A deficit of attention to overdiagnosis

a/Opinion by

The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) among primary school children has increased dramatically over the past several decades. Twenty years ago, approximately five per cent of American children were thought to have the disorder, compared to 11 per cent this year. While data from the US demonstrates the most extreme surge in diagnoses, the growing prevalence of children with ADHD is a worldwide trend. Such a steep and sudden proliferation of a congenital disorder has prompted skepticism; how is it possible for the prevalence of ADHD to have more than doubled in only two decades?

The answer is that an increasing number of children are being misdiagnosed.  ADHD has become a catch-all term for a host of other potential factors or conditions that result in similar symptoms.

Of course, this is not meant to trivialize ADHD; when properly diagnosed, it is a serious disorder with real effects on the ability to maintain focus and control impulsive tendencies. However, the recent increase of children being diagnosed with ADHD indicates the strong possibility that many of these cases can be attributed to other factors.

Our general approach towards education is changing. More and more focus is being placed on standardized testing, leaving less time for students to engage in subjects such as art and gym.  Some schools have even cut gym class altogether in an attempt to improve test scores by spending more time in the classroom. It is not surprising that when creative and recreational outlets are diminished and substituted with rote, repetitive exercises designed to increase standardized test scores, students become disinterested.

Yet parents, teachers, and doctors are increasingly blaming the children themselves by diagnosing them with a disorder, rather than addressing the underlying causes of their distraction.  It has even been shown that students with late birthdays, who are perhaps less mature than their classmates, have a higher rate of ADHD than their older cohorts, another indication that ADHD is being used as a go-to explanation for a student behind in class.

This leaves the question of whether these diagnoses are being made in ignorance or in spite of an understanding of these external factors. One possibility is that parents and teachers who are unable to control hyperactive children, or unable to provide adequate explanations for why they aren’t succeeding in school turn to ADHD as a convenient explanation. The frequency with which children diagnosed with ADHD receive medication to reduce their symptoms may indicate frustrated adults who don’t know how to cope with behavioural issues and learning obstacles in children.

While psychotherapeutic drugs such as Ritalin and Adderall have proven effective in managing the symptoms of ADHD, they are powerful stimulants that should only be used in cases of absolute necessity. Even proper use of such medicines could result in harmful side effects and dependency. The ease with which those diagnosed with ADHD may acquire prescriptions for these drugs means that their use among children has increased to such a degree that it is becoming mainstream. The prescription of Ritalin to children, for example, has doubled in recent years. Not only is this potentially harmful to the children to whom they are prescribed, but the effects of the widespread availability of these drugs are increasingly visible in universities, and even in high-achieving high schools where students have begun illegally selling and abusing ‘study drugs’ in order to gain advantages in competitive academic settings.

The widespread diagnosis of ADHD among young children, and the frequent prescription of drugs to fix their perceived problems is, indeed, an epidemic. It is necessary to identify and address the true causes of their difficulties. Otherwise, we threaten to restrict the life chances of an entire generation, and label healthy children with a disorder that they will carry with them into adulthood.