ADD Over-Diagnosis in American Children: A Critical Review
This paper examines the widespread over-diagnosis of Attention Deficit Disorder (ADD) and ADHD among American children. It reviews the disorder's uncertain causes, the lack of a definitive diagnostic test, and the dramatic rise in stimulant medication prescriptions since the 1980s. The paper highlights expert concerns that gifted children, emotionally immature children, and those from chaotic home environments are frequently mislabeled with ADD. Drawing on multiple researchers and clinicians, it argues that physicians, parents, and teachers must take a more careful, individualized approach to diagnosis before resorting to medication.
- Introduction: Scale of ADD diagnosis and medication in America
- The Causes of ADD: Uncertain genetic and environmental causes of ADD
- Misdiagnosis and Overlapping Conditions: Giftedness and maturity confused with ADHD symptoms
- Analysis and Conclusions: Call for careful individualized diagnosis over quick medication
✍️ How to write this paper — guide, tools & examples ▾
What makes this paper effective
- Uses concrete statistics (e.g., five million diagnosed children, medication numbers doubling every two years) to ground its argument in measurable evidence.
- Anticipates counterarguments by acknowledging that ADD is a real disorder before arguing it is over-diagnosed, which strengthens the paper's credibility.
- Draws on a broad range of cited experts to support the claim that gifted children are frequently misidentified with ADHD, lending academic weight to what could otherwise seem like a fringe position.
Key academic technique demonstrated
The paper effectively uses the technique of convergent citation — marshaling a large list of named researchers who independently reach the same conclusion — to demonstrate that the giftedness-ADHD misdiagnosis concern is well-established in the literature rather than anecdotal. This is a useful strategy when arguing against a dominant institutional practice.
Structure breakdown
The paper follows a classic analytical essay structure: an introduction establishing the scope and scale of the problem, a section on etiology (causes), a section on diagnostic problems and misdiagnosis, and a final analytical section that synthesizes the evidence into a policy-level argument. The conclusion broadens the stakes by framing accurate diagnosis as a societal and civic responsibility.
Introduction
A few decades ago, if a child did not behave in school, at home, or elsewhere, the child was given a punishment aimed at teaching him or her to follow the rules. In recent years, however, there has been a marked increase in the diagnosis of Attention Deficit Disorder (ADD), accompanied by a significant change in the way schools and families handle the behavior issues of their children.
Currently, approximately five million American children carry a diagnosis of ADD. The diagnosis is given to boys three times more often than to girls, and more than two million of those diagnosed have been placed on stimulant medications in an attempt to control the disorder's symptoms (Ullman, 1997). In 1988, half a million American children were taking stimulant medications for ADD; that number has doubled every two years since then (Ullman, 1997).
American children are diagnosed with ADD and prescribed medications five times more often than all other nations in the world combined. A recent report commissioned by the United Nations concluded that three to five percent of all American school children are taking stimulant medications for ADD or ADHD.
There is a growing school of thought that the actual incidence of ADD is not on the rise, but that doctors, parents, and teachers are too quick to attribute any misbehaving or inattentive symptoms to ADD — thereby causing a large-scale over-diagnosis of the problem (Ullman, 1997).
The Causes of ADD
There is no current scientific consensus about what causes true ADD, and this uncertainty is precisely what makes accurate diagnosis so difficult. The disorder is believed to have a genetic component, though no definitive link has been found that conclusively identifies ADD as a medical disorder.
Researchers have identified the first abnormal gene associated with a severe form of childhood ADD, representing a decreased sensitivity to the neurotransmitter dopamine. Ritalin is known to stimulate dopamine release, which may explain why the drug is helpful in cases of ADD (Ullman, 1997).
References
Hartnett, Neil. (2006). The possibility of misdiagnosis of giftedness and ADHD still exists: Response to Mika. Roeper Review.
Ullman, Robert. (1997). Ritalin-free kids. Mothering Practices Journal.
Always verify citation format against your institution’s current style guide requirements.