Overdiagnosing Children With ADHD

I just found this map of how often children are diagnosed with ADHD on parents’ request at a very enlightening post published by feMOMhist:

The good news is that I live in a state that is doing better than many others in this country in terms of this diagnosis. We “only” have 6.1% to 7% of kids diagnosed with and medicated for not being subdued little robots all the time. Just across the border in Missouri, things seem to be worse.

Still, the sad reality of teachers not willing to do anything to get their students’ interested in learning and pushing parents to zombify little children with medication instead remains. Read feMOMhist’s post to see how this is done.

Many people have a lot of compassion towards teachers who do such things. It is hard, they say, to keep a large classroom of small kids interested and engaged in learning. I believe, however, that a teacher who solves this issue by requesting (or sometimes even insisting) that a small child be drugged in order not to create any difficulties in the classroom is a profoundly unprofessional person who should be thrown out of the teaching profession as soon as possible.  Small kids fidget when they are bored. This is not a disease or a mental disorder. The only people with a mental disorder are the ones who believe that such behaviors in children should be addressed through medication.

34 thoughts on “Overdiagnosing Children With ADHD

  1. Thrown out of the profession indeed! I am sure that I would have been diagnosed with ADD, maybe even ADHD if it had been popular when I was a child. And, often a parent’s only defense is to home-school, sadly.

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  2. Not as much flak as you think. I’m a student teacher just getting ready to enter the profession in a couple of months. I think that in all but the most extreme cases, drugging the kid is not helpful at all. In many situations, I believe that the ease of access to medication sometimes blinds very well-meaning people to the fact that some kids are just excitable, and need to move around.

    Whether or not that has anything whatsoever to do with their attention span or ability to learn is uncertain. Certainly we medicate too much.

    However, there ARE some medically necessary instances where a neurochemical imbalance can be corrected by medication and improve student success drastically. But only some.

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  3. I am somewhat bemused by the outbreaks of ADHD that have appeared in the last 15 years or so. I suspect there are a number of causes. It easier for a parent to have the child diagnosed with ADHD rather than acknowledge any fault on their part (i.e., Lack of stimulation, lack of setting boundaries, poor diet). It is also easier for a teacher to accept a diagnosis of ADHD rather than question the work they do.

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  4. thank for the link love. Just wanted to clarify a tiny point, CDC asked parents to report if their child had been diagnosed with ADHD, not that parents requested the diagnosis

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  5. If you look at a map of child poverty in America, it has a high degree of correlation with this map. Children with hunger and a poor diet i.e. lots of sugar would exhibit behaviours that mimic ADHD and dosing the kids with Medicaid paid for medicine is cheaper in these areas than feeding them with proper meals. The minimum wage for a porter or other folks who receive a tip in Atlanta, Georgia is $3.5 an hour. And the Republicans have a bill in the house to reduce food stamps!

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  6. I very much agree with you on this. I come from a clan where children often present some discipline problems, but drugging isn’t the answer.

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    1. Thank you, Tony!

      I expected a lot of disagreement from people on this issue but that seems not to be the case. Let’s hope the attitudes to this are slowly starting to change.

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  7. What interests me about this chart is how it defies my expectations about the diagnosis pattern of ADHD. I would have presumed that it correlated in some way with states which have a much more solidly upper middle class, educated population, because they would be more likely to have access to bestter medical care/specialists, but the most dense diagnosis states are Kentucky, West Virginia, Louisiana, and Alabama. The East Coast in general is more likely to have diagnoses than the West Coast, which fits my presumptions, but I would have expected states like Massachusetts to have it more than West Virginia.

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    1. I think that middle and upper middle class parents have more time to spend with the children playing with them and channelling their energies. Overworked lower middle class and blue collar parents who have to work 2 or 3 jobs might simply have neither time nor energy to do such things for the kids. The quality of a kid’s daycare and school also might be a huge factor.

      When my niece wasn’t in day care and then went to a lower quality daycare, she was very active at home in a way that made being with her very hard. Then, she went to a very high-quality daycare (and very expensive, too) where kids are involved in dozens of developmental activities and her “hyperactivity” simply went away.

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  8. I agree with you that many of the behaviors that we try to medicate away are perfectly normal. If a child’s behavior is really a problem, I think it’s preferable to try to work with them to find solutions instead of immediately trying to medicate them. As a college student with ADHD, I’ve found that something as simple as changing the way I take notes in class can make a big difference to my ability to stay focused.

    I’m mainly opposed to psychiatric medication because of the truly awful effects it can have. I experienced two years of memory loss and cognitive impairment because of an anxiety medication I used to take.* Some medications can be helpful (I’m still taking medication for ADHD), but I’m strongly opposed to prescribing them to children. Kids aren’t usually allowed to make their own medical decisions, and I think that everyone should decide for themselves if the potential benefits of a drug outweigh the risks instead of being pressured into taking it by doctors, teachers, or parents.

    * My cognitive abilities and memory gradually returned when I stopped this medication, but I have since read that for some people, these problems can be permanent.

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    1. Thank you for this great comment, JB! I have also met people who suffered from all kinds of side effects of these types of medication. I’m very glad to hear you are doing better now. But it’s true that for many people after effects last for a very long time.

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  9. The thing is that you [em]can’t[/em] medicate away normal behaviour. ADHD is caused by an underarousal of the cingulate cortex, the part of the brain involved in attention and impulse control. If you were to compare fMRI scans of a healthy child with an ADHD child (which I have), you would see that they are clearly different. Ritalin and other ADHD medications are amphetamines. They have a calming effect on kids with ADHD because they increase arousal in the cingulate cortex, allowing the kids to better regulate their behaviour. If you were to give Ritalin to a child who does not have ADHD, it would (as you might expect with an amphetamine) have the opposite effect. That is to say, if you give a kid Ritalin and it calms him down, that means that he did have ADHD.

    This is not to say that I’m in favour of medication being the first line of defense. There have been plenty of studies (I can try to find some available to the public if you like) showing that the symptoms of ADHD are much less severe in environments where the kids are engaged in something they enjoy. But it’s important to distinguish between “Psychiatric medication should be a last resort, but more people than ever are just going straight to it without trying other things first,” and the reactionary and inaccurate “Kids are being drugged into subservience for just being kids!”

    As a child I was, like most bright children, bored in school. I fidgeted, daydreamed, doodled in my notebook and generally ignored the lesson after the five minutes that it took me to understand the concept of arithmetic or whatever thing they were over-explaining that day. And frankly, I did that until college. I did get screened for ADHD, but I was not diagnosed with it as the psychiatrist rightly took me for a bright kid who was bored with too-easy classes. But had I been misdiagnosed and put on medication, they would have found out quickly that they were wrong.

    Why the huge disparity between states? That I couldn’t tell you. My field is psychobiology, and that’s a question that a sociologist would be better equipped to handle. But it’s food for thought for everyone and something that certainly bears paying attention to.

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  10. Ack, sorry for the incorrect tag, I came here from a WordPress link and didn’t look at the URL to see that this wasn’t a WordPress blog.

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  11. As a parent of a child with ADHD, I am often flabbergasted and even a little hurt at the reactionary and ignorant “drugged into submission” comments I hear from people when discussing the disorder. Reaching the decision to medicate my son was the single most painful parenting decision I have ever made. When the years of cognitive and occupational therapy, the classroom accommodations, dietary changes and scores of other crazy alternatives left us with a boy who felt terrible about himself and who, with his 165 IQ couldn’t complete even the simplest of tasks, we tried medication.

    The first day my son spent on Ritalin all of the amazing things swirling through his overloaded brain settled and for the first time in his life, he was able to share them with other people. He is an amazing kid. This is something I always knew but no one else could see it through the tornado of impulsiveness and frantic, constant motion. I wept at the end of that day, long and hard. I wept for joy at the relief my beloved boy finally felt and for sorrow over the suffering he endured for so long. And rest assured, he is no zombie! He still fiddles and fidgets, he is still a little impulsive, as is typical for a bright, energetic 10 year old.

    If you don’t have a child with ADHD, or haven’t lived with it yourself, you don’t know what it’s like. It feels a lot like a person without kids giving parenting advice. Basically (and with all due respect) you don’t know what you’re talking about so you should probably hold your tongue. Think about the scores of people who suffer with un-diagnosed ADHD who just think they are stupid, or bad or worthless. Think about my son, think about me. And for goodness sake, think before you offer an uninformed opinion.

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    1. I’m sure you don’t realize how unhinged your comment sounds. You must surely think it’s normal to tell complete strangers to hold their tongue. You probably also think that every post in the universe that addresses a wide-spread phenomenon must be about you personally. You also somehow manage to find parenting advice in a post that is very obviously not about that.

      If you seem to believe that approaching strangers with this degree of hysteria is a normal thing to do, I’m honestly not surprised your son has issues. I shudder to imagine what you expose him to on a daily basis.

      By the way, the only reason why anybody would think they are stupid, bad or worthless is that this is the image of themselves their parents offered to them.

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      1. Clarissa, I certainly didn’t mean to imply that your post was about me personally or even about parenting advice per se. I was simply offering up, upon reading through the comments, a differing account, one from a parent who has seen the looks, read the books, and witnessed first hand the suffering ADHD causes and the miracle the appropriate medication can be.

        I admit I sort of chuckled when you called me hysterical and claimed I am the reason for my son’s issues. I wasn’t going for unhinged or hysterical in my comment! I guess if you knew us and could see the interactions we have you could decide whether we are wholesome and well adjusted. You can build your child up every minute you’re together and still have him get off the bus at the end of the day in tears saying things about how ‘bad’ he was at school.

        So hold your shudders. We’re perfectly normal around here. Nothing to worry about. And it’s funny how you can read something and get a completely incorrect sense of what a person is trying to say.

        And also, if one doesn’t have an informed opinion, don’t you think it wise to keep it to oneself?

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        1. And what would make your opinion on ADHD more informed than mine? Your experience of interacting with one ADD child? I have this sort of experience, too. Please see my post on “Dealing with an ADHD student.” I can’t provide a link right now but you can find by entering the title into the search box.
          Sent via BlackBerry by AT&T

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  12. So in your experience dealing with Javier, you can see how ADHD can effect a child’s feelings of self-worth. And I truly appreciate the strategies you employed in your classroom. Those strategies might help for one part of Javier’s day and I’m sure that is a comfort to him. We work with my son’s teachers to provide a solid home-school connection, one that works for all the members of the team. Teachers gain a better understanding of our son and can use a few tried-and-true techniques we have learned along the way, and we learn the classroom vernacular in a way that helps integrate the teachers’ ideas at home. It works a little. But it doesn’t address the whole child and it doesn’t address the child’s whole day.

    When considering the current notion of the over-diagnosis of ADHD I think about my Dad. He dropped out of school when he was in 9th grade in the 1950s. He was always a discipline problem. The nuns would hit him with a ruler, suspend him, all of that. When I was studying for my SATs as a kid, I helped my dad get his GED. Now that I have experience and an understanding of ADHD, I can look back at that time and realize he clearly has some undiagnosed learning disabilities. I keep his struggles in my mind when I consider children who are labeled or treated as behavioral problems. And I think about how my father has lived his entire life thinking he is stupid and incapable of learning. It’s simply not true and it’s a shame he’s had to live with those feelings. Were he a child today, teachers with a greater understanding of learning disabilities and pediatric specialists could maybe have seen him through his struggles. Maybe he would have been diagnosed with ADHD, properly medicated and given the opportunity to achieve to the limits of his imagination.

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  13. Getting Supplemental Security Income for a “disabled” (i.e., diagnosed with ADHD and put on medication) child is a financial lifeline for many poor families. SSI can add up to $30K a year to a family’s income. I have no doubt that families are informed of this through “financial help is available for your disabled child” talk that motivates parents to allow diagnosis/medication as a means to access SSI and thereby feed, clothe, and adequately care for their families. Plus they can also believe that they’re helping their child succeed through medication and the money that pays for better food, clothing, and housing. But I also don’t doubt that there still exist modern counterparts of parents who would do as some did in ages past–laming or blinding children to make them more sympathetic beggars.

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    1. Are you serious?? Surely, this cannot be true, can it? The pharmaceutical lobby is powerful but can it be that powerful? Getting the government to waste taxpayers’ money on creating life-long customers for them?

      Of course, a zombified and stupefied populace that firmly believes in the magic pill’s power to bring happiness is very easy to manage. So, ultimately, everybody wins. Except, of course, those miserable creatures who are pumped full of psychotropics from early childhood.

      Gosh, a responsible parent goes through agonies before offering a simple Tylenol to a kid. What are these people thinking stuffing their children with amphetamines?

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      1. I had a half-serious discussion with a therapist about my sometime inability to cope with the responsibilities of my adult life. I said I wished I could get what an old friend called “crazy pay,” i.e., SSI.

        “Well, you might qualify, but you’d have to be diagnosed as mentally ill, which would follow you everywhere, and you’d probably have to be hospitalized, and you’d have to be on medication.”

        Which, all things considered, was too high a price to pay. I had that choice–many children don’t, however. And the check isn’t written to the kid, but to the parents. I mean, even fully adult politicians and celebrities often can’t resist the allure of ready cash. It becomes easy to rationalize taking the free money if you’re told by everyone around you that you’re doing the best thing for your child. And few children will challenge you on the cupidity issue.

        I know a pediatrician who regularly prescribes medication for children–for one in particular, she said, “His parent is a single dad who works, and he can’t be with him as much as he needs, and this makes life easier for both of them.”

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        1. This is just horrible. I can’t help but feel completely terrified about what the future has in store for us if this continues for much longer.

          And then educators keep bitching about students who are indifferent, have no enthusiasm for anything, and only want to be given the right answers where no thinking on their part has to be involved. How many of these kids were forced to hand over their personalities and brains to pills?

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  14. Thanks a lot Christine. If you hadn’t pulled out the bullshit “I’m a parent so I’m an expert/you’re not a parent so shut up” line, we could have had an interesting discussion about the necessity of medication for some kids and the unfortunate stigma that still surrounds taking psychiatric medication for any reason. From what you described with your son’s situation we are more or less on the same page with regards to when we think medication is a good idea, but by pulling out the ad hominem you made me look like an asshole by association.

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  15. JCM1953 (post 24) has it right. The mother hears from an expert that her child has a condition that can be treated, the treatment will help him perform better in school, and the child’s condition will allow the mother to apply for SSI and get a few extra dollars for her perpetual-crisis budget. That expert has 4 to 8 years more schooling than the mother, and the mother is likely to think “Maybe the expert is right…”. All parties may be making decisions in good faith for the benefit of the child. Perhaps the decisions are wrong in many cases, but that doesn’t imply that all such mothers are intent on scamming the system at the expense of their child’s health. (Of course, there will be a few mothers who believe that the expert is full of B.S., but hey, the drug doesn’t seem to hurt the child, and why not scam the SSI system?)

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