Is ADHD in kids overdiagnosed? If so, is lack of discipline to blame?

In My Humble Opinion
1

I think ADHD is overdiagnosed and only a fraction of people diagnosed nowadays even have it… I think for those who do have it, it is a very real condition and not simply a matter of being rambunctious or not sitting still.

For many, though, I think it is nothing more than an attempt to drug our children into submission because all the touchy-feelies have systematically removed any sort of order or discipline in the school. Teachers no longer have any powers to enforce rules so what better way to get the children to behave then to drug them? Nowadays a child could be stabbing their classmate and all the parent will say is something asinine like, “Oh look…my little Johnnie is expressing himself.”

I think the ADHD rates rising is because what is normal child behavior that parents used to discipline for, they now look for excuses to drug them into being submissive.

If parents disciplined like they used to, it’d remove a significant number of people diagnosed from being diagnosed, leaving only those with the real condition diagnosed.

2

What do you think the true prevalence of ADHD is, and what’s the basis for your opinion? Not that I don’t share the concern about possible overdiagnoses - I think most people at least think that’s a possibility - but I don’t think a vague feeling of ‘this is overdiagnosed!’ is much to go on.

3

You’ve left out quite a few options. Did you lose track of what you were doing?

4

I don’t feel that the SDMB is an ideal place to dicuss serious issues in depth, nor is it a place I’d feel comfortable sharing much personal information.

Even so, I will tell you this: before I had children of my own or any experience with ADHD, I had read and heard MANY commentaries like those in the OP. And coming from a family with an old-school disciplinarian Dad, I used to find such commentary somewhat convincing. AFter all, in my day, I’d gone to Catholic schools where stern nuns with yardsticks managed to keep 45 kids in line. Surely, I figured, if kids are out of control in a classroom, a few whacks on the butt, Sister Mary Ignatius style, could go a long way.

I know better now. I have a son with major ADHD, and I’ve seen first-hand that there’s a HUGE difference between an ADHD kid and an ordinary mischievous or bored little boy.

Look, almost EVERY little boy has some trouble sitting still and shutting up. I WAS a little boy, and even good, studious, obedient little nerds like me got out of control occasionally. EVERY little kid has times when he either can’t focus on a boring-but-important task or can’t drag himself away from a fun project. But with an ORDINARY little boy, a sharp command or an “I MEAN it this time” glare will get a response.

There are kids who are way beyond that. My son is one of them. If yelling and getting tough were enough to whip him into shape, well, believe me, I’ve DONE that.

I’m quite prepared to believe that ADHD is overdiagnosed, or that some schools push parents to medicate kids who just need a no-nonsense teacher, some firm discipline and an occasional rap on the knuckles with a ruler. But there are other kids who can’t and won’t repond to that. They MAY need meds, as my son does.

And contrary to widespread belief, the meds in question are NOT tranquilizers that turn happy, healthy, fun-loving little boys into sleepy zombies. Most of the time, ADHD is treated with drugs that are STIMULANTS. It sounds counterintuitive, I know, but stimulants often help kids regulate their behavior better.

My son is getting MUCH better grades in school than he did before medication. He’s also not getting into trouble nearly as much. And BECAUSE he’s no longer getting intoi trouble constanty, he doesn’t dread going to school as he used to. He’s a long, long way from perfect, and will probably have issues for years to come.

I don’t want classrooms full of doped-up lethargic kids- but that’s not what we actually have.

5

Right. I meant to add that I’m doubly suspicious of ‘it feels like ADHD is overdiagnosed’ when it’s coupled with ‘parents today are too soft and won’t discipline their kids.’ Thank you for sharing your experiences, astorian.

6

Since giving ADHD meds to someone who doesn’t have it would make them start bouncing off the walls, I’d say it’s not overdiagnosed - that’s a pretty clear litmus test.

What it may be is overmedicated or mishandled*, but that’s a different kettle of fish.

*having flashbacks to that coworker who couldn’t work on tasks he hadn’t set to himself unless someone was staring at the back of his head. That was how he’d done his homework and studying between starting school and graduating college. If someone was looking at him, he stayed on-task. As soon as that someone went to the bathroom, he’d start searching for the chemical composition of butterfly wings or for Plato’s bibliography.

7

It’s really hard to take your OP seriously when you make ridiculous assertions like “teachers no longer have any power to enforce rules” or "a child could be stabbing their classmate and all the parent will say is something asinine like, “Oh look…my little Johnnie is expressing himself.” " Those things are clearly not true. Also, ADHD medications do NOT make a child submissive. Oh, how I wish that were the case. You obviously need to do some research on this subject before you present the world with your vague observations- you clearly know absolutely nothing about it.

8

In my district and nearby districts, I’m seeing friends forced into getting their kids an ADHD diagnosis because schools won’t accept late work - or accept it only for half credit. So a kid who is disorganized needs a diagnosis to pass middle school. With a diagnosis, the teachers are obligated to take late work for full credit and remind the kid to turn in work - without it, I’ve been told “its the student’s responsibility to turn in work on time, they know where the basket is.” If I ask if they remind the kids that “the worksheet on rivers is due today” I’m told they generally don’t because “its the student’s responsibility to turn in work on time.” Until my school decided not to grade down for late work, I was seriously exploring getting a diagnosis for my kids as well.

One of my girlfriends has a son who is blowing the tops off the tests, and gets Ds on his coursework because he just isn’t ORGANIZED and has a lousy memory for turning it in.

The other one is timed tests. Kids with ADD can’t pay attention, so they get more time on the tests. If your kid isn’t finishing tests quick enough, a diagnosis gives them more time. For someone like my daughter, smart as a whip, but prone to having her brain wander off mid Algebra problem, that can be the difference between a C and an A. (My daughter is probably marginally ADHD).

Some of these kids don’t get meds - they just need the diagnosis to get the schools to individualize to their kids needs.

These aren’t disciplinary issues, these are kids who sit fine in class, don’t mouth back, aren’t smoking in the bathroom - their disciplinary issue has to do with not paying attention, not keeping the red tape in mind. As someone who has to look for my purse when I go out, and usually forget to pick up one thing on my list at the grocery store, I get this.

The way school is managed has changed so much since I was in middle and high school. My kids don’t get “Get out your folder and pull out your homework. Pass it to the front of the room so I can collect it.” All their teachers have baskets. For a kid who still comes down stairs having forgotten to brush her hair in the morning, baskets are a non-starter.

9

I didn’t vote. The binary yes/no options presented are far too simplistic. IIRC, more than one specialist is usually involved in diagnosing ADHD and this can be expensive, depending on country and socio-economic circumstances. It is entirely possible that a sympathetic GP may prescribe a Ritalin generic for a child who displays signs of ADHD without going through the recommended and expensive rigmarole. (I’m sure medical types will be along shortly to either confirm or tell me I’m wildly off base.)

Like **Alice the Goon ** I also have difficulty taking OP seriously.

10

Are ADD and ADHD overdiagnosed? Sure, but less now than 5 or 10 years ago.

They are real problems, not simply a tag replacing “overactive” kid. The overactive kid can behave with guidance and selfcontrol. ADD and ADHD sufferers simply can’t.
Being a teacher shows you that difference every day. Teaching being more open and less strict means less chance to be forced into the rules. Medication and therapy work great.
But, it’s like saying diabetes can be controlled thru willpower.

You can, of course, control overactive kid with pills, but good teaching usually works.

11

Getting diagnosed with ADHD involves the parent answering a questionnaire and the kid’s main teacher answering one, with scoring. I’ve never encountered a situation where you can just tell a doctor that the kid has ADHD and get an Rx. Most doctors, ethical ones, anyway, don’t allow laypeople to diagnose themselves or their children.

Instead of worrying about children getting stimulants for school problems, maybe the OP should concern himself with the college students that use them off-label to stay up all night cramming instead of studying throughout the year, or the housewives that use them to control their weight, or the addicts that use them when they can’t get meth or coke. That seems to be more of a problem where I live than kids using them for actual ADHD.

12

Every town has That Doctor (or Those Doctors) who WILL write prescriptions for anything on request. This is why we have pill mills.

Until about 10 years ago, ADD/ADHD appeared to exist only in white children from low-income families. I left retail pharmacy in 2002, and NEVER filled an RX for a non-white child.

You do encounter schools that are VERY aggressive about getting as many kids with some kind of diagnosis as possible, because they get more money for them. Some schools use, as their “diagnostic” criteria, children who are not living with both biological parents, regardless of why. Hmmmmm, I thought the days of assuming that kids with divorced parents were automatically bad news were long gone. :confused: In addition, this kind of thing is practicing medicine without a license.

I’ve found that an excellent way to tell if it’s the child or the parents is if the parents (okay, let’s face it, mothers) brag about it. If they don’t, the child really has it. It is also NOT about violent, antisocial behavior. ADD/ADHD DOES NOT cause children to act out sexually, set fires, abuse animals or other children, etc. It just doesn’t. A child who acts that way may have it, but this wasn’t the cause. Also, if 10 or 15 doctors have told the parents that the child doesn’t have it, they probably don’t. :smack: I had a boss years ago who did that with his kids (he was convinced that meds would make his B student kids into A students), but he himself had a lengthy history of walking out on jobs without giving notice and is probably a sociopath himself, so go figure.

Some people have been able to get SSI for this, which is another reason why it’s so overdiagnosed.

There are adults, some of them very successful, who have been diagnosed later in life because they read about it, or had a child or other relative with it, and got evaluated and diagnosed, and the correct medication dramatically improved their lives.

As for violence, several years ago there was a story in the newspaper about a 7-year-old boy who was walking up to strangers at Kmart and kicking them really hard. When the manager tried to kick the family out and they refused to leave, he called the police, and the child was taken to the hospital, which had a child psych unit. :eek: One wonders what else that child did! Anyway, the mom was trying to convince people that he had ADHD, and maybe he did but ADHD doesn’t make people do things like that.

The first woman I ever met who thought her poop was stink-free because she had a child on the autistic spectrum used ADHD as an excuse for her son’s behavior problems, too. It was REALLY obvious that her son wasn’t normal (and she was peculiar herself because she didn’t look at people) but it was just as obvious that her kids didn’t have any rules. Of course, this was all her husband’s fault, KWIM?

13

I think claims of overdiagnosis are overwrought. They seem to come from people who have a whole lot of opinions about everything, but few first-hand experiences.

I see this attitude with other health-related phenomena. The prevalence of food allergies is also increasing, and I’ve come across the sentiment that these aren’t “real” either. The same with autism…the same with obesity, diabetes, fibromyalgia, etc. Maybe these folks are right. Maybe what we’re really seeing is an increase in hysteria and hypocondria…and I have no doubt that the internet does contribute to some overenthusiatic self-diagnosing.

Or believe it or not, it could be that we are actually seeing more sick people. But doing something about it would require rethinking our way of life. It’s easier to dismiss the problem as “overdiagnosis” versus doing something about it.

I used to not care about this issue at all. I personally didn’t know anyone with a diagnosis, and I didn’t think I’d ever have to go to the doctor over a neurological issue. This all changed when I hit my early 20s and gradually realized that my own brain wasn’t quite right. It took over a decade for me to get adequate treatment because I didn’t want to be one of “them”…you know, whiny people just looking for excuses for character defects. Then I started to pay attention to my family history and the life outcomes of close relatives and realized 1) no, I wasn’t being a hypochondriaic and 2) no amount of self-flagellation was going to “cure” me of my problems.

It may be that people are simply more confident and assertive about addressing personal issues in themselves and their children than they used to be. Which does not have the same urgency as “OMG EPIDEMIC!”, but doesn’t dismiss the seriousness of the problem. There is a wide middle ground between “massive epidemic” and “shit’s all made up”.

14

I assume you are refering to my post. if not, I apologise. I googled ADHD diagnosis earlier. The link I clicked on (USA based) implied a procedure a lot more complex than simply filling in two questionnaires. Unfortunately, it spoke of procedures that a doctor “may” do, not what a doctor “will do” and much of what a doctor “may do” may be reserved purely for the more severe cases.

I have no idea what the recommended or merely acceptable procedures are, although two questionnaires do sound rather minimal. No diagnosis with a child actually present? I’m not trying to be snarky here, I’m genuinely curious.

15

My only real experience with this is when my son was in first grade and having trouble sitting still and focusing in class. The teacher really urged us to take him in because he was probably ADHD. I explained that he could sit still and focus on a game of chess or sit through a whole movie he liked, and that I thought his problem was he was 6 yrs old. She continued to urge us to get him tested. Later I found out she had done this to about half the boys in the class and some of the girls. All these kids were the more active ones, but most of them were not ADHD.

This was about 10 yrs ago.

16

The “two questionnaires” process is one way to be diagnosed, most often used by a pediatrician or general practitioner. There are, of course, other ways, more in-depth evaluations that can be done, by psychiatrists, psychologists, and other practitioners that specialize in behavioral health. Children aren’t the most reliable reporters of their own behaviors or reasons for those behaviors, so doctors do have to mostly rely on their parents and teachers for help with diagnosing ADHD.

17

Ok. I wasn’t thinking of children reporting on their own behaviour, but rather being observed, even if only for a very brief period of time.

18

Neither is hard. The doctor is diagnosing on parental and teacher feedback. And when the teachers have spent enough time talking to the parents about late work, and both are at their wits end, the teacher ends up sayings something like “have you considered an ADHD evaluation.”

19

Do you also believe that autism is overdiagnosed?

20

And if only a couple of children are having problems with remembering to put their assignments in said baskets, this is a perfectly reasonable conversation to have. How your teachers handled things back in the day is not relevant.