Motivational and inspirational writer, Bryan Hutchinson is the author of several books about life with ADHD including the highly acclaimed, best selling "One Boy′s Struggle: A Memoir" and the author of the hilarious eBook that went viral "10 Things I Hate about ADHD"

Are Kids Being Diagnosed With ADHD Too Early? What is Not being said…

Kids with ADHD?

The answer is yes according to a recent study. In short the study determined that if kids in the same class are separated by their age the youngest are most likely to be diagnosed with ADHD and treated with medications to improve their behavior.
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I’ve always said that today’s need for perfect compliance and behavior are stunting the growth of our youth, whether they are diagnosed with ADHD or not. Kids are simply not allowed to be ‘kids’ to play around, goof off, climb trees and get in the trouble kids get into. Scraped knees and falling out of trees isn’t normal anymore (Okay, that was never normal per se, but it was fun!). Passing notes? Whispering? Squirming? Those weren’t allowed when I was a kid either, but how far are we going to go until everyone is properly medicated into conformity? I sometimes wonder how kids today learn right from wrong if they are no longer allowed to have a little freedom to get into what used to be the usual, typical troubles that come naturally with childhood. Legal restrictions and punishments have become so severe that parents are scared out of their minds about anything their child might do when they are not monitored. If normal evolution is too slow for our society and medication will help keep them in line and out of mischief, well… But that’s another debate.
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However, what’s more important here are the kids that are missed who really do have ADHD and do need professional treatment and possibly medication. All that this study tells me is the same-old – same-old! And that is if kids act up and goof off they are more likely to be considered to have ADHD. Some of them really do have ADHD and some of them are genuinely immature. But how do we know which is which? Current diagnosis is too often based on a guessing game. Is it age? Is it immaturity? Or is it energy being withheld because the child has no way of releasing that energy naturally without getting into trouble with adults? We have to get away from guessing at diagnosis and allow only trained ADHD specialists to confirm diagnosis.
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Part of the problem is impatience. As ironic as that may be. Is there time enough to monitor a child in all facets of his or her life to allow for a proper diagnosis? Kids need to behave as desired right now, not tomorrow. However, kids with ADHD inattentive still remain the children most likely to go undiagnosed. This tells me that grades and performance still have too little to do with diagnosis. It’s the physical behavior that remains the main indication. For example girls are more likely to behave with less hyperactivity and yet still may have ADHD, but the symptoms are more subtle and less noticeable such as with constant daydreaming and seeming to be lost when asked a question or interrupted from zoning out. Take myself for example, I was a daydreamer extraordinaire and failed nearly every grade, but ADHD was not diagnosed until I was an adult. Lack of understanding about what ADHD really is and how it affects people still remains too much of a mystery to the vast majority of the public (arguably with some professionals, too).
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Although the recent study seems to indicate that children are OVER diagnosed with ADHD I think it may be showing that diagnosis is still mostly a “maybe” game and that children who genuinely have ADHD and need help are still slipping through the cracks of misperception. I often talk to teachers and parents about ADHD and with some, just in day to day conversations, it is easy to notice that there is still too much confusion as to what is and what isn’t ADHD, but what is clear is that kids need to settle down, be quiet and not cause disruptions. And the kids that behave accordingly, whether they have ADHD or not, seem much more likely to not receive consideration of ADHD, even if they really do have ADHD and everything else aside from disruption points to it!
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So the question isn’t really about ADHD at all in some cases, it is still about compliance and disruption. And who suffers from this? Parents and teachers to be sure, but mostly the kids (and even adults) who really do have ADHD, but as long as they find some way to not interrupt and not upset others they will still most likely slip through. And they then miss out on the benefit of proper treatment and possible medication for their ADHD!
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The current hit and miss diagnosis is not good enough. And this is 2012? Really? One of the main reasons I published One Boy’s Struggle: A Memoir was because I did not meet the physical behavioral criteria for ADHD as a child (every teacher, doctor and parent needs to read it). Thanks to constant punishment I submitted. My energy was thwarted, but the more important criteria for a proper diagnosis were dismissed because ultimately I didn’t get myself into obvious, disruptive trouble. I found ways to make myself unnoticed as best I could. And worse, my poor grades were considered to be on purpose because I supposedly did not care enough (some still believe that myth and it angers me to no end). Maybe I would have been better off waving my hands and jumping on my desk. Maybe then ADHD would have been diagnosed? No, if you read my book then you know I would have simply been punished more. No thanks.
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But even today for kids who do act out and get noticed, if that’s the primary (and sometimes, only) criteria for diagnosis, that doesn’t necessarily mean they do have ADHD. More likely what it does mean is that a lot of kids who do not act out physically are still being missed or are diagnosed much later, too often late in adulthood. I was diagnosed at 37. Many are diagnosed even later.
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Bottom line is that ADHD diagnosis should not be a crap-shoot based primarily on disruption. Kids with ADHD deserve better consideration. Adults, too, for that matter.
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Alicia March 13, 2012 at 1:44 pm

Thanks Brian! I was baffled when I read that study several days ago. Why? Because I was a December baby. Always the youngest in my class. No behavioral issues. Yet I went UNDIAGNOSED with predominantly inattentive ADHD with sluggish cognitive tempo till I was 27 (only finally discovered because I was unable to learn to drive). My fear is that this study will further discourage parents and counselors from exploring a diagnosis of ADD. I know there are plenty of misdiagnoses of ADD. there are also plenty of MISSED diagnoses of ADD. Please don’t throw all those kids under the bus!

Bryan Hutchinson March 13, 2012 at 3:22 pm

Yep, Alicia, your story is all too common. I think far more common than perhaps the hyperactive symptoms, simply not as ‘attention getting’! No, they shouldn’t be thrown under the bus, they at the very least need a cross walk!

Bests,
Bryan

Sabrina A March 13, 2012 at 4:28 pm

I completely & 150% agree!

My son was dx w/ ADD/ADHD-Inattentive in late 2nd grade – and *only* because I noticed a trend in his behavior and answers.
Or more accurately – lack of answers. He would recite something learned in school or for homework, yet couldn’t retain that info even 15minutes later. He couldn’t stay focused on anything that was Really Interesting. His K, 1st & 2nd grade teachers ALL said that he’d stop working & ‘daydream’ – and when asked what he was doing “I was thinking”. That combined with his full-grade level-below reading skill allowed me to finally get him assessed – for what I thought might be dyslexia since vision problems had already been ruled out.

Imagine my surprise when instead, my dear Space Cadet tested quite high in IQ & vocabulary – but horribly poorly in retention & work-speed – due to being easily distracted.

After several months with routines & what behavioral modifications I could do on my limited income & non-work time… I tried medications. He had an instant 180degree turnaround, and went from being a D+ student to an A student in the Gifted Program.

Learning about ADD & ADHD for his sake, led me to the disturbing hypothesis that I too was ADD… but because I *hadn’t been disruptive in school*, I never blipped on anyone’s radar. Thanks to a lot of work at home by my parents (& myself), and a very different general learning method, I learned coping mechanisms that allowed me to “get by” in life. But the strict routines of a school day faded when I became an adult, and my ‘successful life’ went in the other direction.

At age 37, I was dx with ADD myself. Between the *coping* methods I’d learned over my lifetime, some of which work for my son, and the new things I’ve learned while learning for him, I’ve started to turn my life around. I sometimes take a stimulant medication, for those times my workload is chock-full or details are especially important.

I am happier & more productive at work, which let me be even happier – and a happy Mom = patient Mom, and a better homelife. It also helps that I know my son isn’t being a forgetful twerp just to be one – he has a medical condition which we work with & around.

I can only thank both his school, who was willing to listen to a single mom’s concerns – not guilt – & take quick action. I must also thank my parents, who worked with their hyper-focused gifted daughter while dealing with their other hyper daughter, who as grandparents realize how they can help their adult child & their grandson, who apologized for their blame of my parenting & are fully supportive of efforts since they see how alive & happy their grandson is – a far cry from the boy who would call himself a Retard, Idiot, Stupid, Dumb, Loser, etc – and slap his face or bang his head into a wall in frustration.

jennifer newhouse March 13, 2012 at 10:10 pm

This is so disturbing, some kids are young for their class and some kids just have adhd there is no getting around it and if can be such a struggle for parents and children to “convince” those in the educational arena to help the child regardless of diagnosis or lack there of.
My son was diagnosed by his dev. pediatrician at 5 with adhd, and it was the dr who brought it up not me, but boy was I relieved because I was pretty sure that, that was what was going on with my little guy!
He was a preemie with an August birthday so when we sent him to kindergarten we had an inkleing that he would perhaps repeat it but since the peer group from his church all went that year we sent him.
He repeated Kinder and by this time we had a good idea what was going on with him educationally the teachers all really wanted to just see “maturity” so we waited… First grade was not a wonderful experience, although we had a teacher who actually had a special ed endorsement as a first grade teacher, she had little or no patience for children that “just needed to try harder to be a better boy” exact words! So off we went on our own dollar for an extensive battery of tests by a neuro educational specialist and a phychiatrist to have another diagnosis but more importantly a set of reccomendations that might help our child.

IT did, it does and after several years of struggle and intense behavior modificaton he is gettting A’s and B’s in his first year of high school. His social skills are coming along and he is thought of well by his teachers. It is still a daily work though to stay on track, not get behind, to prioritize, and to remember that he has to do things differently than some do to accomplish the same outcomes. Frustration is a work in progress! and gets dealt with. Being happy, having safe and encouraging friendships are important as are daily schedules of work and excercise. Video games are much loved but recognized as being “not so good for my brain” He hasn’t decided exactly what to do about that yet!
Role models are incredibley important. Wyatt’s turning point, seeing himself more positivly was when he met his middle school principal. It wasn’t under great circumstances but great things came of it. He has ADHD himself and he saw in my son the amazing person he was and would be. He encouraged, compelled, advocated, and diciplined Wyatt in such a way as to gain that child’s respect for ever. In his student speech at the end of the year, he credited him with “thank you sir, if it had not been for you I would not have survived middle school!” Indeed he made a lasting impression on my son and is someone he goes to for advice to this day. Never underestimate the value of a great role model and thier impact on your child.

Margaret Bertoldi January 11, 2013 at 5:09 am

Bryan, I just read this blog post, and feel compelled to comment.

I have to admit I get sick of comments that are made over and over claiming that doctors are over diagnosing and over medicating children with ADHD. Frankly, if you give a non-ADHD child meds for ADHD, they don’t do very well!!

Doctors do not diagnose ADHD by saying “oh, yes, he/she is really hyper, here’s some Ritalin”. Really, we don’t.

We gather information about inattentive and hyperactive/impulsive symptoms. These need to be present in home, school and community settings, so we get collateral information from schools, coaches, etc. We gather information about symptoms of ODD, anxiety, depression, autism, and global developmental delay. We gather information about any potential physical problems – snoring, sleep apnea, asthma, seizures, past head injuries, drug abuse, prenatal drug and alcohol exposure, genetic problems. We gather information about the child’s social situation – structure or chaos at home, bullying, child abuse, etc. We gather information about the extended family and other family members with the same sorts of difficulties.

Then, after having gathered all that information, we synthesize it, and try to fit it into a coherent picture. Sometimes, the picture is confusing. Just because one thing is there, doesn’t mean that something else is not. A child may have a social history from hell, with a history of chaotic family life, or child abuse – remember that ADHD is genetic, so generally at least one parent has it – diagnosed or not!!

It takes work to do all of this. Sometimes, it is an easy diagnosis – everything is textbook classic. Sometimes it is difficult and complex. Generally, it is in the middle.

As for diagnosing early – all 2 year olds look like they have ADHD. By age 4, they should not all look like they have ADHD!! If a child clearly meets all the criteria at age 4, and it is significantly impacting their life, why should the diagnosis not be made? Why wait until they are 7, with everyone just assuming that they are “bad children”?
Okay, rant done!

Bryan Hutchinson January 11, 2013 at 1:06 pm

Excellent points, Margaret. I know most doctors trained to diagnose ADHD do a good job of it. However, my point is mostly about what brings the parent to the doctor in the first place and that is usually disruption, causing problems for the parents or teachers, but if the child is quiet and stays still, then other issues may be overlooked till later. Not always, but this seems to be more common.

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