Danville Express

Living - August 31, 2007

The 411: ADHD diagnosis not to be taken lightly

by Katharine O'Hara

The high number of children diagnosed with attention disorders in recent years has led several experts to question whether they are an epidemic sweeping today's youth, or simply a question of over-diagnosis. Approximately 4 million children in the United States ages 3-17 (7 percent) were diagnosed with Attention Deficit/Hyperactivity Disorder (ADHD) in 2005, according to a recent report released by the Centers for Disease Control and Prevention (CDC); of these, boys were more than twice as likely as girls to be diagnosed with the disorder.

ADHD is a chronic behavioral and developmental disorder primarily characterized by inattention, hyperactivity and impulsivity, and is often discovered during childhood or adolescence, but sometimes not until adulthood. CDC lists symptoms as distractedness, forgetfulness, losing things, organizational issues, excessive talking, fidgeting, often interrupting or intruding on others, impatience, etc. Attention Deficit Disorder (ADD), the only name for the disorder before 1994, refers to those who experience the same symptoms as ADHD, but do not have the hyperactivity aspect.

Some teachers who observe even slight inattentiveness or over-activity in their students are advising evaluation for ADHD and many times push for prescribed medication. However, it is simply unrealistic for any parent or teacher to expect a typical, vivacious 7-year-old boy, or energized high school football player for that matter, to sit still and quiet in a desk for six to eight hours a day. With this narrow perspective of how youths should behave, many doctors may pass off other attention issues (due to visual, auditory or motor difficulties), or even perhaps essentially normal behavior, as ADHD, due to pressure from various sources (parents, teachers, etc.). It is important to remember that young children are, after all, supposed to wriggle and run around to a certain extent, and that each and every individual develops at a different rate.

Because ADHD symptoms closely parallel symptoms of other mental illnesses such as depression or bipolar disorder (which can grow worse without treatment), it may be difficult and time costly to correctly diagnose the disorder. Many times ADHD prescription medicines are incorrectly prescribed and can actually detract from treating the true, underlying condition.

The drug methylphenidate, the generic name for a group of amphetamines that includes Ritalin and Concerta, has been at the forefront of controversy in recent years, as other drugs in the same category include cocaine, morphine, opium and methadone, and side effects can include anxiety, heart palpitations and increased blood pressure. Thus, taking these medications could result in especially disastrous effects if a child does not actually have ADHD.

Another controversial motive behind ADHD diagnoses is that the College Board offers students extra time and other accommodations on the SAT for those with learning disabilities. Many feel it is easy for those diagnosed to use an ADHD diagnosis to their advantage, and sometimes only at their convenience. Additionally, I have heard of numerous instances at my own high school of kids selling ADHD medication for recreational drug use.

Misdiagnosis in a sense absolves children of the responsibility to change their behavior (if they do not truly suffer from the disorder). Mistakenly associating behavior with ADHD excuses inappropriate behavior as acceptable and uncontrollable, and doesn't encourage changes in those who are capable of it.

Numerous adjustments can be made within the classroom that can accommodate students' varying learning styles, eliminate hazardous misdiagnosis and unnecessary prescription medication, including: modification of the classroom setup, more kinesthetic activities, and more project-based learning.

While misdiagnosis is a prevalent issue, proper diagnosis and treatment of ADD and ADHD can also be beneficial in a teenager's life. A San Ramon Valley High School senior (who requested anonymity) describes her own experience with taking Concerta to control her symptoms of ADD, which she was diagnosed with at the end of her freshman year.

"I saw a psychologist who asked me a lot of questions, eventually diagnosed me with ADD, and recommended I give medicine a try to help me focus in class," she said. "I had never been able to focus before I went on the medication, which helps me out a lot."

The only side effects she complains of are difficulties sleeping if taken too late.

"People are typically surprised to hear I have (ADD). Since I don't have ADHD, people can't really tell, but might think I'm just a little out of it sometimes," she added. "As a child, before I found out, everyone just thought I was a little bit of a zoner."

When asked if misdiagnosis of ADHD is a danger to kids who don't actually suffer from the disorder, the teen replied, "It's not an imminent danger, but I think it can definitely affect how kids view themselves."

"I don't take Concerta that frequently anymore, and definitely won't as an adult. I will probably take it for taking tests in college, but I've become aware that I can achieve my goals and survive day to day life without it," she concluded.

Instead of grouping all fidgety kids with short attention spans into the ever-expanding ADHD category, it is important that children and teens with suspect behaviors undergo extensive evaluation so their unique issue is properly identified and treated, whether it be ADHD or any other disorder, and so those who truly have ADHD can receive the treatment they need.

The 411 offers information and insight on the teen scene by Katharine O'Hara, a senior at San Ramon Valley High School who spends her free time going to concerts, enjoying her friends, and playing the piano. E-mail her at ohara5@comcast.net.

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