Andrew is hyperactive, acts without thinking, talks out of turn and can’t pay attention. Mom thinks he has ADHD. Brittany is “spacey,” never seems to know what’s going on, doesn’t make friends at school, and her grades are lousy. Her teacher says she has ADHD. Is Andrew’s Mom right? Is Brittany’s teacher right? Maybe so. Maybe not.
ADHD is real. That’s a fact. And it can cause all kinds of problems in school, with friends, at home. It can make kids miserable and their parents frantic. It can drive teachers crazy. ADHD-like behavior is epidemic, but ADHD itself is wildly over-diagnosed.
ADHD: How Is It Diagnosed?
There’s no lab test for ADHD. No throat culture. No x-ray. In short, no medical procedure is available to help doctors make the diagnosis. Usually only a series of questions from the DSM4 (“Diagnostic and Statistical Manual of Mental Disorders,” 4th edition) determines the diagnosis.
Often ADHD is casually diagnosed. Eight-year-old Andrew is running all over the house and it’s driving Dad crazy. Plus, for two weeks in a row, Andrew hasn’t done even one tiny bit of homework. His grades are lousy. Andrew’s teacher thinks he has adhd. Dad suggests taking Andrew to the doctor.
Mom agrees and takes Andrew to Dr. Levin, a pediatrician. Mom says, “We think Andrew has ADHD, so does his teacher. Can you prescribe something to help him do better in school and calm down at home.” Dr. Levin, who is not trained in psychotropic drugs or neurological disorders or psychology and has only 15 minutes to spend per patient, writes out the prescription.
Or ADHD is diagnosed by a psychologist who refers Brittany to a child psychiatrist who can prescribe an ADHD drug. Dr. Allen asks Brittany’s Mom a few questions from the DSM4. Brittany’s Mom answers “yes” to all the questions and leaves the Dr. Allen’s office with a prescription for Ritalin, the most common drug prescribed for ADHD. Dr. Allen like Dr. Levin has only 15 minutes per patient.
Dr. Levin and Dr. Allen are both excellent physicians and have the best training in their specialties. They care about children’s health and are highly respected among other doctors. But Dr. Levin isn’t trained in psychology, psychiatry, or the stimulant medications used in these fields. And Dr. Allen isn’t trained in looking for medical conditions or diseases that aren’t of a psychiatric nature.
Turns out that Andrew is extremely allergic to red dye 40 found in dozens of foods and most candy that isn’t chocolate. As for Brittany, she has extremely low levels of Vitamin D.
When Andrew stops eating anything with red dye 40 and Brittany starts taking Vitamin D supplements suggested by Dr Levin, their behavior improves. And their grades go up.
At least half a dozen conditions and situations can look like ADHD.
ADHD: How to Get the Right Diagnosis
Many psychiatrists agree that the most accurate diagnosis comes from a brain scan such as the qEEG. However, brain scans are expensive and insurance rarely pays for them.
But a complete physical exam with lab tests can help determine if something other than ADHD is going on. And a family psychological evaluation can help determine if stress at home is causing behavior that looks like ADHD.
Savvy parents can experiment at home. Cut out foods with artificial color and artificial flavoring. Ask the pharmacist about side effects for medications your child is taking. Decide that you will stop worrying and arguing about the mortgage and car payments every night at dinner in front of the kids.
Maybe your kids don’t have ADHD after all and maybe just a change in diet or environment will help with ADHD symptoms. To find out what looks like ADHD and isn’t, I invite you to get your copy of the FREE “Maybe They Don’t have ADHD” inventory and checklist.