According to The Center for Disease Control estimates, approximately 4.5 million children 5-17 years of age have ever been diagnosed with ADHD as of 2006.
The National Institute of Mental Health estimates that approximately 2 million children are currently diagnosed with ADHD.
These estimates translate into 7-8% of school aged children having the diagnosis of ADHD. If you thought these numbers seem a bit higher than those for other mental illnesses like, say, Obsessive Compulsive disorder, you’re right. ADHD is among the more prevalent diagnosed disorders, especially among those seen in children.
The diagnosis of ADHD has seen its share of controversies. Some argue it’s a sham disorder. Some say it’s a result of overparenting. Etcetera. Etcetera.
Among the controversies, is age. How young can ADHD be detected? At what age can it be diagnosed?
The majority of young children are active, perhaps even hyperactive. They explore everything that’s around them, and they love experiencing the way their bodies feel when moving, jumping, running, and so on.
As they mature, those naturally elevated activity levels start waning, giving way to well-behaved and obedient young men and women. Or, at least, that’s the hope. One way or another, the terrible twos usually last one or two years hence.
Therefore, the diagnosis of ADHD has traditionally been reserved for children 5 years or older. Some diagnosticians don’t diagnose before the age of 6 or 7. Other measures are also taken to avoid misdiagnosing children as having ADHD. For example, one of the diagnostic criteria is that the child in question must exhibit the symptoms in more than one environment – to make sure the symptoms are not caused by a specific environmental stressor.
Yet, with all these precautions in place, ADHD is still being grossly over-diagnosed.
According to a recent study conducted by Michigan State University’s economics professor Todd Elder, nearly 1 million children in the United States are potentially misdiagnosed with ADHD simply because they are the youngest – and most immature – in their kindergarten class.
Elder studied some 12,000 young children. He found that the youngest kindergarteners were 60 percent more likely to be diagnosed with ADHD than the oldest children in the same grade. Similarly, when that group of classmates reached the fifth and eighth grades, the youngest were more than twice as likely to be prescribed stimulants for ADHD.
Overall, the study found that about 20 percent – or 900,000 – of the 4.5 million children currently identified as having ADHD likely have been misdiagnosed.
ADHD can and should only be diagnosed by a physician, preferably one with special training in developmental pediatrics. However, very often parents are driven to look for a diagnosis because of teachers’ reports. According to this study children who are younger than their peers and, subsequently, less mature in all areas of development, are being held to the same standards as their older and more mature peers.
While emotional, behavioral, and intellectual immaturity may mimic the symptoms seen in ADHD, gross misdiagnosis on this scale – if this study’s results are sound – should create an outcry.
Age and developmental norms are taken into consideration during every evaluation of any child. ADHD is unique in that it considers a child’s attention span, impulse control and activity level, all areas that most younger children have difficulty with, particularly when compared to children who are older than they are. As this study suggests, caution must be taken by teachers when considering whether to alert parents about their child, by parents when taking their child for an evaluation, and by diagnosticians administering evaluations.
Determining a child’s age compared to those of his peers and classmates is a rather simple thing to do. And it is a crucial thing to do before jumping to any conclusions.
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Some children have behavioral issues due to maturity, age, lack of discipline, or problems at home but there are SOME children with real neurological disorders. It may manifest itself in withdrawn behavior or hyper behavior – it depends on the child. I like what Brain Balance has to say about the issue – http://www.brainbalancecenters.com . Strengthening brain communication through education, exercises, occupational therapy, etc. can make a big difference without drugs. I understand the difficult job that teachers have with 20 or more students who learn differently and at different levels. Never-the-less, it’s not as “easy” as every child with behavior or attention problems having ADHD. Some have sensory issues, etc.
Jennifer, you are absolutely right that the majority of children diagnosed with ADHD do have a real neurological deficit. ADHD is real. It is very real.
You make a very valid point about the teachers having a hard job dealing with 20 or so children who learn differently and are at different levels. They have my full respect for their hard work and dedication.
Thanks for stopping by and for a thoughtful comment.