ADHD: Effective Diagnosis and Treatment

By Jan Hittelman

Attention Deficit Hyperactivity Disorder (ADHD) is estimated to affect 3-7% of school-age children. For many, these challenges continue into adulthood. There are three types of ADHD; “Predominantly Inattentive”, “Predominantly Hyperactive-Impulsive”, and a combination of the two (“Combined Type”).

Over the years there have been valid concerns that many children are inaccurately diagnosed as having ADHD. This is problematic in part because medication is often prescribed to treat the disorder. It has been shown that some children, who were initially diagnosed as ADHD, were actually in the early stages of having Bipolar disorder and the ADHD symptoms were a function of the manic component. In these cases, prescribing stimulant medication can actually trigger manic episodes. There have also been instances where children were initially diagnosed with ADHD and it later was determined that their concentration problems were actually a symptom of depression. Finally, there are large numbers of children that were simply misdiagnosed and did not need to be put on medication at all.

To accurately diagnose ADHD there need to be several indicators that together confirm the diagnosis. These would include: feedback from parents, teachers and children themselves; objective evidence based on standardized psychometric tests constructed to assess for ADHD; and meeting the specific criteria developed by the American Psychiatric Association. Too often these critical steps are skipped and medication is prescribed.

As a parent it is important to work with mental health professionals who have expertise in diagnosing and treating children with ADHD. Too often ADHD medication is administered by a primary care physician instead of a psychiatrist, who has specialized training in administering and monitoring psychotropic drugs. While psychological testing can be time-consuming and expensive, it is a critical component in reaching an accurate diagnosis. In addition, tests that specifically measure ADHD can be used to monitor and adjust dosage levels to ensure maximum effectiveness.

In my experience, when a child is accurately diagnosed with ADHD and put on the proper medication regimen, the results can be dramatic in terms of their newfound ability to focus in school and reduce their impulsive behaviors. In addition, behavioral strategies to help strengthen the child’s social, coping, and problem solving skills are often an important component of an overall effective treatment plan.

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