Does your child have an accurate ADHD diagnosis?
Recently, a study by the George Washington University Institute of Public Health reported that 12% of U.S. children, a whopping 5.7 million U.S. children ages 5-17, were diagnosed with ADHD in 2011, across all ethnic groups. This is a significant jump since the last time this population was studied in 2003. In fact, a 43% increase. The study also found that more girls have been diagnosed–up from 4.3% in 2003 to 7.3% in 2011–while the rates for boys remained steady. The study did not look into underlying causes for this increase but suggested it could be due to the tendency to over-diagnose and recommended more research. How you can make sure that your child has an accurate ADHD diagnosis? Generally, there are three common routes leading to an ADHD diagnosis: via your pediatrician, via a psychotherapist or via the child’s school. Whichever route you choose, I want to put in a plug for psychological or educational evaluations. Testing can be a great way to understand how your child’s brain works more in depth, how they are performing academically and what is going on emotionally. Only certified school psychologists and licensed psychologists (or neuropsychologists) are trained to and do these types of evaluations. You can go through your public school system for an evaluation. Or, you may decide to see someone in private practice. Both options, although different in terms of cost, time and depth of analysis, are beneficial. Sometimes health insurance companies will pay for testing but not always. Personally, I think these evaluations, however obtained, are absolutely worth it. The comprehensive information that you gain from these reports can be tremendously helpful to everyone–parents, kids, teachers. They assist you in specifically understanding how ADHD affects the brain, behavior and emotion of your child and can validate that she or he really has it. Of course, pediatricians are absolutely helpful and well-informed in the diagnosis process and often they are the first people many parents talk to about ADHD. To make an ADHD diagnosis, they usually rely on speaking with you to get a sense of what is going on with your son or daughter (including gathering additional developmental or family history) and giving you some forms for you and the school to fill out. The Vanderbilt, Conors and BASC scales are common ones. Based on that information and any other relevant information that you have, your doctor will make a diagnosis. Many mental health practitioners do something similar and lots and lots of experts think these are sufficient, which they often are. But, in light of the statistics at the top of this post, what could be happening differently? Most parents want to be sure that their kids have ADHD before giving them medication, putting them in special classes or getting them expensive tutors etc. I think testing provides you with the extra information that promotes a fuller understanding of what is going on for your child. Many pediatricians and mental health practitioners recommend it but some do not. I think reliable testing and valid interpretations of the results could make a big difference. Today, my goal is to encourage you to obtain testing, if you haven’t already, and especially if you are uncertain that your child has been correctly diagnosed. I have seen numerous families in my practice be reassured and enlightened by the results, even though they can be complicated and sometimes overly focussed on weaknesses and problems. While the process of getting tested may be cumbersome, I believe the pros outweigh the cons. If you think your child may be incorrectly diagnosed, I encourage you to speak to your pediatrician or school psychologist and arrange for a formal evaluation.