Overdiagnosis of A.D.H.D.

When did inability to sit still in class become a medical condition?

Posted May 24, 2013

When I was in college in the 1970s, the prevalence of Attention Deficit Disorder (A.D.D.) was approximately 5-10 percent. Today, some states are reporting rates as high as 23 percent. What accounts for this huge increase in attention disorders? A true increase in the prevalence of the neurological disorder? Unlikely.

Much more likely is an increase in the rate of diagnosis. When I was working in the Child Guidance Center in 2004, every kindergarten teacher had from 2 to 5 boys in her class with A.D.H.D. And some teachers had even more. These excessively wiggly boys that the teacher could not control were referred to our clinic. Once in our clinic, they easily met the DSM criteria for Attention Deficit Hyperactivity Disorder (A.D.H.D.) such as: squirms in seat, talking excessively, on-the-go, blurting out answers, difficulty awaiting turn, and interrupting. After a diagnosis of A.D.H.D., the next step was medication. This was almost automatic without a second exam by the pediatrician. Nearly every 5 year old boy referred to our clinic met the criteria for A.D.H.D and the prescriptions were liberally administered.

It has been my observation over the years, that ordinary childhood behaviors like impulsivity have become medical illnesses. A child that was once considered impulsive, active, or absent minded has a neurological condition these days. Instead of exercise and lessons in self-control, the child gets pills. No wonder. This is faster and easier. Parents are too busy to discipline their children (oops, did I say the D word?), a medicated child is easier on the teacher, provides a steady income for doctors, and substantial profits for pharmaceutical companies. And, to make matters worse, the trend toward the medicalization of mild symptoms is only increasing. The most recent version of the DSM now includes an adult diagnosis, Adult Attention Deficit Disorder. Just think….parents now have excuse for losing the car keys and a pill to treat it.