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Overdiagnosis of ADHD in Children: Problems and Solutions
Attention-deficit/hyperactivity disorder (ADHD) is a chronic condition characterized by reduced levels of attention and concentration, overactivity, and impulsivity (Fonagy et al., 2014). Individuals with ADHD have difficulty staying focused or listen and are easily distracted, forgetful, and hyperactive. They talk too much, interrupt others, and cannot perform any activities quietly (Mayo Clinic, 2016). Research shows that ADHD can be caused by a number of factors including genetics, environment, brain injuries, etc. Moreover, ADHD is associated with several comorbid conditions including depression, anxiety disorders, bipolar disorder, learning disabilities, and so on. This condition affects millions of children around the world and can continue into adulthood if not addressed properly (Mayo Clinic, 2016). However, increasing rates of ADHD cases for the past decade suggest the possibility of overdiagnosis, which puts children and their parents under pressure (Dunlop & Newman, 2016). In this research paper, the author attempts to discuss the problem of overdiagnosis and analyze solutions proposed in the current clinical literature.
Before proceeding to the problem itself, one needs to understand how ADHD is diagnosed. Currently, there are no specific tests to detect this condition, so a health care provider should use a combined approach (Mayo Clinic, 2016). Thus, a general examination is typically performed to assess the child’s health and determine whether other diseases are present. Furthermore, information is gathered regarding current medical issues, medical history, family and school environment, academic performance, etc. Sometimes, interviews and questionnaires with family members can also be conducted to collect additional information. Moreover, pediatricians use ADHD criteria from the Diagnostic and Statistical Manual of Mental Disorders DSM-5 developed by the American Psychiatric Association (Mayo Clinic, 2016).
According to the estimates, medication prescription rates have increased by almost 50% (Thomas, 2013). Needless to say that overdiagnosis adversely affects children and their families. Medication costs associated with ADHD reach up to $500 million in the United States, which highlights a huge financial burden of the condition for the country and individual families. More importantly, some children have drug reactions and experience stigmatization because of their health status (Thomas, 2013).
Several factors account for increased diagnosis of ADHD in children. First, there is a growing awareness about the problem both among parents and healthcare workers. Research has generated valuable knowledge concerning ADHD causes and risk factors, potential health consequences and comorbidities, effective medications, etc. (Dunlop & Newman, 2016). Second, numerous randomized control trials have been conducted proving the crucial role of comprehensive intervention in minimizing the symptoms and ensuring positive long-term outcomes.
Third, some alarmists suggest that the actual cause of increased ADHD diagnosis is the very environment in which children currently grow. More specifically, they are exposed to toxins and air pollution and spend too much time in the virtual reality, which make them sick, aggressive, and impulsive (Frances, 2016). Fourth, the growing pressure on children in school results in many of them being unable to meet the high academic standards, which is erroneously taken for ADHD (Newmark, 2015). Finally, unlike severe ADHD, diagnosis of these forms of the disorder depends mainly on subjective opinions of clinicians (Perry, 2013). Whatever the case, evidence suggests that many children are misdiagnosed, either because of pediatricians’ lack of knowledge or parents’ desire to change their children with the help of “magical pills” (Hicks, 2013). In fact, ADHD symptoms may be caused by a variety of different factors that doctors and parents do not recognize, such as sleeping patterns, family relationships, natural restlessness, giftedness, and so on.
Given extensive research regarding the scale of overdiagnosis in children, more effective and accurate diagnostic approaches should be employed to prevent them from needless treatment. It is critical to continue studying the pathophysiology of ADHD and disseminate the findings among health care providers. They need to be aware of adverse consequences of overdiagnosis and be ready to change their approaches to ADHD diagnosis and treatment in line with evidence-based practice (Coon, Quinonez, Moyer, & Schroeder, 2014). Moreover, researchers call for clinicians to use a six-step approach to addressing ADHD, which implies prescribing medications only after all other diagnostic methods and treatment options have been used (Batstra & France, 2012).
To summarize the argument provided above, one may note that the current approaches to ADHD diagnosis and treatment should be improved. Naturally, this condition is a serious disorder that adversely affects both children and parents and therefore should be treated effectively. However, many children diagnosed with ADHD actually do not have this condition or do not need powerful medications. The growing awareness about this disorder and availability of effective medications encourage parents to seek treatment while pediatricians do not have relevant knowledge and skills to differentiate ADHD from other conditions. It is important to realize that ADHD symptoms may be caused by many other factors that require no more than parents’ attention and slight lifestyle changes. Thus, diagnostic criteria for ADHD need to be improved to prevent health care providers from prescribing unnecessary treatment and putting additional pressure on families.