ADHD diagnoses rising, potentially misdiagnosed often

Apr 4, 2014

Diagnoses of attention deficit hyperactivity disorder have been rising for the past 20 years. Today, 3.5 million children in the United States are on medication for the disorder. This week on WRVO’s health and wellness show "Take Care," hosts Lorraine Rapp and Linda Lowen speak with Alan Schwarz, a writer for The New York Times who has reported extensively on ADHD. Schwarz discusses the rise of ADHD and how it is likely being over diagnosed.

Lorraine Rapp: According to the CDC, 11 percent of school-aged children have been diagnosed with ADHD. What is your take on why this is happening?

Alan Schwarz: Oh, there are so many factors. I think we’ve started to appreciate just how much trouble these kids were having, kids with extraordinary low attention spans, impulsivity, hyperactivity. I mean these kids have been known for a long time, a lot of them were dismissed as bad kids, or uncontrollable kids and they were left behind. And then in the late 90s and 2000s, because of very good formulations of medication, it became very easy to say, ‘hey, my kid has a short attention span, my kid is very hard to control. Perhaps some Ritalin or Adderall will get him or her, usually him, to calm down, make his teacher’s life less insane.’ I think a lot of people are concerned, though, that we’re kind of pathologizing childhood. We’re taking what is relatively normal, now perhaps annoying, and perhaps above average, but nonetheless relatively normal behavior and medicating it as if it were a condition bad enough to warrant that medication.

Linda Lowen: You know, we all think we know what ADD is, and what ADHD is, would you just briefly go over the two and how they differ?

Alan Schwarz: ADHD is marked by traits in the following three categories: inattentiveness, impulsivity, and hyperactivity. If you don’t have hyperactive symptoms, which are generally found more in boys than anybody else, then you can still have ADHD, but it’s the inattentive type. It’s not ADD, it’s still ADHD, but not hyperactive. So there’s really no difference between the two.

Lorraine Rapp: So the assumption is that there is a brain chemistry thing going on in these kids that doesn’t allow them to pay attention and if they take this medication, it will not change who they are, but allow who they are to really come through. Is that really it?

Alan Schwarz: That’s how some people phrase it, but I think that depending on how you use that description it can be fair. I mean basically, it can slow the world down for these kids, allow them to take in information better, and that may allow the teaching of some skills to come through.

Lorraine Rapp: What is the research and what is the doctor’s point of view in all of this?

Alan Schwarz: If it’s 15 percent of American kids having been diagnosed at some point, some of those are absolutely real. We need to make sure that we take care of the ones who are absolutely real and cannot be left behind. The question is: how far we have overshot this thing? Somebody is misdiagnosing a lot of these kids, but no one seems to be willing to admit it. An awful lot of medical people insist that five to eight percent of kids have ADHD, and so many of them are being missed out there. And hey, that may be true, but then why are 15 percent of children being diagnosed? I mean, it’s twice as many as it should be, which means more than half the time they’re getting it wrong. No one seems to be making them accountable to that.

More of this interview can be heard on Take Care, WRVO's health and wellness show Sunday at 6:30 p.m. Support for this story comes from the Health Foundation for Western and Central New York