|
There is a growing concern today that some children are being improperly diagnosed as having ADHD (Attention Deficit Hyperactivity Disorder). Another concern is that there are also several other children who have ADHD but yet have never been diagnosed.
The nation’s pediatricians hope to calm these concerns by issuing their first policy on how to determine precisely who actually has this disorder. This report can be found in The Journal of Pediatrics. It is aimed specifically toward those children who are between the ages of six to twelve years old. According to this policy, the American Academy of Pediatrics (AAP) recommends that doctors use DSM-IV. This is a precise summary of behaviors which has been developed by the American Psychiatric Association in order to properly identify children who have ADHD. Harvard Medical School pediatrician James Perrin co-chaired the panel that wrote this new policy. He states that prior to the release of this study, two-thirds of the primary-care doctors who were diagnosing children as having ADHD were not using this scale. He continues on to state that approximately 75% of children who are between the ages of six and twelve years old have been diagnosed as having ADHD. He openly admits that, "Doctors have been asking us for the best science on this. Some children who have been diagnosed don't have ADHD, and others do have it and are never diagnosed."
The DSM-IV lists specific signs of hyperactivity, inattention and impulsive behaviors which professionals should look for before pronouncing a diagnosis upon a child as being ADHD. Now, children who qualify for such a diagnosis must show six of the nine behaviors that are indicated within this report, and these symptoms must have been observed within at least two different settings. For instance, the behaviors must be occurring both at home and at school, for a period of at least six continuous months. The report also states that these behaviors must also be imperative unto the child, either academically or socially. Some of the behaviors which would fit into the description within each of these categories include:
Hyperactivity: The child will often talk excessively or leave his or her seat at times when remaining seated is expected of them.
Inattention: The child often has difficulty sustaining attention in tasks or in play activities. It may often appear as though the child often does not seem to listen when spoke to directly.
Impulsivity: The child often has difficulty waiting his or her turn, and thus he or she will often interrupt or intrude upon others.
The AAP advises doctors to speak with both parents and teachers or other school officials when they are in the process of making such a diagnosis. Peter Jensen is the director of the Center for the Advancement of Children's Mental Health at Columbia College of Physicians and Surgeons in New York. He suggests that when physicians are in the process of making an ADHD diagnosis, which doctors should also screen children for other emotional disorders, such as depression and anxiety. There is good reason for doing this is because statistics show that two out of every three children who are diagnosed as having ADHD will also have other disorders that need to be treated but are oftentimes not even diagnosed.
Lawrence Diller of Walnut Creek, California states that he believes that "These guidelines are right - they're what needs to be done."
Nevertheless, Linda Nathanson-Lippitt, an Atlanta pediatrician and expert in neurological disorders, feels that managed care "imposes a lot of pressure to medicate kids quickly... If you're lucky, third-party payers allow you 15 minutes with a patient, and you can't do a decent ADHD work-up in that time." This has led Nathanson-Lippitt to no longer accept patients who rely upon insurance, even though she does both understand and agree that "in the world of real medical care, it becomes virtually impossible for many doctors to do this kind of assessment without literally losing money."
The National Institute of Health estimates that between 3% and 5% of the children within the United States have now been diagnosed with ADHD. Nevertheless, there are fewer than 3% of these children who are actually receiving any medication for it. In fact, it is primarily those children who live within upper-middle-class families who are receiving proper diagnosis and medication for ADHD. On the other hand, poor and minority youngsters are amongst the least likely to be properly diagnosed with ADHD or to receive the appropriate medication.
| 
