Fac­tors con­tribut­ing to overuse of ADHD di­ag­no­sis

Imperial Valley Press - - SCOREBOARD - ELAINE HEFFNER Elaine Heffner, LCSW, Ed.D., is a psy­chother­a­pist and par­ent ed­u­ca­tor in pri­vate prac­tice, as well as a se­nior lec­turer of ed­u­ca­tion in psy­chi­a­try at Weill Cor­nell Med­i­cal Col­lege. Dr. Heffner was a co-founder and served as di­rec­tor of the

Are chil­dren to­day be­ing over-di­ag­nosed with at­ten­tion deficit hy­per­ac­tiv­ity dis­or­der? The rate of the di­ag­no­sis has al­most dou­bled in the last 20 years with con­sid­er­able vari­a­tion in the di­ag­no­sis across states.

More than 5 per­cent of chil­dren in the United States take ADHD med­i­ca­tion.

Does the re­ported in­crease re­flect a real change in the be­hav­ior of chil­dren these days as com­pared to pre­vi­ous gen­er­a­tions, or do other fac­tors en­ter into the chang­ing statis­tics?

This di­ag­no­sis is made pri­mar­ily based on the per­cep­tions and re­ports of par­ents and teach­ers, al­though psy­chi­atric and psy­cho­log­i­cal ex­am­i­na­tions are also part of the process.

Re­cently, in a con­ver­sa­tion with my 20-some­thing grand­son he re­ferred to him­self as an ADHD. Asked why he said that, he an­swered he had been given that di­ag­no­sis.

Did he agree with the di­ag­no­sis? He thinks he has out­grown the hy­per­ac­tiv­ity part but agrees that he has an at­ten­tion deficit based on his dif­fi­culty fo­cus­ing and dis­tractibil­ity.

His fi­nal ev­i­dence is that cof­fee helps him con­cen­trate in­stead of mak­ing him jit­tery, this para­dox­i­cal re­ac­tion con­firm­ing in his mind that he has an AD dis­or­der

It was in­ter­est­ing to hear this given that there is a large sub­jec­tive el­e­ment in this di­ag­no­sis.

Of course, at his age and de­vel­op­men­tal stage he is able to re­flect upon his own be­hav­ior and ap­par­ently has also done some re­search on the di­ag­no­sis.

Young chil­dren given the di­ag­no­sis are not par­tic­i­pants in the per­cep­tions and ex­pec­ta­tions of par­ents and teach­ers — or their tol­er­ance level for be­hav­ior.

When does ac­tive be­come hy­per­ac­tive? When does rest­less­ness, be­come an at­ten­tion deficit? What is the tol­er­ance level of a par­tic­u­lar par­ent or teacher?

What are their ex­pec­ta­tions for be­hav­ior? Nu­mer­ous fac­tors in the world of ed­u­ca­tion have had an im­pact on the an­swers to these ques­tions.

Large classes make in­di­vid­ual at­ten­tion dif­fi­cult, lead­ing to a greater de­mand for com­pli­ance and con­for­mity on the part of teach­ers.

Teacher eval­u­a­tions based on stu­dent suc­cess can mean less tol­er­ance for a stu­dent who has dif­fi­culty keep­ing up with the class.

Chil­dren at­tend groups at younger ages and judg­ments are of­ten made of their be­hav­ior in re­la­tion to ex­pec­ta­tions that ex­ist for ap­pro­pri­ate school be­hav­ior.

Func­tion­ing in a group re­quires skills that young chil­dren have not yet de­vel­oped or are still de­vel­op­ing. De­vel­op­ment of these skills is a process that takes place over time and pro­ceeds at a dif­fer­ent pace for dif­fer­ent chil­dren.

Not all chil­dren of the same chrono­log­i­cal age are at the same place in their de­vel­op­ment.

When it comes to ac­tiv­ity level there is great vari­a­tion in young chil­dren.

Sit­ting at at­ten­tion in a cir­cle or at a ta­ble or desk can be very chal­leng­ing for some chil­dren. As they go for­ward in school, this may be­come a sig­nif­i­cant fac­tor in their readi­ness to at­tend in the man­ner a teacher may re­quire or wish for.

These fac­tors are sig­nif­i­cant in light of re­cent stud­ies show­ing a cor­re­la­tion be­tween an ADHD di­ag­no­sis and birth­date.

School en­try has a cut­off date in Septem­ber. Those chil­dren born in Au­gust be­come the youngest in the class while the Septem­ber chil­dren who just miss the cut­off be­come the old­est.

The sig­nif­i­cance of be­ing the youngest in the class is strik­ing to an observer.

Of­ten, when con­cern is ex­pressed about the be­hav­ior of a par­tic­u­lar child, it emerges that the child is the youngest in the class.

Be­hav­ior that may seem de­viant in an older child can be de­vel­op­men­tally ap­pro­pri­ate in a younger child.

Those ex­tra months of de­vel­op­ment make a big dif­fer­ence.

One more fac­tor to con­sider be­fore ap­ply­ing the ADHD la­bel.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.