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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