Misdiagnosis of Attention Deficit Hyperactivity

¶ … misdiagnosis of Attention Deficit Hyperactivity Disorder. The writer explores the question of medical vs. social cause and the legitimacy of diagnosis. In addition the writer discusses treatments and what harm they may pose to the misdiagnosed as well as what pressure parents often face to diagnose their children with a learning disability.

Attention Deficit Hyperactivity Disorder (ADHD) and Attention Deficit Disorder (ADD) have been the focus of media attention for more than five decades. One of the problems with the disorder is that there is no definitive medical test to prove or disprove its existence. With the inability to diagnose with concrete medical fact parents often find themselves pressured to accept a subjective diagnosis and place their child on medications that are as controversial as the disorder is. There has always been a question as to whether or not the disease is actually medically legitimate or if it is caused by social attitudes. Because of the limited legitimacy in the diagnosis there is concern about treatments and potential harm to the misdiagnosed. It is important to determine when the diagnosis is legitimate and when it is simply school or physician pressure so that parents can make the best decisions about their child.

The Problem

Congressional hearings recently uncovered a nationwide problem when it comes to ADHD, schools and parents. According to the members of congress that testified parents nationwide are being pressured by the schools to place their child on medications for ADHD and ADD. "In some cases they were told their child would not be allowed to attend school if he did not begin taking psychotropic drugs. One parent who was given the option of placing her son on a stimulant drug or removing him from school elected to home school her son. She told me that it just didn't make sense that a straight a student would be labeled "learning disabled." A Douglas County parent I spoke with said she was told her son had ADHD. What she was being told about the behavior her son supposedly exhibited and what she observed were not consistent. She investigated the matter and the school's special education director eventually admitted that she had coaxed the teacher to answer the questions of the checklist used to determine if the child had ADHD in a certain manner so her son "Would get the help he needed." This infuriated her so badly she removed her son from the school (Congressional, 2000)."

These stories are not uncommon and resonate throughout the nation according to those involved in public office, schools and the field of medicine.

Detractors from the large number of ADHD diagnosis's each year point to finances as a reason for the increase in diagnosis. School systems are given a set amount of extra funds for each child diagnosed with a learning disability. ADHD is not definable by concrete medical standards therefore a diagnosis can be manipulated and achieved through correct answers on subjective questionnaires.

There is a constant question about the legitimacy of medical diagnosis vs. social diagnosis and schools pressuring parents to put their children on medication creates a valid argument for at least part of the children on meds being on them because of social diagnosis vs. medical diagnosis.

The problem has become so prevalent that congress recently appointed a subcommittee to determine whether schools are receiving financial incentives for the number of children being diagnosed with ADHD which would lend strength to the argument that there is a social diagnostic movement underway to diagnose children and place them on meds (Practical, 2000).

One child was reportedly threatened to be removed from school if his mother refused to place him on ADHD medication. She reluctantly agreed and he displayed problems. He had negative affects from the medication that included psychosis, and she removed him from the medication. Further investigation determined that he was not ADHD and was being medicated for a disorder he did not have (Hearn, 2004).

When she stopped the medicine, the school reported her to state child protective services for child abuse. Though charges were dropped, the Weathers case has become a symbol of the simmering controversy surrounding attention deficit disorder/ADHD, treatment for it, and the subjective diagnostic tests some critics say has led to an overuse of stimulants in schools (Hearn, 2004).

Though there is no official count of people claiming coercion, (Weathers says some 800 parents have logged complaints of similar coercion on her website (www.ablechild.org),child abuse allegations appear to be infrequent, perhaps because states are moving to pass laws that to some degree limit what schools can say or do regarding ADHD and other behavioral disorders.

To date, according to activists who track the issue, seven states have laws prohibiting school personnel from recommending psychotropic drugs for children. Over the past few years, 46 bills in 28 states have either passed or are awaiting action (Hearn, 2004)." recent study in Australia produced even more shocking results. According to this study on ADHD children and misdiagnosed there were a full 75% of the children in the study misdiagnosed. According to the published report following the study the children being medicated with stimulant medications were at risk for side affects and addiction for a medication they did not even need to take (Clarke, 2004).

In our experience, many of the children misdiagnosed with ADHD in fact are assessed to be suffering from significant developmental and learning disorders; attachment problems, anxiety or depression (Clarke, 2004)." Coupled with the misdiagnosis was the nationally high rate of prescriptions of stimulant drugs prescribed by WA doctors to treat ADHD - due, the report said, to a lack of knowledge about other possible therapies. "By virtue of their training and workload it is likely that pediatricians are more prone to use drug therapy in the first instance than the other therapies recommended for the management of ADHD," the report said. "There may be many children receiving stimulant medication when it is not necessary or warranted," the report said (Clarke, 2004)."

Doctors see children with ADHD. They also sees children with learning disabilities, depression, dysfunctional families, hearing loss, severe anxiety, seizure disorders, psychosis and plain old boredom who have had ADHD misdiagnosed by doctors (Poirot, 2000).

The children are inattentive, energetic and impulsive, they fidget, daydream, don't pay attention and are academic underachievers. For these kids, the physician's long-held dictum, "First, do no harm," requires a prerequisite: First, get the diagnosis right (Poirot, 2000).