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: ADHD: an epidemic?
DEAR DR.PAUL: I keep hearing all kinds of things about
ADHD (Attention Deficit Hyperactivity Disorder) and medication
issues. It seems that more children have ADHD today. Is there
a true ADHD epidemic?
PEDIATRICIAN DR.PAUL Answers: You ask a very popular question,
as it seems that it has become fashionable to label children with
seemingly any type of behavior or school problem as "Hyper". Although
there are many concerns about medication use, let's focus on the
basics of making the diagnosis of ADHD which in itself is not
very simple. The three main features of ADHD are impulsivity,
inattentiveness and hyperactivity. In order for the diagnosis
to be made, these must be present for at least 6 months and interfere
with both school and social functioning. Parents also do not realize
that there are social problems related to ADHD such as difficulty
in making and keeping friends and low self esteem. In addition,
ADHD can be associated with other conditions such as learning
disabilities, anxiety or mood disorders and oppositional or defiant
disorders.
Importantly, non-ADHD conditions/situations can make a child seem
to have ADHD. For example, children with home or family related
stress may act out at school and on the surface, be labeled as
having ADHD. In today's stressed society, an increasing number
of children are acting out and have school difficulties. Facing
budget cut-backs and lack of resources, school and social service
authorities are often quick to look for the possibility of ADHD
in these children, when in fact, the behavior is related to home/family
problems. The possibility that children can exhibit ADHD-like
symptoms, without having ADHD, and that ADHD may be associated
with other conditions, makes the diagnostic process difficult,
yet all that more important.
ADHD can be accurately confirmed only with the involvement of
all the people caring for the child, both at home and at school.
Other key members of the team include the doctor and other consultants
such as a psychologist or school specialist. The process involves
gathering information from the school about the child's academic
and social performance and interactions with other children. Equally
important are the parent's observations. Both of these observations
can be scored on a Conner's (Scale) Sheet, a useful aid in helping
confirm ADHD. Psychological tests will evaluate how a child works
academically, will assess the child's intelligence level and screen
for learning disabilities. A full medical evaluation will make
sure that there are no medical problems mimicking AHDH. As you
can see, there is no one single test that exists to diagnose ADHD.
Only after the gathering of all the above information from what
I like to call the "Hands on Team", can the diagnosis be made.
If we sift through all of this and look at the actual number of
cases diagnosed with ADHD, we see that the rate of properly diagnosed
ADHD has not increased over some time in spite of media alerts
about "An ADHD Epidemic".
The following is a quick questionaire to screen for any school
difficulties:
As a quick way of screening for ADHD and possibly other learning
problems the American Academy of Pediatrics suggests that parents
respond to these questions during routine check ups:
- How is your child doing in school?
- Are there any problems with learning that you or your teacher
has seen?
- Are you concerned with any behavioral problems in school,
at home or when your child is playing with friends?
- Is your child having problems completing class work or homework?
If the answer is not well for the first question and/or yes
to any the rest, you should discuss this further with your child's
school and doctor. |
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The information provided in this site is
designed to be an educational aid only. It is not intended to
replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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