Posted: April 5th, 2023

ADHD is a highly publicized and controversial topic in healthcare

ADHD is a highly publicized and controversial topic in healthcare and our educational environments today. Pick two of the questions below to discuss in depth, remembering to back up your opinions with scholarly research.
1. How do you differentiate between a normally active child and a child who has ADHD?
2. Who are the useful informants for a doctor diagnosing a child who may have ADHD and why?
3. What non-pharmacological treatment has been useful in treating children with ADHD?
4. What are the long-term effects on the brain of children who have used medication for ADHD? What are the possible long-term benefits and negative impact of those medications?
5. What are the reasons for an increase in the prevalence of ADHD diagnosis? (Consider knowledge, public awareness, lack of exercise, lack of recess, nutrition, etc....

I will discuss questions 2 and 5 in depth.

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Question 2: Who are the useful informants for a doctor diagnosing a child who may have ADHD and why?

The diagnosis of ADHD typically involves gathering information from multiple sources, including parents, teachers, and healthcare providers. According to the American Academy of Pediatrics (AAP), parents and teachers are considered the most important informants when it comes to assessing ADHD symptoms and their impact on a child's daily life (1).

Parents are often the first to notice symptoms of ADHD, which can include hyperactivity, impulsivity, and difficulty with focus and organization. They can provide valuable information about the child's behavior at home, including their daily routines, social interactions, and ability to complete tasks. Teachers, on the other hand, can provide important insights into the child's behavior in the classroom, including their ability to follow directions, stay on task, and interact with peers.

Healthcare providers can also be useful informants, as they can perform clinical assessments and provide guidance on appropriate treatment options. However, it's important to note that ADHD is a clinical diagnosis, meaning that there is no single test or diagnostic tool that can definitively confirm the presence of the disorder. Instead, diagnosis typically involves a thorough evaluation of the child's symptoms, as well as their medical history and family history.

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Question 5: What are the reasons for an increase in the prevalence of ADHD diagnosis?

Over the past few decades, there has been a significant increase in the prevalence of ADHD diagnosis. According to the Centers for Disease Control and Prevention (CDC), the percentage of children with an ADHD diagnosis in the United States increased from 6.1% in 1997 to 10.2% in 2016 (2). There are likely many factors contributing to this trend, including:

Increased awareness: As public awareness of ADHD has grown, more parents and healthcare providers may be recognizing and seeking treatment for the disorder.

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Changes in diagnostic criteria: In 2013, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) changed the diagnostic criteria for ADHD, which may have led to more children being diagnosed.

Changes in healthcare delivery: With the advent of managed care and other healthcare delivery changes, there has been a shift towards primary care providers being the first line of care for children with behavioral problems, leading to increased diagnoses.

Environmental factors: Some research has suggested that environmental factors, such as exposure to toxins and pesticides, may play a role in the development of ADHD. However, more research is needed in this area.

Increased screen time: There is growing concern that excessive screen time, particularly among young children, may contribute to the development or worsening of ADHD symptoms. While more research is needed to fully understand this relationship, reducing screen time may be a helpful intervention for some children with ADHD.

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It's important to note that while there may be multiple factors contributing to the increase in ADHD diagnosis, the disorder is a legitimate and clinically-diagnosable condition that can have a significant impact on a child's quality of life. Treatment options, which may include medication, behavioral therapy, or a combination of both, can be effective in managing symptoms and improving overall functioning.

References:

Subcommittee on Attention-Deficit/Hyperactivity Disorder, Steering Committee on Quality Improvement and Management. ADHD: Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents. Pediatrics. 2011;128(5):1007-1022.
Centers for Disease Control and Prevention. Data and Statistics about ADHD. Retrieved from https://www.cdc.gov/ncbddd/adhd/data.html.

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