According to a survey of parents conducted by the CDC, 6.4 million children were diagnosed at some point in their lives with ADHD, as of the 2011-2012 study. Almost half of those, 3.5 million, were taking medication to control their ADHD symptoms. As Alan Schwartz points out in his new book, ADHD Nation, many of these diagnoses are made by primary care physicians based on responses to a single questionnaire. In fact, the CDC website even contains a checklist of ADHD symptoms that parents can bring to their child’s healthcare provider. This method of diagnosing ADHD in young children is insufficient and may lead to overdiagnosis.
Psychologists and psychiatrists use the Diagnostic and Statistical Manual, Fifth Edition to guide their diagnoses. This manual clearly outlines the criteria for ADHD and requires that symptoms are present in at least two environments, home and school, for example. While this criterion can probably be established with questionnaires, it is not sufficient for a diagnosis because other conditions, such as anxiety, exposure to trauma, among others, must be ruled out as the cause for symptoms that may appear on the surface to be related to ADHD.
So, what can parents do to make sure that their children aren’t misdiagnosed or placed on medication unnecessarily? If parents have concerns about their child’s behavior and those behaviors include hyperactivity, poor concentration, difficulty with organization, daydreaming, or acting without thinking, they should consider consulting a reputable psychologist or psychiatrist for a thorough evaluation. Psychologists will use actual tests, including computer-based measures of attention and impulsivity, to get an actual sample of these symptoms. Questionnaires will also be used, not only to gain information about ADHD, but also to rule out other conditions that may be causing problems with attention and concentration.
Finally, if a diagnosis of ADHD is made based on a thorough evaluation of your child, I urge you to consult a board certified child psychiatrist to gather information about the risks and benefits associated with ADHD medication. There has been a lot of attention given to the use and overuse of ADHD medication, but a lot of what is published in mass media is based on anecdotal evidence rather than scientific data resulting from high quality research. Look out for the next blog, which will synthesize key research studies on the use of medication to treat ADHD.