The number of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) has grown exponentially in the last few decades. In 2016, a staggering 9.4% of children in the United States had been diagnosed with some form of ADHD (Predominantly Inattentive, Predominantly Hyperactive-Impulsive, or Combined Presentation) (Danielson et al., 2019). Despite years of psychological and clinical research, there have been recent shifts in how ADHD is diagnosed. In recent years, ADHD among children is often diagnosed during a brief pediatric visit rather than through the use of psychodiagnostic testing and interviewing methods. In determining a proper diagnosis, it is important to note that the diagnostic process should involve clinical judgment, data, and expertise. It should also involve multiple perspectives, such as parents, teachers, and psychologists.
Inaccurate Diagnostic Testing
When diagnostic testing is not comprehensive to include multiple perspectives of a child or adult’s behavior, it can result in ‘false positives’ and even ‘false negatives.’ For example, if a professional only uses a symptom rating scale to diagnose ADHD, this may lead to an inaccurate positive diagnosis of ADHD if an individual is experiencing attentional deficits due to an anxiety disorder. Although bias and error are inherent in every measure, we believe that if the diagnostic process accounts for multiple perspectives and utilizes multiple standardized measures, we reduce the likelihood of error or bias. In addition, the use of objective measures, such as neuropsychological tests of attention and working memory, helps to reduce biases and error.
Overreliance on Medication
Once properly diagnosed, ADHD medications (e.g., stimulants such as Adderall) can help address some symptoms and impairments in functioning, like school or work-related functioning. However, extensive research supports that psychotropic medications, such as Adderall, should be simultaneously prescribed with behavioral health treatments. If medications are only used, treatment effects are not as strong as both medication and behavioral health treatments combined. Behavioral health treatments, such as Cognitive Behavioral Therapy, can help address the antecedents and consequences of ADHD symptoms. Behavioral health interventions can also provide parents with parent training to manage their child’s ADHD symptoms.
More generally, ADHD symptoms can be managed by increasing the amount of physical activity; limiting screen time; and creating an environment that is structured and organized. A provider should address these environmental factors as a comprehensive approach to treatment.
Comprehensive Testing and Treatment
Parents, providers, and teachers are strongly advised to consider how children, teens, and adults are being diagnosed with ADHD. They are also strongly advised to consider how ADHD treatment is addressing multiple facets of life and providing tools for long-term personal, academic, and interpersonal success. With the right treatment approach, ADHD can be effectively managed.
At Interface Consulting and Psychological Services, we aim to provide an accurate ADHD diagnosis in order to inform treatment planning. We strive to adequately differentiate ADHD from other conditions, such as anxiety disorders, when necessary. Furthermore, we provide behavioral health treatment that addresses multiple facets of functioning. For those who need a lower level of support (e.g., accountability, action planning), we can also provide ADHD coaching. Let us help you today.
Reference:
Danielson, M. L., Bitsko, R. H., Ghandour, R. M., Holbrook, J. R., Kogan, M. D., & Blumberg, S. J. (2018). Prevalence of Parent-Reported ADHD Diagnosis and Associated Treatment Among U.S. Children and Adolescents, 2016. Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 47(2), 199–212. https://doi.org/10.1080/15374416.2017.1417860
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