Medications and over-diagnosis

 

The use of stimulant medication has always been controversial, with critics among both parents and professionals. There are those who believe ADHD is a behavioral problem, not a medical one, and that without any clear biological marker present in diagnosis, the disorder should be treated educationally and environmentally and not medically. Critics of medically based treatments contend that the diagnosis of ADHD is subjective, based upon a child’s behavior at home and school, and that most children exhibit symptoms of ADHD at one time or another.

 

They believe that professionals are over-diagnosing and over-medicating children. Some critics believe that, without a reliable physiological test to “prove” the existence of ADHD, the condition is a myth. Many factors, such as depression, anxiety, or family and/or school problems can cause children to seem overactive, inattentive and impulsive. The critics feel that many children don’t have “real” ADHD, and are medicated as a means of controlling their disruptive behavior.

Conversely, there are numerous studies of children who were diagnosed with ADHD, and when given psycho-stimulant medication, improved in reading, writing, and other learning skills due to an increase in their ability to sustain attention to the material at hand.

 

When the levels of the medication are carefully monitored, children are not “sedated,” one of the side effects often mentioned by critics. Rather the drugs appear to be effective in helping children control their hyperactivity, impulsiveness, and inattention. Given the damaging effects of ADHD on a child’s self-esteem, socialization, and the ability to benefit from school, medication may indeed be an important component in treating this disorder.

 

Combined approach most effective

 

Whether or not we are over-diagnosing ADHD and over-medicating children are not questions I can answer. What I can say about ADHD is that medication is not the only effective, nor the best, treatment option for all children diagnosed with ADHD.

 

Medication attempts to address the biological roots of ADHD and should be used in tandem with some form of behavioral training, such as behavior modification and parent training, as these youngsters need, in addition to medication, modes of treatment that address the psychological and social influences often accompanying ADHD.

What’s the best approach? All three used in combination. The comprehensive use of medication, behavior modification, and parent training can help the child with ADHD.

 

There is no one solution that works with all children. Success is achieved when parents work with medical and school personnel to develop a plan for their child’s individual needs. Keep in mind that as a parent with a child diagnosed with ADHD you DO have a choice.

 

Paul Schwartz, Ph.D., is a professor of psychology and education at Mount Saint Mary College in Newburgh.

Read more about ADHD here.