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Second Opinion: What You Should Know About the Diagnosis & Treatment of ADHD

Diagnosis of attention deficit hyperactivity disorder appears to be at an all-time high. Is the increase of ADHD caused by more awareness, or is an increase in misdiagnosis at play? Regardless of the causes, the costs that are related to diagnosing and treating this condition won’t shrink anytime soon.

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Parents always face a dilemma when their child exhibits signs of attention deficit hyperactivity disorder (ADHD). Should they worry that the child has ADHD, or should they chalk it up to a normal phase that the child simply will outgrow? Now more than ever, the latest developments regarding this increasingly common mental-health condition paint a confounding and potentially unhealthy picture for consumers.

On the one hand, medical experts raise doubts about a national study that indicates that ADHD rates in 2013 are higher than ever before. On the other hand, it’s difficult for Consumers Digest to imagine why ADHD rates wouldn’t increase at a time when medical and mental-health experts, some of whom have ties to the companies that make medications that are marketed to treat ADHD, expand both the definition of ADHD as well as the age range during which people can be diagnosed.

Evidence also suggests that pediatricians sometimes don’t follow proper diagnostic protocols. This could lead to preschool children being misdiagnosed or receiving unnecessary treatments for which parents pay extra. Furthermore, new types of medications that are beneficial for some patients typically aren’t covered by health insurance. Finally, a new tool that’s designed to add a layer of confidence to the diagnostic process might be no better at confirming ADHD than any other test that exists, experts say.

ADHD is a condition that typically manifests in childhood and is caused by problems in the central nervous system that lead to a person being overly hyperactive or easily losing focus on everyday tasks. An estimated 5.4 million children ages 4–17 were diagnosed with ADHD, according to a report by Centers for Disease Control and Prevention (CDC) from 2007, which is the most recent year for which data are available. Sixty-six percent of those children were prescribed medication to treat ADHD, CDC says.

Fortunately, medical and mental-health experts whom we interviewed say parents who take a cautious and deliberate approach are more likely to find the right path toward getting the most accurate diagnosis—along with the most appropriate treatment.

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GROWING PROBLEM. ADHD rates increased steadily since independent researchers began to track them in 1973, but it’s unclear what percentage of children have the condition in 2013. Rates that are based on a 2012 survey by CDC weren’t available at press time, because the agency still was evaluating the data, CDC tells Consumers Digest. A preliminary analysis of the 2012 CDC data by The New York Times, which the newspaper published in March 2013, indicated that 11 percent of U.S. children might have ADHD. An 11 percent ADHD rate would represent a significant increase. Two previous CDC reports estimated that 7.8 percent of children were diagnosed with ADHD in 2003, while 9.5 percent were diagnosed in 2007.

Medical and mental-health experts whom we interviewed say CDC’s data-collection methods are flawed, because they rely on telephone surveys of parents rather than on the medical files of confirmed cases. For instance, Russell Barkley, who is a clinical professor of psychiatry and pediatrics at Medical University of South Carolina and the author of 16 books on ADHD, says the 11 percent who say their child has ADHD could include parents of children who are diagnosed by an inexperienced physician or even a nurse who has little or no knowledge about ADHD. Barkley and six other experts whom we interviewed about prevalence believe that the national ADHD rate likely is no higher than 9 percent.

Nonetheless, CDC stands by its research methods and maintains that the numbers are climbing. “Our research suggests that our survey estimates closely approximate those generated from medical-record reviews,” says Susanna Visser, who analyzes health statistics for CDC. Other medical and mental-health experts also tell us that CDC numbers shouldn’t be dismissed as inaccurate, because ADHD rates likely increased from previous years as a result of greater public awareness as well as an expanded definition of who can be diagnosed.

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