Is ADHD overdiagnosed?

Alexandria, Va. (WUSA9) -- 8 year-old Jack Geronime has always been a handful. One doctor diagnosed him with autism, but once Jack started school there were outbursts in the classroom and he wasn't focusing. So his mother, Lara, took him to another doctor.

Geronime says, "So the doctor said after talking to me for 10 minutes and me describing some things said, 'well I think he has ADHD too, they are co-diagnosing these a lot and lets try Concerta.'"

"It's nice to hear, 'it's not your fault, here's some meds,'" adds Geronime.

Concerta is a time-release version of Ritalin. Jack was on it for 6 to 8 weeks. His mom noticed fewer behavior problems, but she also noticed that he was acting "numb".

Geronime says, "He wasn't absorbing anything because when I would come home I would have to reteach the material."

According to the Centers for Disease Control and Prevention, 6.4 million kids are diagnosed with Attention Deficit Hyperactivity Disorder, also known as ADHD.

But a local expert says the disorder is not only misdiagnosed, but it doesn't exist. Clinical Psychologist Dr. David Stein says, "Well, if I say that, that gets people angry and the political way of saying that is 'it's overdiagnosed."

"The reality is that when we say that it doesn't exist, there's no evidence whatsoever of a chemical imbalance or any neurochemical problems. Those don't exist," adds Stein.

He says focusing is a learned skill. He trains parents to work with their child, so the child can concentrate, memorize, organize, and focus on their own. It is called the Caregivers Skills Program, or CSP for short. It's a different approach to discipline. He says other treatments are too coddling and drugs are not necessary.

Dr. Stein says, "The types of behavioral programs that they are recommending now actually are to treat the child like they are hadicapped. It makes a child worse because they become more and more dependent on that kind of help rather than doing it themselves."

Clinical Neuropsycologist Dr. Robb Mapou says ADHD is the most widely researched childhood psychiatric disorder, and it affects between 5 to 9 percent of all kids. He says that experts know more about it than any other disorder.

Dr. Mapou says, "There's no question that ADHD exists."

"We have converging evidence coming together from research from multiple studies, that show an underlying basis in the brain. Dysfunction in certain regions in the brain, that are linked to the cognitive or neurological factors that we see in ADHD and its behavioral manifestations," adds Dr. Mapou.

He says the link between the brain dysfunction, symptoms of impulsivity, and difficulty paying attention is what forms the syndrome. But he does agree that misdiagnosis happens.

Dr. Mapou says, "I have seen patients where, and particularly in adults who are coming to me because they may have been misdiagnosed with ADHD. Where there was a very casual report of these difficulties by the teacher, by the parents. They go to a family physician who really does not have experience in diagnosing the disorder. The family physician says 'okay, I see problems with attention, I see problems with hyperactivity, let's just treat it.' That's not the proper way of making the diagnosis."

Dr. Mapou says that's the role of the psychologist or the neuropsychologist comes in. That clinician can look at the child's behavior in a certain context and do tests looking at the child's cognitive functioning to understand where there is a deficit.

"The clinician will thne look at rating scales, all of this needs to be considered in making the diagnosis," adds Dr. Mapou.

Lara Geronime says the CSP program worked for her son, without the medications.

Geronime says, "Everyone's happier, there's less yelling, there's no fighting, there's an expectation of 'this is when we work, this is when we play' and I think you know we read at night and there's a whole bunch of things like that that have just created a much nicer atmosphere at home."

"If its a matter of trying some new things or some new techniques that would improve things, it's hard to hear, maybe you should try that instead of turning to meds," adds Geronime.


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