ADHD wildly overdiagnosed; new study finds kids born in August 75% more likely to be diagnosed

Miscellaneous and Personal Stuff I Must Share
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Behavior modification works with SOME of those cases, and takes time. For others, it won’t work because without medication, they can’t process. So you’ve wasted time discovering it doesn’t work - and in elementary school, that time can be the difference between getting pegged as a bright kid who is college bound and a troublemaker who might not get through high school - and how you are pegged follows you.

I have an idea. Let’s run a battery of tests on someone and put some metrics around their ability to process. If they have borderline ADHD, they get a diagnosis and therapy and special services in school, but not medication. However, if testing shows - as it did with my daughter, that 98% of people sequentially process information better than she does, and 99% of people hold more than one idea in their head at a time better (she is functionally brain damaged without meds - she has a genius IQ though, so it took a long time to hit the wall), then you medicate because someone with that level of processing disorder will not benefit from behavioral therapy without medication - like a kid who cannot see with glasses will not learn to read simply by throwing more phonics at them. And a delay in getting them the medication means a delay in having them learn those habits - as well as a delay in having them be able to perform to their potential at school - which limits their opportunities

(And, this is what is done when the diagnosis is made according to accepted medical protocol. ADHD may be overdiagnosed, but that doesn’t NECESSARILY mean those diagnosis are all medicated. My husband is diagnosed, but not medicated. My brother in law was diagnosed, but not medicated. My son was tested, and not diagnosed, my daughter was diagnosed and “whoa Nelly!”).

I completely support that ADHD needs to be properly diagnosed with the battery of tests (which are really expensive). And that medication shouldn’t be handed out when it isn’t needed (when we were self employed, my daughters meds were $300 a month - also not cheap). But I completely disagree that behavioral therapy should always be tried first - because in my experience, the testing is complete enough to provide a good indicator of when behavioral therapy will not be helpful without medication - and in my experience, a six to eighteen month delay while the rest of the class moves forward without you is very difficult to make up.

(On the delay side of things - it was a three month wait to get an appointment to start testing. Testing took another two months. Getting her into a behavioral therapist took another three months. Had we not medicated, we would have spun wheels with the therapist for many more months before we saw improvement).

I also think that we need to change our educational system so that teachers don’t need an IEP to tailor education to a kid - and are encouraged to let kids succeed with more subjectivity. That includes smaller classes, more teachers aids. The need to get your kid some sort of label so they will be able to reach their potential at school rather than get treated like a part to be moved through the factory (that makes shitty parts and throws 15% of them away), contributes to half assed diagnosis and unnecessary interventions.

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(Oh, and there are some individual teachers - a minority in my experience, but some - who go above and beyond is working with kids as individuals and not as parts - with or without an IEP - and truly work to make sure the kids succeed. My daughters forth grade teacher worked extensively with her to have her develop the habits that would make her successful - unfortunately, it didn’t really stick - because at that point she wasn’t medicated and wasn’t capable of performing in that way. So she was wasting her time - but it was appreciated).

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I just can’t see any attempt to engage. It seems that your assumptions are the there were no issues back in the 60s as simple discipline takes care of any problems, any medication makes students drugged out (? don’t remember the exact phrase) and that any diagnoses is wrong.

There doesn’t seem to be any point in having a discussion with you as there is no common ground.

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Uh huh. It’s like you didn’t read the thread. I’ve repeatedly stated my position that it’s important to properly diagnose ADHD before drugging children with amphetamines.

And yet you can’t let it go that I pointed out my class survived the ADD crisis before drugs. That must mean I reject the use of drugs even though I’ve stated otherwise.

The engagement failure is all on you.

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This is an interesting read. where on the timeline did she “hit the wall” and what exactly does that mean?. This has always bothered me about diagnosing the condition. It doesn’t just show up one day. You’re born with it. We should see evidence of it in Kindergarten. Diagnosing it in say, the 5th grade, would be a huge gap in treatment.

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I tried inquiring earlier in the thread but my question must have been seen as a thread hijack. I dont believe it was. I posted a link much earlier re certain experts who are critical of the mainstream medical protocol of treatment of ADHD with amphetamines. It uses an old study (1990) to show that there was an upswing in OCD diagnoses in children who had already been diagnosed with ADHD.

The accepted wisdom at that time (which these doctors disagreed with) was that treating ADHD “exposed” OCD and thus allowed doctors to properly diagnose it. What the dissenting doctors are (were) arguing was that it was actually the amphetamines that were the cause of the OCD symptoms, and this is why no diagnosis was made until treatment for adhd with amphetamines had begun. Further, they argued that the financial boom and cultural fad that treatment/diagnosis of adhd had become made portions of the medical and pharmaceutical communities reticent to see what was going on in an accurate light.

Now i admit to not having a good grasp of the nuances here, thats why I’m bringing this up in a thread with so many people who are so much more knowledgeable than myself. Are the concerns about amphetamine treatment for adhd causing other disorders still active in the medical community? Or have they been put to rest thru studies and research? The article i linked to seemed fairly legit, but that is admittedly to my ignorant layman’s understanding of things. Also, while the study highlighted in the article was old, the viewpoint of the dissenting doctor(s) is current.

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Another point made was that comorbidity of OCD and ADHD was almost impossible without additional external factors influencing the patient (like amphetamines). Being distracted, unable to focus and being obsessive and engaging in activities compulsively are seemingly mutually exclusive.

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I don’t have knowledge on this issue, but if the study was published in 1990, that probably means the data was collected 30 years ago. That is a long time for new research to come along and validate those findings.

Unlike some people suggest, science isn’t some vast monolithic body which picks an agenda and doggedly sticks to it. Researchers can launch their entire careers by upending established doctrine. Usually what happens though, is there is some really surprising finding, but even without an obvious explanation (the researchers did something wrong), nobody else will get the same result, and eventually it is just a footnote, and then people stop citing it, so it isn’t even that.

If the surprising finding is real, then other labs will find it, too. Researchers will attack it, but the findings just won’t go away, and eventually the surprising finding becomes the accepted outcome. (This is of course when everything is working right.)

So, if there was some hypothesis presented in 1990, but it wasn’t mentioned much since then, then it probably wasn’t supported by additional research. Due to the file drawer effect, the failures to replicate may not ever be published.

In this instance of ADHD, it is possible that ADHD and OCD are comorbid at population rates, so finding 2% (or whatever) of ADHD kids also show OCD isn’t a big deal (except for those kids). Or, it might be that they’re comorbid at a higher than expected rate, but it just seems that the two disorders go together, and it isn’t due to the treatment. Genetics can often help disentangle this. For example, do kids with ADHD have a higher than expected number of relatives with OCD? Or, it may actually be a side effect of the amphetamines, but they are the only effective treatment, or it happens so infrequently that amphetamines are still used as a treatment. Or even doctors are evil and think it is funny that they can get kids to sit still and count ceiling tiles.

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ADHD also has the hyperfocus aspect. Once again, this is not my area of research, but I work near some people who do work in this area, so most of my knowledge is from colloquiums, talks, and posters.

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When I worked at the hospital, it was not uncommon for a person to be admitted to a psych unit, and on the 2nd or 3rd day, we would get an order to “discontinue all psych meds” so the staff could see what the person was REALLY like, and go from there. This was most often done on adults with bipolar disorder, but I did see it done more than once for children.

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She was fifteen. There were definitely signs of it earlier, but teachers told us “she would grow out of it” - I now believe they were trying to avoid ANOTHER IEP. And she had mastery of the material and was well behaved. Girls tend to be underdiagnosed - and bright girls with inattentive ADHD can be really difficult to catch. And, if she was capable of adjusting, I really didn’t want her labeled and medicated - as you have been pointing out, the medication is serious stuff - and the label often becomes an excuse rather than a reason.

Because she has mostly inattentive ADHD, she appears as more of a daydreamer than a troublemaker, and she is smart enough to perform at fairly high levels even with her disability. She tests great, and she writes well. What she doesn’t do well is “executive processing” - i.e. to write a paper due on Tuesday I need to start on Friday, have a draft by Sunday morning, polish it on Monday and then actually turn it in on Tuesday. But when you write better than 95% of people, cramming it out Monday night gets you through most of high school with decent grades.

She hit the wall - as I said upthread - with advanced math. Algebra II. She would have passed fine with a B - but she is way smarter than that. By the time she was medicated, she was heavily discouraged by math.

The other place she hit the wall was socially. Poor impulse control leads her to say things better left unsaid. She doesn’t choose her words, she blurts.

In addition to ADHD, she has some conflating diagnosis - depression and anxiety - which adds to the difficulty in diagnosing and treating.

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Yes it does. And so does autism, which also sometimes exists in these kids (not mine, she has enough non-neurotypicality to deal with).

Kids with autism and ADHD are often the ones who can identify every dinosaur at four and who have read every Harry Potter book four times by sixth grade. Especially if they are smart on top of it - which can make diagnosis difficult. If you can identify every dinosaur at four, why are you having problems in school at six? You are obviously capable, so you must be lazy. It doesn’t occur to someone without ADHD that you can’t turn on and off paying attention - if something grabs you, you hyperfocus…if it doesn’t, you cannot. Not will not, cannot.

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thanks for your posts.

What is the process behind an IEP? Is it something initiated by the parent or by the school? I don’t want to derail the topic but I’d like to know more about it because we didn’t have that when I was in school.

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It was evident in my daughter at 5 months. People commented on her behaviour but no one said ADHD. It would be kind of crazy to diagnose a 5 month-old. And an active 3 yr old is fine. At a certain point (different for every child), behavioural and learning expectations, especially from teachers, exceed the child’s abilities. Now there is something that can be called a problem. When my daughter was 8, the school recommended we have her tested, because she was obviously struggling. She got tested for all kinds of things (IQ, vision tests, hearing and auditory processing, amongst others). No one would say directly what they thought, but they would hint at it. So yeah, she was completely untreated for 8 years. Actually even after that, I was thinking ADHD is so over-diagnosed. What if it’s not really ADHD, and I am giving her this medication for nothing? Is it really a good idea to give psycho-active drugs to an 8 yr old? So there was another 4-5 years of faffing around on my part. The delays didn’t do my daughter any favours. I would do it differently if I could go back.

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My son is fine now, but when he had a speech delay that was serious enough for him to qualify for intervention from First Steps, we had him tested for everything we could think of first. Of course, we had his hearing tested, in spite of the fact that his hearing was normal at his newborn screening, because he was now old enough for a processing problem to be picked up, and additionally, it was not impossible that he had developed a hearing problem somehow since his birth. We had his vision tested, just because, you never know, and we had him tested for movement disorders. I suspected he might be slightly dyspraxic, and in fact, he eventually was given that label, but he is subclinical, which is to say, not enough standard deviations below the norm for it to be considered a problem in need of intervention (he’s a 1/2 a standard deviation above getting a diagnosis). In common parlance, he is a klutz. He didn’t learn to swim until he was 8, or to ride a bike until he was 9, and we had all sorts of private lessons for the former.

He was very briefly hypoxic at birth, and that may be the cause. I don’t know whether it caused his speech delay, or not.

At any rate, we wanted to clear him of any problem that would make speech therapy a waste of time and torture for him, if it wasn’t doing him any good; fortunately, we had great insurance at the time (the US Army insurance, as DH is a war vet). But at one time, DH did say “Maybe he should go ahead and start the therapy while we continue testing; he’s losing time, because we have to wait so long for appointments.” That’s when I realized my approach was being colored by the horror stories of forced speech therapy I’d heard from so many of my Deaf friends.

So we started.

It helped.

I think maturing helped too, though. He was a late walker, but he eventually walked just fine, and he had trouble getting a latch when I was nursing him, and I had to bottle-feed him breastmilk for a few weeks, but then one day he just got it (and nursed until he was 2 & 1/2).

His handwriting is really terrible, but then, so is my brother’s-- just awful; seriously, you’d think my brother had CP if you didn’t know better. The weird thing is, my brother can draw, and was on his way to becoming a commercial artist, when he discovered computer imaging, and now he’s a CGI tech in Hollywood.

My son can draw too, in spite of being a terrible klutz. He’d get picked last in gym, if he weren’t also the biggest kid in class by a head.

And he never shuts up.

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IEP stands for Individual Education Plan, or Program, depending on your school system. They go back to Public Law 94-142, which was implemented in 1974.

Every child who has a disability has an IEP. It describes what a student’s particular needs are, and what adaptations will be in place for that student. There are meetings anywhere from quarterly to once a year to review an IEP. How successful the student is dictates how often an IEP is reviewed. But it must be reviewed a minimum of once a year. Sometimes if a student is really struggling, a special review can be called.

I called one once. I was officially just an interpreter hired to work with Deaf students in a high school, but it became apparent that they needed aides some of the time, notetakers some of the time, and resource teachers some of the time. I had a college degree, and had experience tutoring Deaf college students in English, so I had the credentials to do all those things, but I wanted my role to be clear in the case of one student, who actually had a lot of residual hearing, but was additionally an ESL student, and needed something besides an interpreter. He also needed to be in a resource room, because he needed extra study time, and needed to get credit for it.

In high school “Resource” is a class, where students who need extra help for whatever reason-- often severe dyslexia, but sometimes they are students will illnesses that cause multiple absences, sometimes they are MMR students, who are capable of pursuing a diploma, but need extra tutoring, sometimes they are students with severe vision problems, or students with movement disorders, who need help getting through their assignments. My kid needed someone to go over his classroom material with him to make sure he was getting everything. He was actually quite bright, but it didn’t always come through.

Usually it is a parent or teacher who calls one, because they feel a student is struggling. Occasionally an administrator calls one, because they think maybe a kid doesn’t need everything they have been getting anymore, as they have gotten older, and want to see if cuts can be made. :mad: I know a kid who called one once, because he was a wheelchair user, and his schedule had him in classes that were really spread all over the building, and he couldn’t get everywhere on time. His counselor was not helping. So he asked for an IEP meeting.

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Every kid who has a disability who wants an IEP is entitled to one. We didn’t bother because by the time of her diagnosis, she’d finished all the necessary math, was being medicated, and I didn’t think that was the point to put in the supports that would be yanked in two years when she went to college.

Accommodations that she would have likely had would be more time for math tests. No points lost for late homework - and reminders to turn it in. And regular check in points for longer length assignments like papers. Some of those things can be provided in college as well, but others won’t be accommodated. And, of course, when you reach the workplace, you don’t necessarily get all your accommodations met - if you are a tax accountant, late work is bad…

She does have one accommodation in college - she is permitted to record lectures since its very difficult for her to listen and take notes at the same time. But we went out of our way to find a small school where large lecture based courses are not normal and discussion is more common. Of her four courses, three are discussion based.