Ya know how there are myths that are scary, like “Don’t use your mobile phone near a gas pump or it may explode”? And then there are myths that are reassuring, like “Police officers won’t give you a speeding ticket if you cry.” The myths I’m about to talk about, myths around how to tell if your child has ADHD, are of the reassuring variety.
And I’m about to bust ‘em up. Sorry.
But us parents really need to know this stuff, lest we be sold some ocean-front property in Arizona.
Myth #1: There is a clear-cut test for finding out whether my child has ADHD.
I will use this paragraph from chadd.org’s website because it sums up the truth:
“While there are no biological, physiological or genetic markers or independently valid tests that can reliably identify the disorder, the scientific consensus is that the diagnosis of ADHD can be made reliably using well-tested diagnostic interview methods.”
Instead, diagnosing ADHD is a complicated process; information is carefully considered, gathered from many sources and evaluated using specific criteria. Among the things considered: a child’s medical, social, emotional and academic history and the presence and severity of symptoms. Symptoms, such as difficulty following directions, forgetting materials or acting impulsively, are evaluated through the use of checklists and rating scales. These questionnaires are completed by parents, teachers and other caregivers. For example, one question may ask if the child blurts out answers during class discussions, and the evaluator is asked to select never/rarely/occasionally/often/always as to the frequency/severity. The evaluator is also prompted to consider the child’s behavior compared to other children the same age. This is because everyone can act impulsively at times; clarifying what we can reasonably expect from a child is important.CHADD is the largest advocacy group for children and adults with ADHD; information published on CHADD’s website reflects what the medical community currently believes. (What I’m saying is, I vouch for them.) There is no single test that gets a definite “yes” or “no” answer as to whether or not someone has ADHD. While recent research has shown physiological differences in the brain activity of children with ADHD, this has not brought about a diagnostic tool. Yet.
In addition, other medical conditions, such as visual and hearing impairments, must be ruled out before a child is diagnosed with ADHD.
So…diagnosing ADHD is a thorough process, but not a cut-and-dry one. Which is good, since human beings don’t tend to be cut-and-dry creatures.
Myth #2: It’s easy to tell whether my child struggles with ADHD and not a learning disability, depression or anxiety.
Nope. Wish it wasn’t so, but ADHD, specific learning disabilities, anxiety, depression and other challenges often have overlapping symptoms.
Hence the need for the through evaluation process discussed above.
Myth #3: All doctors diagnose ADHD similarly.
Any board-certified physician who has experience working with children or adults with ADHD should use the criteria listed in the Diagnostic and Statistical Manual, Fifth Edition (the DSM-5). This book, published by the American Psychiatric Association, is “the bible” of ADHD.
And most physicians do use the criteria in the DSM-5.
But I would be lying if I said I’ve never seen physicians bend to the will of parents who 1. desperately want a diagnosis for their child and 2. are paying for the doctor’s evaluation. If you see a conflict of interest here, you’re right. In an ideal world, no one would not be swayed by the desires of the person paying him, but…yeah, I don’t really need to finish that sentence, do I?
Why would parents want their child diagnosed or “labeled”? There are several common reasons. The first being that, despite all of the controversy around ADHD and medications, children with ADHD who go untreated are at a far greater risk of dropping out of school, experiencing depression, using drugs engaging in dangerous behavior. I believe most parents want to protect their child and help him succeed, and this desire creates anxiety around getting a diagnosis and accompanying treatment.
Along similar lines, parents often want their child to receive a diagnosis—and the justifying paperwork—needed for their child to receive extended time on standardized tests, including the ACT and SAT. Providing extended time is a common accommodation for children with ADHD.
My intention is to share helpful information with parents, not to pass judgment on those involved in the process of diagnosing ADHD. Replacing inaccurate beliefs with information about the complicated, nuanced framework with which children are evaluated is helpful if we are to understand children’s emotional, social and academic needs. I hope this has been helpful.