Misdiagnosing of Attention Deficit Hyperactivity Disorder
It is common knowledge the increase of the diagnosis for Attention Deficit/Hyperactivity Disorder, commonly known as ADHD. Some teachers have reported that in every class they teach, the teacher have at least one child that suffers from ADHD. Unfortunately, there has been miscommunication between teachers, physicians, and parents; the number of children being diagnosis with ADHD is at a rise .
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The Role of the School
The school is a main component in a child becoming diagnosis with ADHD. The student’s teacher is the first to make an implication that the child may be having difficulties focusing in class; a trained professional will then come into the classroom and examine the child’s behavior.
Example, does the child have outburst at inappropriate times, when the rest of the class is in line with the activity. There seems to be a problem with the diagnosis of children in the junior and high school level because teachers are with their students for a short period of time, is this enough time to make a diagnosis that a child may be exhibiting signs of ADHD (Sibley, Pelham, Gnagy, Washbush, Kuriyan, Babinski, Molina, Garefino, Karch 2012)? This begins the signs of the miscommunication between the child’s school, primary care taker, and physician.
After a child has been evaluated by a trained professional in ADHD, the child is then taken to their physician with a recommendation of the teacher at the child’s school. Since the lack of communication begins with the inaccuracies of the symptoms that a child may be displaying. A child may not have the same behavior at school and have a different behavior when at home with their parents. Some symptoms that are described in class may not be symptoms to the child’s primary care taker or physicians.
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The Role of the Doctor
At times, some physicians will not take the consideration of the educational professional because there have been reports by teachers (Sibley, Pelham, Gnagy, Washbush, Kuriyan, Babinski, Molina, Garefino, Karch 2012). Because of this lack of communication, the only person that suffers is the child. “However, increasing support for community physicians by offering enhanced training, outreach, and telepsychiatry consultation may be effective” (Morely, P. 385, 2010). Instead of bouncing a child around from teacher to physician, there need to be a common goal, what is best for the child in their different environments?
Different Alternatives to Treatment
Not only does a child become loss in the miscommunication of the diagnosis of ADHD, the treatment is also a constant debate. The school system is quick to push medication to be used for the treatment of a child, the results of a child’s behavior to change in a timely manner is with medication (Dang, Warrington, Tung, Baker, & Pan 2007). Some say there are other ways of treating ADHD without pushing pills into children at such an early age. Some schools have implemented programs “that school nurses could use as an intervention program for students who have been diagnosed with ADHD” (Sibley, Pelham, Gnagy, Washbush, Kuriyan, Babinski, Molina, Garefino, Karch, P. 3, 2012). These programs focus on implementing skills for children with ADHD to be in smaller groups, rather than large classrooms of children. Children are able to focus on their temperament, learning style, activity levels, social influences, family dynamics, and the educational system (Sibley, Pelham, Gnagy, Washbush, Kuriyan, Babinski, Molina, Garefino, Karch, P. 3, 2012). These programs are to helping children with ADHD focus on real life situations and not have to be medicating at such a young age.
Related articles
- Adhd (41staid.wordpress.com)
- Diagnose Me (cutelypoisoned.wordpress.com)
- Is ADHD really on the rise? (psychologymum.wordpress.com)
- Motherlode Blog: Blaming parents for the overuse of ADHD drugs isn’t the best way to bring about change. (parenting.blogs.nytimes.com)
- Classroom Modifications for Students with ADHD (stevensm1.wordpress.com)
Hi Carmen,
I wanted to respond because I feel very passionate about this topic and I wanted to add my viewpoint based on my experiences. My son has ADHD, but now at the age of 14 we have learned to work with this and I am happy to say that he is no longer on any medication, however this has not come about easily. Teachers, medical staff, counselors and his father and I have worked hard for many years so that he could learn how to manage structured settings. I knew at the age of 4-5 that he had difficulties however by Kindergarten he was having so many problems with attention, hyperactivity and impulsivity that it was definitely affecting his education. I was called at work daily from his Kindergarten teacher and told to pick up my son for disruptive behavior. Soon thereafter I began parenting classes, behavior modification training and family/individual therapy, and even after all my efforts, he was still having difficulties. I had a very hard time with several of his teachers, I felt that many of the staff did not want to deal with him and I also felt that they were not trained at all in the area of working with a child who had ADHD or its symptoms. It took the patience and care of his 3rd & 4th grade teachers, along with an IEP team, to refer him for evaluation. You mentioned the steps in the process of diagnosing ADHD, but I feel that there is missing information. From my experience there is a lot more involved but that may be due to my particular school district. For instance the medical professionals did not make a medical determination based solely on IEP recommendations or his teacher’s accounts. These individuals observed his interactions in structured and unstructured settings to observe the behavior that was under question so that a proper diagnosis could be attained.
I wanted to respond to your blog because I feel that you were trying to make a point in favor of alternative treatment of medication for ADHD, and I agree that medication alone is not as effective as pairing meds with behavioral training and counseling. If you strictly medicate in my opinion, the reinforcement for the behavior is not be attended to, resulting in continued unwanted behavior while not taking medication. We wanted to improve his success in and out of the classroom. In his instance, we were advised to only administer his medication if he was going to school, since that was the one environment that I could not be at consistently. The remaining time I was solely using the training I received. Oh boy was homework a fun time around the house (sarcastically)!!!! Another important dimension to add is the family environment. If you have parents who are not willing to participate in the additional effort, work, and time suggested by educators and medical staff, then often times the behavioral techniques and family support strategies will not be effective, which in turn may leave medication as the only option to help this particular population of children.
I agree that the diagnosis for ADHD has been on the rise and I believe that one reason for this is a growing awareness from educators, medical staff, psychologists/counselors and parents. This knowledge is needed, so that these children can receive help. Lastly, I think that adding a section about the parents/caregivers or parenting a child with ADHD would be relevant, since I truly believe that knowledgeable, positive parenting can contribute to a child’s success. There isn’t a parent in this world in my opinion that wants to hear that there is something different about their child. I also believe many parents do not want to medicate their children however in some cases medication along with behavior modification training and family support strategies are the only options. In my sons case these paired efforts have led to his success.
Thanks,
~Lila~
Hey Lila,
Just wondering, were you not part of the IEP team for your son?
I have the Learning Disabilities class with Wakefield and he went over who is supposed to be on the team and he did mention that parents have the right to be on the team.
Parents are essential to a successful IEP. Unfortunately, and this is not in regard to Lila, but many parents do not realize the extent and breadth of their rights over their children’s education, which is a shame.
I completely agree that many parents are not aware of their rights. Again I think this varies depending on the schools and/or districts, educators and school psychologists. Parents should have the opportunity to understand their rights and be provided the necessary assistance, so the best interest of the child will be taken into consideration.
I was a part of the IEP team and ultimately his father and I made the decisions about his treatment plan, but the collaboration from all involved helped us in our decision tremendously.
I have come across two schools of thought on why the rise in diagnosis for ADHD. One is that we are more aware and second one is that we, as a society, are increasingly adamant about placing labels on children. I personally feel that it is a combination of the two. The first one, awareness, is the positive side for we are not just writing the kids off as disruptive. The second I feel has a more negative connotation to it. For me placing a label on a child affects their self-worth and can exasperate the issue. Sometimes kids just need time to mature and trying to “fix” things is not always the answer. Further, physicians have been prescribing medication far to often (especially without concurrent therapy) because we, again our society, expects things to be fixed by a pill. We have to keep in mind that not everything is so simple and there are other treatment options.
If I may, you have a few fragmented sentences in your blog, you might want to watch those in the future. There are a few words that were left out, which made the reading a little difficult. Also, some incorrect words were used that muddled the meaning a bit. Lastly, if you are going to use in text citing also include the reference cite so that we can find the reference.
One of the more intriguing theories to explain an increased prevalence rate in ADHD (mainly in boys and ADHD in girls typically an inattentive type and therefore causes fewer behavioral problems) is due to the increasing demands we are putting on kids in the educational environment. For someone with ADHD, having to sit and concentrate for hours a day is anathema to the way their brain works. At this point the environment is working contrary to physiology. As environmental pressures and demand increase, the student’s ability to control symptomatic behavior becomes more difficult–hence the child comes to the attention of the parents or the teacher.
More than likely the prevalence rate has not changed in the population over time. I think one possible answer is that it went largely undetected because the environmental demands could be more easily tailored to an “ADHD brain”. Some form of ADHD has been in the medical literature since the 1900s when it was first labeled a kinetic disorder.
Throughout the last century we have undergone tremendous changes. When we moved from first an agrarian then to a production and finally to a service information society (where level of education is paramount) the demands of the education system increased. Consider this, summer break comes from a school system in which children were given time to work on farms. On a farm, ADHD is hardly a liability.
Just my two cents.
BTW, general physicians shouldn’t be allowed to prescribe stimulants for ADHD with the freedom they have today.
Carmen,
I feel that your point was a bit weary and are some misunderstandings in the way children are diagnosed with ADHD in a school setting. I agree with you that no teacher should have the right to diagnosed but to only bring up the matter to parents and school administrators. All though procedures change from time to time and from school districts, assessments should be considered not only by teachers, school administrators, and physicians, but most importantly the parents. There are different directions one could take in a matter like this, but the most important of them all is that the family pay a key and important role because of their time spent at home with the child.