Is ADHD Being Overdiagnosed?
In recent years, children have been identified on a regular basis with having attention problems and disorders such as ADHD. The prevalence of such disorder seems to have risen dramatically compared to several decades ago. Is this sudden increase related to a better understanding of the disorder, an ADHD epidemic, or a tendency for doctors to overdiagnose the problem?
In 2011 the rate of attention-deficit/hyperactivity disorder in children ages 4 to 17 was 11 percent with 6.4 million kids diagnosed with ADHD. About 30 years ago the rate of children being diagnosed with ADHD was only between 3 and 5 percent. Between the years of 2003 and 2011 alone, the prevalence of the disorder increased as much as 35 percent.
It can be difficult to tell whether the disorder itself has become more widespread or we are simply better able to spot the symptoms now than we were in the past. Physicians, psychiatrists and parents are likely much more conscious of ADHD now than they were 30 years ago. However, some believe that the dramatic increase in the rates of the disorder is related more to overdiagnosis than true attention problems in children.
Accurate vs False Diagnosis
ADHD is a disorder that can take time and lots of regular evaluation in order to diagnose very accurately. Unfortunately, many clinicians provide inadequate evaluation and are too hasty to identify a child as having the disorder because they may appear to have some of the symptoms. Overdiagnosis can be a serious problem for kids that are being medicated for a disorder they may not really have.
Another reason why ADHD may be overdiagnosed is societal pressure and an increase in the demands being made on children and schools. The diagnosis of the disorder is often contextual, meaning that children with the same developmental traits may be seen as having ADHD or not depending on their social and educational environment. Some areas of the country tend to diagnose the disorder more than others leading to abnormally high rates in certain cities and states.
Experts estimate the 5 percent is a realistic upper limit for the rate of children with the disorder but some states reports rates greater than 13 percent. These high numbers are often dependent on the environment of the children rather than a reflection of a particular psychiatric issue in that state. The widely varying numbers across the country can be an indication that overdiagnosis is leading to falsely high rates nationally.
Providing an accurate diagnosis of ADHD can be complicated because physicians need to take the time to rule out other conditions that may have similar symptoms to ADHD. Children may actually have a learning disability, anxiety, or other issues like post-traumatic stress disorder that can interfere with their attention. The physician would need to observe the child closely in different environments in order to have a better idea of what condition they really have.
However, many physicians feel pressure to provide a diagnosis without taking enough time to explore every possibility. Parents and teachers may want easy and quick answers as to why a child is having trouble focusing in class. Doctors may make a diagnosis and prescribe stimulants to help alleviate the situation.
Understanding Symptoms of ADHD
Parents and teachers may have a vague notion of what ADHD really is and may feel that they see these symptoms in their child. However, not all children who struggle in school have attention problems. A child may seem to be behind in school because of the intense pressure of certain academic environments.
A child with ADHD not only has trouble paying attention but they may also have issues with starting tasks, following directions or stopping one activity to begin another. Students with ADHD may need a lot of encouragement to get through tasks and they may get upset or angry over small issues. These symptoms can also occur with other conditions such as learning disabilities so it is important for parents and physicians to be cautious about assuming a child has ADHD because of their problems in school.
Unfortunately many teachers and parents may witness these symptoms and urge physicians to provide stimulants like Ritalin and Adderall so that the child can focus in school. Overprescribing stimulants can be harmful to a child’s health and may not be addressing the underlying problem that is causing them to perform poorly academically. Although many children have legitimate attention problems and need stimulants, others are medicated when they may not need it.
If you are concerned that your child has ADHD make sure to ask a physician to take time to observe your child to get an accurate diagnosis. Jumping to conclusions about a child’s condition can cause more damage in the long run. Talk to a physician and ask for a second opinion to ensure that you have a true diagnosis.