New study finds ADHD underdiagnosed
Posted
September 4, 2007 at
10:48 am by
Jessica
While many parents may scoff at the idea that 9% of children have ADHD, the effects are felt by many along with the stigma that goes along with giving these children the proper medication — which can sometimes ultimately make or break a child truly suffering with ADHD. It is now being said that the condition is actually being underdiagnosed, contrary to popular belief.
In an age where every diagnosis is the safety net for every behavior under the sun, it’s no wonder that the kids that were once simply considered “weird”, “hyper”, “naughty” or “eccentric” are now conveniently compartmentalized. Don’t get me wrong, as an adult with ADHD, I am all too aware of the ramifications of blowing off such silly attributions and quirks and suffering because of it.
Perhaps the parents of their blessed “normal” children, will refrain from judgment and ridicule when another parent says their child had ADHD. Unless you’ve been to medical school, trust me, parents don’t really don’t care about your opinion and your acting like it doesn’t exist. Parents without an ADHD kid can’t and don’t understand.
“There is a perception that ADHD is overdiagnosed and overtreated,” said lead researcher Dr. Tanya E. Froehlich, a developmental-behavioral pediatrician at Cincinnati Children’s Medical Center. “But our study shows that for those who meet the criteria for ADHD, the opposite problem — underdiagnosis and undertreatment — seems to be occurring.”
The researchers found that some 2.4 million children between the ages of 8 and 15 meet the medical definition of ADHD, but an estimated 1.2 million children haven’t been diagnosed or treated, Froehlich said, adding that “girls were more likely to be undiagnosed.”
What’s more, children from poor families, who have the highest rates of ADHD, were the least likely to have consistent treatment with medication, Froehlich noted. “In addition, children without health insurance were less likely to be diagnosed and treated,” she said.
Tags: adhd, behavioral-pediatrician, developmental-pediatirican, Dr.-Tanya-E.-Froehlich, Health, special-needs |
10 Responses to “New study finds ADHD underdiagnosed”
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1. Petulant Pixie said:
September 4, 2007 @ 1:10 pm
It’s a little more complicated, though, Jess. *I* met the criteria for ADD when I was a child/teen. Katie meets the criteria for ADHD. The one part that’s up to personal interpretation is this: …symptoms … have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level.
Who determines to what degree the symptoms are “maladaptive”? Certainly, some of my teachers felt that my symptoms were maladaptive (hence my need to repeat the 3′d grade). But, others found them within normal range. Same with Katie. Obviously, if you’ve got all teachers and medical professionals in agreement that the child’s symptoms are maladaptive, then it’s clear cut. It’s when they’re marginal that the condition might very well be considered “underdiagnosed” or “undertreated”. But, my question is….what’s the outcome of this “undertreatment”?
I could have been medicated, and it may very well have made years kindergarten-7th grade a LOT easier. But, I wasn’t, and therefore had to learn to work with my “condition”. Eventually, I would have had to learn to work with it anyway, to be a functional person. Katie has an advantage that I didn’t, she has a parent who understands where she’s coming from and who can help give her some tools and have patience with her. I would never consider medicating Katie with her functioning level. She has some definate issues with focus and attention and being able to sit still and be quiet, but we have been able to work with her on those areas and make enormous improvements without medication.
That’s not to say that ANYONE can or should go without meds. It’s a lot like diabetes, I guess. I tried and tried to control my gestational diabetes with diet and exercise and just couldn’t. It wasn’t my fault, it wasn’t that I didn’t try hard enough, it just was not possible and I needed insulin. Some people, by the grace of God or biology can control it without meds–that’s like Katie and her undiagnosed ADHD. But, other’s cannot, and that’s why the meds are there. But, just like diabetes, the meds are not a cure-all, there still needs to be work on the part of the patient (with diabetes to continue to control diet and exercise and with an ADHD patient to continue to learn adaptive skills). I still totally believe though that a non-medicinal route should be tried first in both cases and meds should only be used when they cannot be avoided.
2. Jessica said:
September 4, 2007 @ 5:09 pm
You have brought her to a behaviorial/development pediatrician and had all the testing done and they have diagnosed her with ADHD?
3. Kristy said:
September 4, 2007 @ 8:33 pm
Why do poor children have higher rates of ADHD? What is that based on?
Honestly, the thing that bothers me the most is when adults use ADD as an excuse for their plain ol’ flakiness. It seems like just about everyone I meet these days practically brags about how “Oh, I’m so ADD. I can’t remember anything.” Are we just destined to become a nation of shrugger-offers? Is the ability to concentrate on anything just not even seen as having value anymore? That is the feeling I get lately.
4. Petulant Pixie said:
September 4, 2007 @ 8:47 pm
[quote comment="107422"]You have brought her to a behaviorial/development pediatrician and had all the testing done and they have diagnosed her with ADHD?[/quote]
No…but with my degree in psychology and my experience as a social worker, screening people for conditions, I would guess after reading the DSM criteria for ADHD and finding that she meets just about ALL of the listed criteria, that if I were to take her to be evaluated, she would probably get the diagnosis. The two markers that would disqualify her would be the input from her parents and from her 2nd grade teachers. Those observations are as critical in a diagnosis as how they perform on the tests themselves.
Since *I* don’t feel her symptoms are maladaptive, why would I take her in to have her evaluated? Why would any parent? That’s the point I was making, I’m betting that a lot of the undiagnosed, untreated ADHD mentioned in the article goes on because parents and/or teachers don’t feel the child’s symptoms are causing enough trouble to be treated medically. But, going off the list in the DSM and from my experience, I’m betting if I did take her in, neutral, without input from myself or from her teacher, that she’d test within the range of getting the diagnosis.
I don’t know why you take it so personally when people decide to take a different approach to this, though. I don’t disapprove of your approach. Not at all. I know that you’ve researched and done everything you need to do and are doing what’s best for YOUR CHILD. I realize there is the stigma there of the “lazy parent” who drags their normal but energetic child in to be put on ritalin without really having ADHD (and believe me, those people are out there!), but that isn’t YOU, and nobody would ever suggest it is. So, why do you get so defensive when someone takes a different approach? What we’re doing works, and it may very well be because Katie’s behaviors aren’t anywhere near as severe. There is a gradient. It’s not just black and white. There are shades of gray and it’s in those shades that the questions come in.
5. Jessica said:
September 4, 2007 @ 10:23 pm
No…but with my degree in psychology and my experience as a social worker, screening people for conditions, I would guess after reading the DSM criteria for ADHD and finding that she meets just about ALL of the listed criteria, that if I were to take her to be evaluated, she would probably get the diagnosis.[/quote]
Okay, just what I thought, she hasn’t been properly or formally diagnosed with ADHD. “Probably” isn’t a medical diagnosis.
6. Jessica said:
September 4, 2007 @ 10:27 pm
There is a difference between using “ADD” as a figure of speech and really having it.
I think the reason people use it metaphorically is because people have so much going on these days. We have information overload, stress and “to do” lists a mile long and demands left and right. This is also different from having a true, bio-neurological disorder.
7. Petulant Pixie said:
September 5, 2007 @ 6:44 am
[quote comment="107457"]Okay, just what I thought, she hasn’t been properly or formally diagnosed with ADHD. “Probably” isn’t a medical diagnosis.[/quote]
No…but again, why would ANYONE go and get a diagnosis if they didn’t feel the condition needed treatment? Hence the topic of your blog….underdiagnosed. How can the author of that article say that the condition is underdiagnosed according to your thought process that you have to be DIAGNOSED in the first place? I don’t see how you can believe that it’s underdiagnosed if you insist on a diagnosis, that logic makes no sense.
I’m saying that since Katie has NOT been diagnosed, but she has symptoms, and therefore would perhaps be one of the “underdiagnosed and undertreated” mentioned in your original blog entry. If I had her diagnosed, then she wouldn’t fit that, would she?
8. Jessica said:
September 5, 2007 @ 8:46 am
No, you’re assuming that an MD would automatically diagnose her with ADHD based on what you say, and that isn’t the case.
Trust me, you would know in your heart if Katie truly had ADHD. She wouldn’t be able to manage with a few adjustments. A few symptoms here and there, doesn’t constitute an ADHD diagnosis.
I do believe however, that lack of resources or education and sometimes a fear of stigma does account for why some parents won’t get an official diagnosis. It’s not about kids in which you could finagle the system or lie in order to get them diagnosed (it takes a lot more than, “Oh, my kid is hyper and doesn’t concentrate”). It’s about children whose brain does not allow them to complete tasks or focus and who are falling behind academically, have difficulty making friends and have a difficult time trying to reconcile why they are unable to control their impulses, with significant remorse and guilt and shame over their inablity to manage their impulses, and that’s just some of the issues they face. A lot more goes into taking a step towards medication. There is no evidence that things like diet or discipline or behavior modification as an effective tool for a formally diagnosed ADHD patient.
Besides, it’s really not about what other parents think, it’s between a parent, their child and their doctor, ultimately and what is in the best interest of the child. Unfortunatley, there is a lot of misinformation, myths and outdated information out there.
9. Alexia said:
September 5, 2007 @ 5:09 pm
There isn’t a “real” test for ADD. And my son was diagnosed with it, but the medicine is so hard on him I took him off it. You can’t convince me it’s an acceptable trade off for him to not eat and not grow.
I still think that back in the day there were other ways to deal with it. 9% of the kids I went to school with didn’t fail and/or drop out.
10. Jessica said:
September 5, 2007 @ 6:00 pm
ADHD medication can be tweaked to a point where it’s comfortable, and kids will eat and sleep while on it if it’s the right dosage. It can stunt growth somewhat, but the verdict is still out as to whether that’s permanent or not. For us, it’s not an issue as our son is very tall for his age.
Nobody should have to convince you to put your child on stimulants, but they are one of the most widely studied drugs on the market and their safety has been confirmed through years of observation and research. If your child is able to function and do well in school without it, then that is a decision only you can make and he probably doesn’t need it. The decision to go on medication should not be taken lightly. Some kids are not able to do function properly without the medication and for them, the medication is a real life saver, making the difference between a miserable existence and a quality of life.