ADHD: Misdiagnosis, Symptoms, & Treatement
During my undergrad (2006) I took an interest in the misdiagnosis of Attention-Deficit Hyperactivity Disorder (ADHD). I wrote many research papers on the rise in diagnosis and compared much of what I learned through research to my personal experiences working in the mental health field with youth. Based on personal experience, I do believe that there are many children who have ADHD and can benefit from medication. On the other hand, I do not believe that the number of young people being diagnosed with ADHD suffers from the disorder. To add, I believe that there are many children who are overmedicated simply for the sake of “controlling” their behavior. Past research confirms much of what I believe to be true based on personal experience.
Although I am sure many of you already know what ADHD is, I am still going to give you a brief definition. Attention-Deficit Hyperactivity Disorder (ADHD) is the most common childhood developmental and behavioral disorder. It is characterized by poor concentration, distractibility, hyperactivity, and impulsiveness that are considered inappropriate for the child's age. Individuals with ADHD are easily distracted by sights and sounds in their environment, cannot concentrate for long periods of time, are restless and impulsive, or tend to daydream and be slow to complete tasks. It is suggested that children rarely finish a task and cannot sit still, and their behavior makes it difficult for them to make friends or participate in school activities. If the condition goes untreated, these individuals may become depressed; suffer more injuries, have low self-esteem and other emotional problems such as anxiety disorders, antisocial behavior, and substance abuse.
Attention-Deficit Hyperactivity Disorder (ADHD) affects 9.4% of American children between the ages of two and 17 years old, with boys being four times more likely to be diagnosed. After years of research, scientists are not sure what causes ADHD. It is suggested, however, that the disorder more than likely results from a combination of factors – genetics, environmental, brain injury, nutrition (sugar, food additives), and social environment.
Specialists say that the behaviors of children with ADHD are those of ‘normal’ children; however, they suggest that a child with ADHD differs because their behaviors are more severe and occur more often. To add to their severe and constant behavioral issues they must have six or more of the following symptoms: Inattention – a) Easily distracted, forgetful, switch from one activity to another b) Difficulty focusing on one thing c) Bored with tasks after only a few minutes d) Difficulty focusing attention on organization and completing tasks (i.e. homework, etc.) as well as learning new tasks e) Appears to have difficulty listening, daydreaming, no focus, moving slowly f) Difficulty processing information quickly g) Inability to follow instruction Hyperactivity – a) Fidget, can’t be still b) Talkative c) Very playful, 'busy', not able to be still d) Difficulty with quiet tasks/activities Impulsivity – a) Very impatient b) No restraint with regard to emotions or verbal communication, does not consider consequences c) Inconsiderate to others Treatment for ADHD often includes medication, psychotherapy, education or training, or a combination of treatments. It has been proven that many of the symptoms can be relieved, but there is no cure for the disorder; individuals can be successful and lead productive lives. There is a long list of common medications many of them are stimulants and have a calming effect on children with ADHD. A few of the more common stimulants are Adderall, Concerta, Dexedrine, and Ritalin; each used with the hopes of reducing a child’s hyperactivity and impulsivity and improving their ability to focus, work and learn, and improving their physical coordination. Now, I’ve shared the opinions of the “professionals” now I am going to share my opinion; which I believe to be professional considering I’ve spent a great number of years working with youth who have been diagnosed as having ADHD amongst other disorders. The information that I share with you going forward will only make sense to you if you have an open mind.
Let me start by saying that through my research I have learned that most researchers agree that there has been an increase in the number of children being diagnosed and medicated; a few psychiatrists go as far as to admit that there is in fact an issue with overmedicating. What I find most interesting about this whole thing is that there are several disorders that have similar symptoms when compared to ADHD, for example, Post-Traumatic Stress Disorder (PTSD). Some of the symptoms of PTSD include agitated behavior, acting out, outbursts, impatience, impulsiveness, difficulty concentrating, and a decrease in the ability to socialize. Sound familiar? Could a child experiencing these symptoms be suffering from ADHD? I have another question for you. What do you consider a ‘normal’ child’s behavior? A ‘busy body’, always climbing and jumping around; not able to sit for more than three minutes without squirming? Running around, possibly moving in a way to cause concern about their safety (falling, etc.)? Having difficulties playing with other children their age; maybe a little selfish or stubborn, don’t want to share? A tendency to be loud, sometimes the loudest one in the group? Extra friendly to strangers; a bit ‘too’ outgoing? Not afraid of much; somewhat of a daredevil personality? The inability to focus on more than one thing at a time; losing focus or showing little or no interest after a few minutes on one project/activity? I have three children and honestly, they all had at least six of these symptoms at one point in their young lives, and my sons even more so than my daughter. Did you know in the 1970s, prior to medication, children were being treated with behavioral therapy? Over the past several years, clinical researchers have suggested that stimulant medications may help children focus and behave in school, but it does not make a difference in the ‘long-term’. Apparently, behavioral and cognitive therapy that is focused on reducing impulsivity and reinforcing positive long-term habits can actually replace stimulant treatment in children AND adults. In 2003, there were 7.8% of children in the US diagnosed with ADHD; 9.5% in 2007; 11% in 2011; and currently, 13.6% of children between 12 and 17 years of age. Research questions the ability of drugs; many researchers wonder if they are doing what they were intended to do. Research shows that medication does not improve symptoms of ADHD alone. Alongside medication, one should include opportunities such as behavior management skills, emotional development/management skills, and improve the areas where they are lacking strength (i.e., learn good studying habits to do better in school). Another very important thing to consider is that children with behavioral and emotional issues tend to have parents that are stressed out as they try and cope with their children’s difficulties. Research indicates that parents who learn to deal with their child’s behaviors or emotional problems will find that their children can also cope better and therefore behave and adjust accordingly. Unfortunately, children who become easily excitable, boisterous, or disobedient are often described as hyperactive; a list of the behaviors that most commonly cause conflict or disturbance. By diagnosing a child with ADHD, the blame for the undesirable behavior becomes the fault of the child. In many cases, the other aspects of the child’s life are overlooked but could reveal other reasons as to why the child is restless or disobedient. It is easier to place the blame on the child's perceived faulty brain than it is to ‘dig in’ and get down to the real root of the problem. Once the diagnosis has been established, there is no need to look for making improvements in the environment, eating habits, and so on. By medicating the child, the result is a more compliant or submissive child, but it is only a temporary ‘fix’ to what could be a permanent problem. There are alternatives to helping a child that may have the symptoms some consider ADHD. Alternative 1: There are many natural remedies; most health food stores carry various supplements that can decrease and even eliminate ADHD behavior. Most of the supplements claim the same results: a decrease in hyperactivity, increased attention span, fewer mood swings, and a reduction in impulsiveness and aggression. Parents are drawn to these remedies because there are little if any issues with harmful side effects. Alternative 2: An alternative to (or addition to) prescription drugs and natural remedies is psychotherapy. Behavior modification is a great example of this. It involves direct negative or positive reinforcement of behavioral changes. The child who has difficulty maintaining control might be rewarded by learning to positively adjust some of his behaviors. Even if the child is unsuccessful after trying, he should be rewarded for trying. It is the rewarding of the struggle towards changing the behavior that will encourage the child to continue trying until he is successful in achieving the desired behavior. The therapist should meet with the child and the family with hopes to help them to develop necessary skills to improve with relating to one another. Alternative 3: Other strategies include support groups for children, social skills training groups, and educational specialists. Support groups involving children with ADHD provide an arena to discuss suggestions from both children and adults on how to handle certain issues. This can provide a support group for the child who might feel isolated from other children because of his behavioral issues. While working on issues, the child can form relationships and gain feelings of acceptance. Social skills training groups help children learn how to interact with one another. The therapist provides instruction on appropriate behaviors and the child gets to practice these behaviors in a group. The educational specialist will work with the child on overcoming issues and struggles with relation to school. The specialist will help the child keep track of assignments, books, and papers; time management, develop study skills and writing. In conclusion, there is a tremendous amount of information available to those who are dealing with children who have behavioral and emotional issues. It can be overwhelming and difficult to know if they are making the right choices for the child so here are some important things to consider: a) Seek medical advice from a trusted physician with experience in dealing with children who suffer from behavioral and emotional issues b) Weigh all the facts before deciding on prescription therapies c) Become involved with the people in the child’s life outside of the home (i.e. teachers, etc.) d) Don’t blame yourself or the child e) Discipline is necessary for structure and guidance (within reason) f) Avoid screaming matches – it is counterproductive g) Avoid comparing – what work’s for your neighbor’s child who has ADHA may not work for yours h) Have a support system – join a support group, get family to help, get professional support i) Most importantly….educate yourself Please remember that there is no quick fix on how to handle any child with behavioral and/or emotional problems. The challenges are very real but not impossible to manage. Whatever course of treatment, parents/caregivers should be well informed and comfortable with all decisions concerning the child. Ultimately, it is up to us as adults to think and educate ourselves. Medication is a quick fix, not an overall solution. These children grow up and become adults labeled, medicated, and suffering the consequences of our choices.
It takes a village....