ADHD Among Youth On The Rise..NOT SO FAST!!!!

28 08 2008

The headline is all over the place: ADHD Is on the Rise. ADHD has increased 1997-2006. A new survey from the CDC/National Center for Health Statistics says it’s so.

I can’t and won’t believe the conclusions of this survey.

I’m not saying that ADHD is or is not on the rise (in fact, soon I’ll talk about how common ADHD is!), but I am frustrated by headlines and so-called
“national studies” that are inaccurate and weak.

This study found:

  • 9% of children have ADHD

  • Boys had ADHD more often than girls

  • White and Black children have ADHD more than Hispanic children

  • Children with Medicaid have ADHD more than uninsured or privately insured children

This study (and the headlines) forget to emphasize that they consider a child as suffering from ADHD if “a doctor or health professional ever told the parent that their child had ADHD….

I think that is crazy.

Just because a doctor SAID a youth has ADHD in no way means the youth ACTUALLY HAS the disorder. In fact, they aren’t even saying that a “mental health professional” said the youth had ADHD.

In this day and age of managed care, the burden on pediatricians and family physicians to assess and treat mental health disorders during brief time-limited visits, and health professionals lack of training in psychological testing-the rate of over, under and mis-diagnosis of mental health disorders among youth is becoming epidemic.

Anxiety looks like ADHD. Drug use can look like ADHD. The manic phase of Bipolar Disorder can look like ADHD. Hyperthyroidism can look like ADHD. Chronic lack of sleep can look like ADHD. A child who is being abused or neglected can look as if they have ADHD. Some children are more hyperactive or distractible than their siblings or peers-they don’t necessarily have ADHD.

Did each of these doctors rule out all these other potential causes? Did they interview the child, the parents, teachers, school counselors and other adults familiar with the youth’s behavior?

We don’t know.

This survey tells us what percentage of youth have been DIAGNOSED with ADHD. Many of them may not truly have the disorder. And there are likely plenty of youth walking around suffering from ADHD, but nobody has diagnosed them yet. So this survey tells us nothing about the how many youth TRULY HAVE ADHD.

Plus……

1)    Doctors DIAGNOSE ADHD more often in boys (What about all the girls with ADHD walking around undiagnosed and untreated—the survey doesn’t mention them)

2)    Hispanic youth DIAGNOSED with ADHD less. Due to the stigma related to mental illness in the Hispanic community, is it possible parents are not seeking help from “doctors” for their child’s emotional or behavioral problems? (this study tells us nothing about the true rate of ADHD among Hispanic youth)

3)    Surprise, surprise…..children with Medicaid are DIAGNOSED more often with ADHD “Uninsured” youth aren’t getting diagnosed with ADHD because they aren’t seeing doctors. Privately insured youth are more likely to receive comprehensive mental health evaluations that accurately diagnose ADHD only when appropriate. With Medicaid, doctors are often limited regarding the amount of time they can spend assessing all the potential mental health disorders that mimic ADHD. Receiving a diagnosis of ADHD and a prescription for stimulant medication is much easier than addressing the complex issues that often make low-income youth distractible and impulsive.

If a government agency reports on the number of youth SUFFERING from the mental health disorder ADHD, the answer should not be based on “parent’s report of what a doctor or health professional said.” Even if this current survey accurately reflects the true prevalence of ADHD, using this method is misleading and fails to communicate to families, schools, and policy-makers the importance of a comprehensive mental heath evaluation for accurately identifying which youth truly have a mental health disorder, exactly which one(s) they suffer from, and which youth are displaying typical behavior for their age. Without quality control in this area, over, under, and mis-diagnosis will continue to plague families and schools across our nation.

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