Exactly what behavior truly constitutes ADHD has long been a point of contention among doctors and scientists. The implications of a misdiagnosis — or a missed diagnosis — are far reaching and require serious examination.
In the past decade, the number of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD) has increased. Some doctors believe these numbers point to a better recognition and understanding of the disease, while others are concerned about the possibility of knee-jerk diagnoses and unnecessary drug prescriptions. So how do you know if your child has ADHD? Let’s take a look at the numbers and the research that help make sense of this complicated topic.
What is ADHD?
According to the Diagnostic and Statistical Manual of Mental Disorders (DSM5), “ADHD is characterized by a pattern of behavior, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings.” These patterns of behavior are divided into either inattention or hyperactivity-impulsivity, and include symptoms ranging from failure to listen or follow instructions to fidgeting or excessive talking. The symptoms must be present for at least six months and started manifesting before the age of 12. A comprehensive list can be found on the CDC website.
As of 2012, 5.9 million (9.5 percent) of U.S. children between the ages of 3 and 17 had at some point been diagnosed with ADHD, according to the CDC. Historically, that number hovered between 3 and 7 percent. By 2013, that number had risen to 6.4 million children for 11 percent of the population, as the New York Times reports. That more than 1 in 10 children have received an ADHD diagnosis is a positive sign for some experts, indicating that the disease is better recognized and treated than in years past.
Others have concerns that roughly 2.8 million children could be unnecessarily given powerful prescription stimulants like Adderall, simply to calm otherwise healthy behavior or to improve performance at school, according to another New York Times article.
In part, the dramatic rise in diagnoses may be a result of worried parents and teachers taking children to the doctor too early, particularly kindergartners young for their class, according to Michigan State University. Todd Elder, an economist at Michigan State University, conducted a study and found that the youngest kindergartners are 60 percent more likely than their older classmates to be diagnosed with ADHD. He estimates that 900,000 children are likely misdiagnosed.
These numbers are not evenly distributed between girls and boys, however. The percent of boys diagnosed with ADHD is 13.5 percent, while only 5.4 percent of girls ever receive a positive diagnosis. In high school, these numbers are even higher with a diagnostic rate of 10 percent for girls and 19 percent for boys.
Although diagnoses in girls have increased 55 percent from 2003 to 2011, as QZ reports, misdiagnoses can have consequences for the female population — girls with ADHD are three to four times more likely to attempt suicide, according to the American Psychological Association. One of the issues with misdiagnosing girls and women is that ADHD can present very differently than it does in boys. The disease in girls is more likely to manifest as inattentiveness and disorganization, rather than hyperactivity, and may present much later than it does in boys. Depression and anxiety are more common in girls with ADHD, and can therefore lead to an incorrect diagnosis.
Properly Diagnosing ADHD
Properly diagnosing ADHD is crucial for developing children. Over-diagnosing can lead to unnecessary expenses and prescription drug abuse, while a misdiagnosis can have its own consequences. Ensure your child is old enough to be presenting symptoms and be patient and discerning while seeing if their behavior actually is indicative of ADHD. It is important to eliminate all other possible causes for hyperactive or inappropriate behavior, including inconsistent discipline, boredom, poor teaching, or even bullying. Stress, fatigue, or another underlying illness could also exacerbate problem behavior.
If you think visiting a professional is the next step, finding the best doctor for you and your child’s needs can be daunting. Luckily, SingleCare provides its members with a comprehensive online database that makes searching for the right specialist stress-free. Even members without any coverage can get the same negotiated prices as those who are insured. SingleCare can help you focus on supporting your child, and finding the right treatments without stressing over costs — whatever the state of their health might be.
(Main image credit: dima_sidelnikov/Thinkstock)