School System pushes ADHD Label

How the School System is Labeling Children with ADHD

The number of American school children who are diagnosed with ADHD is increasing every year at a rapid rate, leading some medical professionals and even parents to question whether children are being misdiagnosed with the behavioral disorder when they are simply displaying normal child behavior. By 2011, 6.4 million children between 4-17 were diagnosed with ADHD, amounting to 11% of children in that age group. This figure has risen from 7.8% in 2003 and 9.5% in 2007. Boys are much more likely than girls to be diagnosed with ADHD. Nearly one in five school boys have received a medical diagnosis for ADHD. Overall, the number of children thought to have ADHD has increased by 41% in the last decade.

Medicated Childhood

Now, one in 13 school children are currently taking psychotropic medication, either for ADHD or another behavioral or emotional disorder. The drug Ritalin is a common choice for doctors looking to treat hyperactivity in children. Structurally, it is similar to cocaine, its effects are also very similar and it increases dopamine levels in the brain – the pleasure receptors in the brain that are implicated in addiction. Because of its stimulating properties, some children who take Ritalin will also have to take sedatives so they are able to go to sleep at night. Like cocaine, Ritalin speeds up metabolism and reduces appetite, causing weight loss in some people who take it. The fictional medical TV drama, ‘House’ referred to Ritalin as ‘PG rated cocaine’, but while the program is made up, the concern is real. It is known that a diagnosis of hyperactivity in childhood increases the chance that the person will later abuse substances such as alcohol, cigarettes or drugs. Although this is thought to be because people with hyperactivity are more impulsive, it may be because they become used to the effects of stimulating psychotropics and seek out the same effects in other drugs when they reach adulthood.

Alarmingly, problems of drug addiction don’t always start in adulthood. Kids who are prescribed medications may begin misusing them while they are still in school and it is becoming more common for young people to deal in prescription drugs. Even those with no ADHD diagnosis or other illness may trade pills with other children or teens in order to ‘get high’ or to help them stay up late into the night to complete their studies. As Ritalin increases concentration it is sometimes misused by students as an educational aid. Rates of drug abuse are similar to the diagnosis rates of ADHD, with 11.4% of 12-25 year olds using prescription medications for non-medical reasons. More than two and a half percent of high school seniors have abused Ritalin in the last year and rates are much higher for other behavioral medications like Vicodin and Adderall.

Is ADHD Misdiagnosed?

But why are so many American children given prescription medications? Are the nation’s children really unhealthy and unbalanced or is there something else going on? Psychiatrist Peter Breggin thinks so. Mr Breggin says that the symptoms of ADHD such as fidgeting, talking excessively, leaving their seat in the classroom, impulsiveness, easy to distract, day-dreamy or forgetful are all entirely normal personality traits of some children, particularly young children. If those personality traits become disruptive or harmful there is usually always a non-psychiatric reason such as a physical illness, tiredness, poor parenting or poor teaching, boredom or distress but doctors are increasingly giving children a label of ADHD and placed on medications for symptoms or personality patterns that are mild. However, there are no biological markers for ADHD and no tests that identify any physical problem. Mr Breggin asserts that the symptoms listed in the DSM-5 are merely a list of behaviors present in a classroom setting and are not usually indicative of any psychological disorder.

Poor Teaching Encourages the Drugging of Children

Another sign that children are being misdiagnosed is that the youngest children in the class are more likely to be diagnosed with ADHD than their older classmates. One of the reasons for this is that the ‘disruptive’ children are five years old, rather than six, and that academic education begins far too early in a child’s life. During those formative years, a child learns through play and through his primary attachment figures – normally his parents. If a child is away from his primary attachment figures for long periods of time, unable to play freely, he may rebel through distress with combative behavior. Research shows that in countries where children start school at age seven, their academic success and exam pass rates are higher.

The behavior of infants may only be perceived to be combative, though, as fidgeting, inability to sit for long periods and a lack of focus are often the normal attributes of a five year old.

Around one million five year olds are misdiagnosed with ADHD every year because they display typical five year old behavior and don’t yet know how to conform in a classroom environment, or they are simply bored by unstimulating lessons. As the school system teaches every child of the same age at the same level, the ‘one size fits all’ policy may not work for gifted children, who could find the classroom tedious or resent having to perform a task they already know. The personalities of those who are very bright often have traits that are mistaken for defiance or ADHD, such as skepticism of authority, boredom with routine tasks, reluctance to practice things already learned and a day-dreaming, creative mind. These are all aspects of a highly intelligent mind, yet too often such children are falsely labelled with ADHD or another behavior disorder and may never receive the special attention and education they deserve to cultivate their talents and reach their full potential.

The Parent Factor

Dr. Jerome Chapman from Harvard Medical School says that normal childhood behavior is now being seen as an illness. In some cases, experts concur that parents are asking doctors to medicate their children in order to deal with defiant behavior or worsening school grades. Some behaviors may simply be attention-seeking. If the parents aren’t at home often due to full time jobs or they aren’t giving firm enough discipline or boundaries to their children they may act out with increasingly combative behavior. According to Child and Family Social Work, quality of parental caregiving plays a vital role in the aetiology of the condition and good quality parenting can be a treatment for it. Far from being judgmental, it may be society that has allowed this to happen as now it is seen by some to be a taboo to even say ‘no’ to your child. In the midst of fear of unwarranted litigation, it can be challenging to set appropriate guidelines for a child. Low wages and lack of flex-time jobs for parents may mean they have no choice but to try to juggle work with family life. Other causes could also include the child’s over-indulgence in junk foods (food dyes make you hyperactive), vitamin deficiencies or even an undiagnosed medical illness.

Whatever the reasons, there are too many kids on medication and more parents want a drug-free alternative and a different way of communicating with their hyperactive child.

Author Jenni Rose

Sources  

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A Misdiagnosis, Anywhere, The New York Times (October 13, 2011), accessed May 14, 2014, http://www.nytimes.com/roomfordebate/2011/10/12/are-americans-more-prone-to-adhd/adhd-is-a-misdiagnosis

Attention-Deficit / Hyperactivity Disorder (ADHD), Centers for Disease Control and Prevention (CDC), accessed May 14, 2014, http://www.cdc.gov/ncbddd/adhd/data.html

Report: 1 in 13 U.S. schoolkids takes psych meds, News Day, accessed May 14, 2014, http://www.newsday.com/news/health/the-daily-apple-1.4760551/report-1-in-13-u-s-schoolkids-takes-psych-meds-1.7812933

Charach A, Yeung E, Climans T, Lillie E, Childhood attention-deficit/hyperactivity disorder and future substance use disorders: comparative meta-analyses. J Am Acad Child Adolesc Psychiatry. 2011 Jan;50(1):9-21, accessed May 14, 2014, doi: 10.1016/j.jaac.2010.09.019.

Misdiagnosis: The Recent Trend in Thinking about Gifted Children with ADHD, accessed May 14, 2014, http://www.giftedchildren.org.nz/apex/pdfs15/Edwards%20K.pdf

Prescription Drug Abuse: Young People at Risk, National Institute on Drug Abuse, accessed May 14, 2014, http://www.drugabuse.gov/related-topics/trends-statistics/infographics/prescription-drug-abuse-young-people-risk

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4 Responses to School System pushes ADHD Label

  1. George says:

    The psychiatric community has come under great scrutiny for over diagnosing ADHD when in fact the true problem is a lack of discipline. True cases of ADHD are less common, but can be very serious and require attention and constant treatment and monitoring.

    Good to know basic informations about ADHD symptoms and diagnosis:
    http://www.medicalook.com/Adhd/

    Teaching children over a period of time to recognize their behavior and to self manage is the ultimate goal. This takes time, usually over the course of many years, but children are capable of developing a sense of self esteem and the ability to control their own impulses with constant and effective management. A great number of ADHD children outgrow their symptoms, although that is not the case with every child. Children who do not outgrow their symptoms need to continue treatment throughout their adult years.

  2. I am floored by your article. Yes, there is some misdiagnosis of ADHD happening every day, because it’s a matter of one physician interpreting a patient’s history to make the diagnosis. However, that doesn’t negate the fact that dozens of thousands of kids TRULY HAVE ADHD, and it truly hampers the accessibility of success and happiness. Harping on the over-diagnosis or misdiagnosis belittles those who genuinely have ADHD, and genuinely need treatment.

    I wish people would stop equating ADHD medication to cocaine, just to get public attention. When a neurotypical individual takes cocaine, they get high. When an individual with ADHD takes ADHD medication, it raises their dopamine to the level it should be naturally, but isn’t, due to their ADHD. Children with ADHD who take stimulant medication are NOT getting “high.” Period.

    Furthermore, studies have shown that ADHD medication, when used appropriately, is not addictive. You are correct in citing a study that shows that children with ADHD are more likely to grow up to be substance abusers, but you left out the very important quantifier: they are more likely to be substance abusers IF THEIR ADHD IS UNTREATED. Further studies have shown that taking ADHD medication to treat genuine ADHD in children makes them LESS likely to become substance abusers as adults — most ADHD adult addicts fall down that path through self-medicating.

    I love healthy discussion of ADHD. The more truths we share publicly about ADHD, the better life for individuals with ADHD can be. However, your article supports myths and half-truths to garner attention and readership — these are not the articles the ADHD community needs.

    Penny Williams
    Author of “Boy Without Instructions: Surviving the Learning Curve of Parenting a Child with ADHD”
    http://BoyWithoutInstructions.com

    • sguffanti says:

      I approved Penny’s comment because it is heartfelt, but let’s just look at her first statement, “Yes, there is some misdiagnosis of ADHD happening every day, because it’s a matter of one physician interpreting a patient’s history to make the diagnosis.”

      At least 70% of those diagnosed with ADHD are children of parents who do not have the ADHD genes. This means that 70% are misdiagnosed which is way more than some. It borders on blatant malpractice. Of course when she points out that dozens of thousands have ADHD out of 6 million that is less than .2%.

      Until the political pressure to label kids ADHD is removed studies on children that actually have ADHD will be muddied by the vast numbers of misdiagnosised that are flooding the studies.

      When I have time I will come back and discuss her viewpoint in more depth.

  3. sguffanti says:

    Penny goes on to say that, “Harping on the over-diagnosis or misdiagnosis belittles those who genuinely have ADHD, and genuinely need treatment.” Well, I am one of those that, “genuinely have ADHD,” I do not feel belittled. And I question do I “genuinely need treatment?”

    There are 2 points that need to be made about Penny’s comment. The first is that the true goal of treatment is to make the child adapt to the classroom. If you look at the criteria for diagnosing ADHD you will see criterion like “Does your child leave his seat inappropriately?” This is a classroom related issue. Classrooms are designed for visual or auditory learners. The skill of classroom survival isn’t very lucrative. What is the going rate for someone who can sit quietly in his or her seat? I can think of only 1 job for which that skill is essential – toll booth operator. I don’t know how much they get paid, but I do know that many of them are being replaced by machines.

    The second issue is the effectiveness of the treatment. The ADHD population has three global problems: hyperactivity, impulsiveness and inattentiveness. According to Oregon Health and Sciences University in a review of over 5,000 studies these global issues were not resolved with treatment. This university only studied medication treatments.

    Please keep in mind that one reason for the lack of results might well be that the vast majority of those with the ADHD label simply don’t have ADHD so every treatment will fail.

    What parents really want is their children to change their behavior. If you use EEG biofeedback you can accomplish that objective 80% of the time without any fatal side effects. In fact, there are no side effects of any kind. It works regardless of whether the ADHD label is accurate or not. I recommend that parents who want this outcome go to playattention.com. If you mention my name you will get a discount and bonus licenses. (In case you have more than one child who needs help.)

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