Thirteen years ago my son, Devin, was a high-energy, curious and creative 8-year-old driving his elementary school teachers crazy. According to the teachers, he exhibited signs of attention deficit hyperactivity disorder (ADHD), and they wanted him — and a growing majority of kids in his school — on medication. After many teacher conferences, I decided to take him to the doctor for an official diagnosis. The pediatrician told me there was no true test for ADHD, but we could put him on the medicine and see what happens.
I didn’t particularly like the idea of testing medications on Devin, so I did some research of my own. I learned that ADHD is considered a mental disorder and he needed to be evaluated by a psychiatrist. After several tests and one-on-one appointments with the child psychiatrist, the doctor proved me correct — Devin did not have ADHD. The evaluation stated that while he was high energy, he was very creative and “he needs to be placed with teachers that will encourage his curiosity and creativity while not try to drug him.”
A pediatrician’s perspective
Amy Garlove, M.D., a pediatrician with Norton Children’s Hospital Medical Associates – Dupont, had these comments on a new report published by the Center for Disease Control and Prevention (CDC) stating that ADHD diagnoses have increased 53 percent over the past decade.
“I am amazed by the number of kids I see who are on medication for ADHD, and I am afraid it will continue to rise. Prescription drugs like Ritalin and Adderall work like a charm for a child who truly has ADHD. For those who take these drugs but don’t have ADHD, they can work like a stimulant, helping kids study all night or prepare for college entrance exams. One study estimated that up to 30 percent of prescribed drugs for ADHD end up in the hands of abusers.
I believe there are many kids out there who are incorrectly diagnosed with ADHD/ADD. It is difficult for primary care physicians to fully assess patients who may be exhibiting signs of ADHD/ADD, given the limited time we have with patients and families. Many experts say a full evaluation should include a medical and mental health exam, which often takes several hours.
Using brief questionnaires to determine if a patient has ADHD leads to over-diagnosis of the illness, but I also worry that we are under-diagnosing broader mental health conditions. Approximately 40 to 65 percent of kids with ADHD have other mental health issues, the most common being anxiety, depression, learning disabilities and conduct disorder. If we are diagnosing ADHD but missing the other pieces of the puzzle that are causing difficulties for these kids, we are not doing everything we can to help them meet their full potential.
In my practice, I send all kids who may have ADHD to see one of the psychologists in town who specializes in these areas. Several kids have returned with diagnoses totally unrelated to ADHD. I’ve even had a few patients who have had tonsils and adenoids removed and their symptoms improved.
If I have a patient with ADHD symptoms and any sleep disturbance, I will refer them to get a sleep study or to see an otolaryngologist (ENT). I think it’s important to rule out any other source for the child’s symptoms before they go on stimulant medication.”
Today I feel even more vindicated by Dr. Garlove’s comments and the CDC report that confirmed my suspicion a decade ago. Thomas Frieden, CDC director, stated the most troubling statistic from the report addresses medication rates: About 66 percent of those diagnosed with ADHD have prescriptions for stimulants. Frieden told the New York Times that the rising rates of stimulant prescriptions among children mirror the overuse of pain medication and antibiotics in adults.
Today, Devin is a well-adjusted 20-year-old who has outgrown his hyperactivity and is pursuing his dreams in music. As a side note, I enrolled him in drum lessons when he was 10 and it helped him to slow down and focus his creative energy. I believe there are many children who truly have ADHD and benefit from the medications. I just urge any parent to take the time to have their child properly evaluated before filling that prescription.