine. My mother didnt believe Alyssa really had ADHD. My parents decided to give her caffeine free mountain dew instead of medication. She would have a very small cup of the mountain dew three times a day. This really helped Alyssa calm down without having to take medication that would have side effects with it. It showed my parents that just because Alyssa is a rowdy child it doesnt mean she has ADHD. That being said about my sister, ADHD may be over diagnosed. The American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP) do not see ADHD as being over diagnosed. There are other professionals out there besides the APA and AACAP that feel the same way. Others feel ADHD may be underdiagnosed. Is ADHD over-diagnosed, misdiagnosed, or neither? Many people believe ADHD could be over diagnosed, while others think it is either misdiagnosed or neither. The NIH (National Institution of Health) said, Pediatricians can assess the child themselves, but many will refer the family to a mental health specialist with experience in childhood mental disorders. (ADHD) ADHD can be seen on the rise by two different responses. One is that the standards

of diagnosing a patient are changing, which means childrens symptoms that didnt meet the standards now do meet the standards. The other response is that children are now getting the attention they need with access to care, helpful information, and a decline in the stigma with mental health care. (Koplewicz) Children are not being diagnosed until seven years of age, which makes it harder for ADHD to be over diagnosed. (Zentall) More and more people are becoming aware of children with ADHD in the school or in the home. (Koplewicz) However, in the prevalence rate is lower in the United States than other countries in the world. Germany has a 9.6 prevalence rate while Puerto Rico has a 16.1 prevalence rate. With a low prevalence rate across the world, it is hard to say there is an over-diagnosis of ADHD. Yes, more people are becoming aware of ADHD, but that also means more children are being treated for the disorder. (Horan) When children are having problems in school or misbehaving at home, they need to get help somehow. We cant just watch the children struggle their whole life. With parents knowing this information, they take their children to be assessed more. Therefore, children are being diagnosed more. ADHD may be on the rise but that does not mean it is being over diagnosed. (Koplewicz) Zentall believed that children are under diagnosed for ADHD. When teachers are identifying students in the classroom that may have ADHD; teachers will look at the boys first. In the classroom they will look for oppositional defiant disorder before looking for ADHD. When teachers see that a girl in the classroom may have ADHD, they do not do anything about it at first. Only 1/3 of girls in the class who had ADHD were in special education classes. Teachers didnt think girls conduct fit the signs for hyperactivity. Girls were more responsive when teachers try to control their behavior in the classroom. (Zentall) On page five, it will show how more boys are being diagnosed than girls. There is also the issue of methylphenidate being given to children. Methylphenidate is given out too much to patients. Methylphenidate is reducing the symptoms of hyperactivity, inattentiveness, and

impulsivity. The drug improves childrens behavior and academics in the classroom. In the United States it is prescribed 90% of the time to children with ADHD. Some think that is being overly abused when it is only helping treatment with children. Abusing this drug is extremely rare, when the report was made there was only four cases actually reported to the study. Lisa Horan also said, That right now with ADHD we only diagnose it by descriptive criteria. (Horan) This is how the teachers above would look at the students in their classroom. ADHD is being over diagnosed and the public is becoming more worried about it. The neurobiological disorder is starting to be seen as a socially constructed disorder rather than what it is. Many have opinions to why it is over diagnosed. (Connor) As the introduction said before, 11% of school age children are diagnosed with ADHD. Professionals are worried that this is a big increase of children with the diagnosis. Another worry is the overuse of medication. More than 4% of children are using ADHD medication in the United States and the number will keep increasing. (Connor) As said in a paragraph before the children may take methylphenidate to help with their ADHD. It is said to be a very powerful drug. (Mota-castillo) Side effects of the medication can be slow growth development, trouble sleeping, and an elevated risk of cardiovascular events. (Science & Children) When taking the oral version of methylphenidate it shows slower absorption and longer temporal CNS dopamine receptor binding and releasing properties. Another drug being given to children with ADHD is amphetamine. Children taking the stimulants, they have reinforcing effects similar to drugs like cocaine. (Connor) Another problem with overuse is that doctors are overprescribing the medication. Most of the time doctors prescribe medication instead of trying something different with the patient. This is easiest for doctors to give their patients. (Koplewicz) Methylphenidate is being produced more and more each year. With more methylphenidate being made, that increases the availability of the drug and can lead to more abuse and diversion of the drug. The drug is being made more is because doctors are

overprescribing it and need more of the drug. This does not happen everywhere in the United States. There are some states that are overprescribing while others are under prescribing. In 2003, the CDC found that 40.6% of patients with ADHD in California and 68.5% in Nebraska were taking medication. Then there was a study done in North Carolina that showed 7.3% of children were taking medication, while only 3.4% actually needed to be taking it. A problem thats occurring is patients who are taking ADHD medication when they do not have ADHD. It has been shown that patients who are not supposed to be using the drug are between 5% and 9% in children; while in college students its between 5% and 35%. When doctors are prescribing this to their patients, they need to tell them the consequences of what the drug can do to them. This is very important that doctors show the problems with the misuse of the drug. (Connor) Methylphenidate and amphetamine need only to be used for patients that need it, not just something doctors give out because they have no other option. Another problem is may be bigger than overuse of medication is trouble diagnosing the borderline cases. If we were able to use behavioral parent training or cognitive behavioral therapy, then children wouldnt have to be put on medication automatically. Koplewicz says, BPT tries to change environmental conditions that trigger and sustain inappropriate behaviors. This technique uses positive reinforcement and punishment to get through to the child. CBT will make the child change the way they think and how they go about a situation. Both of these techniques will help children that may have a case of ADHD. However, these techniques are not always as accessible as medication is. (Koplewicz) ADHD has been studied all across the world. One of the more popular studies comes from British Columbia. Before the study, they looked at two studies that showed a link between the relative age of children and the diagnosis of ADHD and prescribing medication. After the University of Columbia looked at this they decided to do their own study to see if the relative-age effect was present in Canadian children. The study looked at gender bias too. Unlike the United States, British Columbias

cutoff date for kindergarten or first grade is December 31. (Science & Children) The study went on for eleven years (conducted from 1997 to 2008). (Staff) The research found that 39% more children were likely to be diagnosed and 48% more likely to be treated with medication for ADHD. This was just comparing the children between December and January. (Science & Children) Researchers looked at the differences between male and female in the study. There were 39,000 boys born in December and 7.4% were diagnosed with ADHD. While the same amount of boys were born in January, there were only 5.7% diagnosed with the disorder. When it came to the girls, they ran into the same occurrence. There were 37,000 girls born in December but only 2.7% were diagnosed with ADHD, while for January girls there was 1.6% diagnosed. (Staff) The study above showed the researchers things about children and ADHD that were not known before. Starting with age, children that may have been born in December were almost a whole year younger than their peers who were born in January. The study suggests that the children right before the cutoff date were not being diagnosed correctly. (Science & Children) Another study that was done after this also showed that the older children in the classroom were 25% less likely to be diagnosed with ADHD. However, the study was done over an eleven year time period and each year more children were being diagnosed and treated. The CDC claims that ADHD is being diagnosed 5.5% more each year between 2003 and 2007. (Staff) With gender the study shows that three times more boys were being diagnosed over girls. (Science & Children) This goes along with the end of page three and how girls may be under diagnosed because of teacher diagnosis. (Zentall) The biggest thing that came from this study was that it showed younger children are not being diagnosed correctly with having ADHD. The truth is that the younger children are less mature and being over diagnosed. (Staff) The next study, scientists from the University of South Carolina and the University of Oklahoma have done one of the largest studies on ADHD to try to find more information on the disorder. The study

was called 10-year (conducted 2002-2012) Project to Learn about ADHD in Youth (PLAY). It is just like the last study except it focuses on children with medication and not gender. The study was funded by the National Center on Birth Defects and Developmental Disabilities of the Centers of Disease Control and Prevention. The study confirmed that a clinician who had little experience with assessing and diagnosing mental disorders often is diagnosing the children. Researchers found that 8.7% of children in South Carolina and 10.6% had ADHD on first diagnosis. In South Carolina, 10.1% of children were taking medication, while in Oklahoma it was 7.4%. In the study only 39.5% of the children from South Carolina had the actual disorder and in Oklahoma it was 28.3%. Children who may not have ADHD were taking medicine for it. Then other children were under diagnosed. These children werent taking medication, which made the scientists think that the condition is still under diagnosed. In this study there is a fine line between ADHD being under diagnosed and over-diagnosed. The bottom line is large number of children are being treated for ADHD who did not meet the case criteria, and the opposite of that was happening too. (University of South Carolina) One huge problem with ADHD being over diagnosed is that it may in fact be misdiagnosed. In the article, The Crisis of Over diagnosed ADHD in Children, it is about a teenager named Maria. Maria was diagnosed with ADHD by a psychiatrist. The psychiatrist did this based on her symptoms of increased energy and disruptive behavior. Then when another psychiatrist took a look at Marias file, he thought that she may have something else instead of ADHD. He found in her file that her father had a bad temper and that her mother is schizophrenia. After that Maria was hospitalized after running in traffic. Without looking at her file, they gave Maria the primary diagnosis of oppositional defiant disorder (ODD) and ADHD as the secondary disorder. (Mota-castillo) This article shows how doctors are assuming that just because a child is full of energy and disruptive that just means they have ADHD. We need to look at everything when diagnosing a child with a mental disorder. Some of the problems that

occur with over diagnosing or misdiagnosing are failure to know about family history, cultural and linguistic barriers, failure to communicate with patient well and misconstruing behaviors as causative explanations. (Mota-castillo) Misdiagnosis can also lead to not diagnosing ADHD at all. Instead of parents or teachers thinking that children have ADHD, they think that its just emotional or disciplinary problems. (ADHD) As of 2011, eleven percent of children and adolescents were diagnosed with ADHD. ADHD will keep rising each year. When seeing eleven percent of children diagnosed, it makes the public believe there is an over diagnosis. Others argue that attention deficit hyperactivity disorder is misdiagnosed, under diagnosed, or neither. ADHD may not be as life threatening as other mental disorders but it still needs to be taken seriously. Researchers have found that it is the parents perception of ADHD is where the problem lies. Yes, parents can start looking for symptoms their child may have, but the child still needs to be taken to the doctor for an initial diagnosis. (University of South Carolina) When diagnosing ADHD we need to include, multi-informant, multi-method, developmental assessment of symptoms, impairment, course of illness, previous assessment and treatments, school and social functioning, and comorbid conditions. (Connor) For ADHD to not be misdiagnosed, medical professionals have to look very closely at the patient to diagnose correctly. If the medical field would take more than a couple days to diagnose a child with ADHD, children who do not have ADHD could be saved from taking medication. We need to stray away from the overuse of ADHD medications too. ADHD needs to be looked at equally in genders and have no bias around. ADHD will stay over diagnosed, misdiagnosed, or under diagnosed until all the correct information is known to the world.

Work Cited "Attention Deficit Hyperactivity Disorder (ADHD)." NIMH RSS. Web. 05 Feb. 2014. Connor, Daniel F. "Problems of Overdiagnosis and Overprescribing in ADHD." Psychiatrictimes.com. 11 Aug. 2011. Web. 12 Mar. 2014.

Gardner, Amanda. Can Food Additives Affect ADHD? Cable News Network. 18 Nov. 2010. Web. 25 Feb. 2014 Horan, Lisa. Report Concludes ADHD is Not Over-diagnosed. CHADD. Web. 25 Feb. 2014. Koplewicz, Harold, and Power, Thomas. "Is ADHD Over diagnosed in American Children?" U.S. News Digital Weekly. 19 Apr. 2013. Web. 25 Feb. 2014. Mota-castillo, Manuel. "The Crisis of Over diagnosed ADHD in Children." Psychiatric Times. 1 July 2007. Web. 06 Feb. 2014. Staff, My Health News Daily. ADHD Over diagnosed In Youngest Kids In Class. NBC News. 5 March 2012. Web. 12 March 2014. University of South Carolina. "Attention Deficit Hyperactivity Disorder Is Both Under and Over Diagnosed, Study Suggests." Science Daily. 19 Oct. 2012. Web. 25 Feb. 2014. "Younger Children in the Classroom Likely Over diagnosed With ADHD." Science & Children 49.8 (2012): 16-17 Zentall, Sydney S. "Diagnostic Perspectives and Controversies." ADHD and Education. Upper Saddle River: Pearson Education, 2006. 28-31. Print.

Das könnte Ihnen auch gefallen