ADHD Overview
Phillip Campbell recently wrote an article here entitled Antidotes for Male Teenage Sloth. The article brought up some interesting discussions online about ADHD. I thought it would be good to give a brief overview of ADHD and treatment options and discuss the issues of overdiagnosis and overmedication of children and adolescents with ADHD.
What is ADHD
If you aren’t familiar, Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder most commonly diagnosed in childhood and adolescence. People with ADHD have trouble paying attention, controlling impulses, and may be overly active. The CDC reports that from 2016-2019 roughly six million children and adolescents were diagnosed with ADHD, about 9.8% of the United States population. While this number may appear large, ADHD diagnoses fell from a high of 6.4 million in 2011. Roughly 77% of the children diagnosed with ADHD receive some form of treatment, with 62% receiving medication as part of their treatment plan (CDC, 2022).
ADHD Diagnosis
That leads to the question, is ADHD overdiagnosed, and are children overmedicated? To answer these questions, I found a review published in the Journal of Clinical Psychology in December 2022. Regarding the first question, is ADHD overdiagnosed? That is a difficult question, but worldwide estimates of ADHD are around 7.2% of all children and adolescents. The U.S. population rate of ADHD is 9.8%, which could indicate overdiagnosis. Many researchers believe that the high rate of ADHD diagnoses in the United States relates to our culture of productivity. We emphasize work and being productive so much that we become preoccupied with performance outcomes (Gascon et al., 2022).
Combine that with traditional schooling that requires sitting still for several hours, and it is easy to see how this may lead to overdiagnosis of ADHD and mislabeled children. A large study in the U.S. supports this hypothesis, as the researchers found that students who attended schools with strict standards for behavior and academics were more likely to be diagnosed with ADHD (Schneider & Eisenberg, 2006).
But what about overmedication? Once again, we do not have a clear answer to this question. The number of children taking medication has undoubtedly risen in the last few decades, and one possible reason is that these medications do work—many children who take medication for ADHD do see a reduction in symptoms. (CDC, 2022). However, researchers and the American Academy of Pediatrics recommend trying behavioral and psychological interventions before medication, especially for young children. Many children respond well to behavioral interventions and may not need medication (AAP, 2019).
When You Suspect ADHD
What should parents do if they think their child has ADHD? First, ask if this is normal behavior for their age. We expect a lot of self-regulation from our children that is not developmentally appropriate. Parents should not expect young children to sit for long periods of time without breaks, and this is true for bigger kids, especially boys. If you think the behavior isn’t developmentally appropriate, then look into these things:
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- Is your child sleeping enough? The importance of sleep is often underestimated. We also tend to have poor sleep hygiene, so we do not set ourselves up to get good sleep. A common culprit is using electronics right before bed.
- Is your child eating healthy? Could any food allergies or sensitives be causing behavioral issues? Too much sugar or caffeine?
- Is there a lot of recent stress or stressful events in your child’s life?
- Is your child getting enough physical activity and free play time? Play is so important for child development, even as your child ages.
- Is your child getting too much screen time? Excessive screen time is another issue, and much research has shown how detrimental screens can be to the brain, particularly for children and adolescents. Consider significantly reducing or removing screen time altogether for a few weeks and see if the behavior improves.
Seeking Medical Intervention
If none of these suggestions help, don’t hesitate to seek out a medical professional. This could be a medical doctor or psychologist. Get an official diagnosis from a professional and see the recommended treatment course. Feel free to seek a second opinion, especially regarding treatment options. There is not one correct way to treat ADHD. Many professionals and researchers recommend trying behavioral interventions first before going on medication. Remember that this is not to say that medication is wrong or should be avoided. On the contrary, medication can work wonders for some people and should be considered a viable option if necessary.
For more specific tips on how to homeschool children with ADHD or who are distractible, make sure to join us at The Catholic Homeschool Conference on June 9-10. On June 10, Dr. Leslie Kelley, will present a live workshop on ADHD and Homeschooling Strategies for Distracted Kids. I also have a prerecorded talk at the conference on Teaching Self-Regulation: Tips for All Ages and Stages. I hope to see you there!
References
American Academy of Pediatrics. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), https://publications.aap.org/pediatrics/article/144/4/e20192528/81590/Clinical-Practice-
Guideline-for-the-Diagnosis
Centers for Disease Control and Prevention. (2022, August). Data and statistics about ADHD. https://www.cdc.gov/ncbddd/adhd/data.html
Centers for Disease Control and Prevention. (2022, August). Treatment of ADHD. https://www.cdc.gov/ncbddd/adhd/treatment.html
Gascon, A., Gamache, D., St. Laurent, D., & Stipanicic, A. (2022). Do we over-diagnose ADHD in North America? A critical review and clinical recommendations. Journal of Clinical Psychology, 78(12), 2363-2380. http://dx.doi.org.easydb.angelo.edu/10.1002/jclp.23348
Schneider, H., & Eisenberg, D. (2006). Who receives a diagnosis of attention-deficit/hyperactivity disorder in the United States elementary school population? Pediatrics, 117(4), e601–e609. https://doi-org.easydb.angelo.edu/10.1542/peds.2005-1308
