Mis-diagnosing Children with ADHD
Why does it see that there are so many children today with the diagnosis of Attention Deficit Hyperactivity Disorder – ADD ADHD?
As I get older the answer becomes clearer to me.
The reason there are so many children diagnosed with ADHD today is that physicians, psychologists, therapists, and/or parents, rush to this diagnosis without doing their “due diligence” in the diagnostic process.
In other words, they cut corners and rush to judgment. They make the diagnosis of ADHD too soon in the process simply to save time and effort.
Here is the Road to a Bad Diagnosis:
1. A physician, psychologist, or therapist is well versed in the diagnostic criteria for ADHD.
2. A parent brings in a child for an evaluation because of behaviors at home or at school.
3. The child meets the diagnostic criteria for ADHD.
4. Therefore, the child has ADHD. Simple. Mission accomplished!
But this is absolutely the WRONG WAY to make the diagnosis of Attention Deficit Disorder.
Even according to the diagnostic criteria for ADHD from the Diagnostic and Statistical Manual ( DSM-4 ), just because a child meet all of the criteria for ADHD does NOT mean that he gets the diagnosis.
Rather it is a child who meets all of the diagnostic criteria AFTER an entire series of other possible explanations have been RULED OUT first!
“The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).”
And this is written with the assumption that other medical conditions that might also explain the symptoms have been ruled out.
This step of ruling out a long list of other explanations is ignored in the diagnostic process almost every time!
Before a Diagnosis of ADHD
Before your child is given the diagnosis of Attention Deficit Hyperactivity Disorder, the following long list of medical and mental health possibilities must be RULED OUT.
And by RULED OUT we mean that the physician, psychologist, therapist, and you – the parent, must carefully consider each other possible explanation, and be able to honestly say, out loud, “NO, THAT’S NOT IT.”
Here is out list of other reasons why children can be inattentive, impulsive, hyperactive, show temper, have poor focus, or look like they are ADHD. Each must be considered and RULED OUT:
- FOOD ALLERGIES – This, in our experience, is the most common alternative cause;
- ENVIRONMENTAL ALLERGIES
- HEAD INJURIES – Can be caused lots of ways, from forcep deliveries at birth, to car accidents, to “baby shaking,” to Fetal Alcohol Syndrome or Drug Exposure in utero, to falling out of a crib, to falling and hitting your head, to playing soccer and heading the ball, and many more;
- BIPOLAR DISORDER or MANIC DEPRESSION – Studies show that 15% of children who are diagnosed as having ADHD actually have early onset Bipolar Disorder. Studies also show that there are as many people born with Bipolar Disorder as there are people born with ADHD. You cannot make a diagnosis of ADHD without ruling out Bipolar Disorder;
- PERVASIVE DEVELOPMENTAL DISORDER
- TOURETTES SYNDROME – Basically ADHD with tics;
- AUTISM OR ASPERGERS
- OTHER PSYCHOTIC DISORDER
- ANXIETY DISORDER
- OBSESSIVE COMPULSIVE DISORDER
- DISSOCIATIVE DISORDER
- CHILD ABUSE OR POST TRAUMATIC STRESS DISORDER
- THYROID PROBLEMS
- MENTAL RETARDATION
- LEAD POISONING OR OTHER HEAVY METAL POISONING
Only AFTER each item on this list has been considered, and each has been RULED OUT, can the diagnosis of ADHD be considered.
Results of Cutting Corners
Cutting corners in this important area of making a diagnosis leads to children being put on medications that not only do not have a chance to help them (because they aren’t ADHD), but can actually cause serious problems.
For example, does Stimulant Medication such as Ritalin cause tics?
No. But a child diagnosed with ADHD, who actually has Tourettes Syndrome, and is given stimulant medication, will develop tics because of the stimulant medication.
Are temper outbursts an indication of ADHD?
No. They may occur with ADHD, but they point more toward either head injuries, early onset bipolar disorder, childhood major depression, OCD or anxiety disorders. And if such a mis-diagnosed child is given stimulant medications it may result in explosive temper outbursts, increased anxiety or compulsiveness, or even suicidal thinking.
Symptoms of head injuries, bipolar disorder, tourettes, autism, schizophrenia, anxiety, obsessive compulsive disorder, depression, and post traumatic stress disorder, can all be made WORSE by treating a child for ADHD with stimulant medications.
Please make sure that you get a good diagnosis for ADHD before beginning any stimulant medications. This is where to make the investment of time and money – in the diagnosis.