ADHD Study May Create Unfounded Doubt
Filed Under: Health & Science, Opinion | Posted: 03/09/2012 at 7:38AM
Comments | Region: New Jersey | United States
A recent article, “Youngest Kids in Class More Apt to Get ADHD Diagnosis: Study,” by Randy Dotinga , raises many questions that does make one skeptical about the methods used for diagnosis as well as the ongoing needs of education about this developmental disorder.
Despite the fact that we have made such great strides in the research of this very prevalent developmental disorder, this article I think just sends us back to medieval times.
Histories of a total of 930,000 children ages 6-12 were studied over years from 1997-2008. 7% of boys between those ages were diagnosed with ADHD. But within classrooms, it showed that 5.7% of the diagnoses were for the oldest and 7.4% were for the youngest.
Study author Richard Morrow, a health research analyst from the University of British Columbia said: “In general, the younger you are within your grade, the more likely you are to receive this diagnosis and get treatment.” “The way we would interpret this is that there are differences in maturity that are coming into play.”
So my concerns are the following:
• The method of diagnosis: The DSM-IV is a statistical manual developed by the American Psychiatric Association that gives parameters by which a diagnosis is made. These areas are more than just looking at behavior. A consistent area that create doubt in people’s minds is the fact that all children are active. Why would that mean they have ADHD? This manual demands that behaviors transcend at least two environments lasting a minimal of 6 months.
• Levels of maturity may vary. But kids with ADHD develop slower than their peers and are generally up to three years behind. That level of immaturity will be seen regardless if a child is 6 or 6 and a half in a given classroom. More likely is that there are certainly differing degrees of impairment that may impact an early diagnosis among those not informed or educated about ADHD.
• ADHD is a disorder of executive functioning deficits. These become more evident as the child becomes older and more demands are made on them.
Certainly multiple teachers with multiple demands can create more difficulties but even as young as third grade, work demands change where kids are expected for instance to read to learn, not learn to read. Executive functioning deficits include planning, initiating, working memory, managing transitions, time management, and emotional regulation. In addition, a significant percentage of kids who are diagnosed with ADHD, up to 40%, have learning issues that also impair function and self-esteem.
• Many times, those without expertise in ADHD diagnose children within an office visit. This is not following the appropriate guidelines. And as a result, children are misdiagnosed. The impression is that we are over diagnosing kids with ADHD. But in reality, because of lack of information and proper diagnosis, we have significant numbers who are undiagnosed and untreated.
I realize that this is a Canadian study. But the fact that it has been brought up in this country is concerning because it seems to not delve into the need to follow very specific parameters of diagnosis.
It is unclear how all of these children were diagnosed. But I would caution all in this country to be much more aware of the needed education in order for accurate diagnosis and treatment of a population of children who so desperately need our support in order to develop a healthy self-esteem and be productive adults.
Karen K Lowry, R.N.,M.S.N.
ADHD Coach for Adults, Teens, and Children
Author, The Seventh Inning Sit: A Journey of ADHD