Sunday, 17 February 2013

Problems and Solutions in ADHD Tests

Let us look at what are the best ways of testing ADHD. Then we shall examine various approaches which are quite different in France and the USA.  We shall also survey the numbers and the risk of making an error when administering tests to diagnose ADHD.

What is ADHD?- biological, neurological or what?

Most experts are now agreed that ADHD is a neurological biological disorder which reveals itself in problems to do with the following areas of behavior at school and at home. These include:-
  • restlessness,
  • fidgeting,
  • hyperactivity,
  • lack of focus,
  • inattention,
  • distractability
  • impulsivity

ADHD symptoms explained

Here we look at the ADHD symptoms but also in the second part how ADHD meds may be actually detrimental and are only a partial solution.

  Is it hereditary?

Most experts now agree that the condition has a strong genetic link. That means that bad parenting will not actually cause it but that the genetic makeup will be the determining factor. It is estimated that ADHD may well run in families and that there is a strong chance that one of the parents may also have this condition. A recent report in The Lancet recently confirmed that there is a gene which is responsible for ADHD behavior.

Why we have to get ADHD testing right.

Diagnosis of ADHD is not that easy and there are many different approaches. We know that in the USA, the condition is usually confirmed by the use of questionnaires and this mainly consists of ticking off boxes and getting an idea of where problematic behavior may lie in at least two settings. Numbers vary but in the US, it is now estimated that between 5% and 10% of the children will have this condition. Estimates for the UK are even higher and are pushing the 10% mark.

The fact that mistakes are made and the diagnosis procedure itself is full of holes has raised some alarm among the experts.  They are worried that:-
  • one in five children in the USA may actually have been misdiagnosed
  • there are over 50 childhood conditions which mimic many of the symptoms of ADHD
  • there are many co- morbid conditions such as OCD, ODD, anxiety and depression which will also be present when properly diagnosed.
  • between 50% to 60% of children will carry this into adulthood
  • there is no pharmacological treatment which can actually cure the condition.
  • only about 5% of children with ADHD actually graduate whereas among normal teenagers the rate is at around 28%.
Differences between France and the USA

When the French approach the problem of ADHD, they are much less prescriptive in their diagnosis and that is reflected in the actual numbers of children with this condition. They do not use the DSM IV (DSM V due in 2013). They have developed their own criteria which are contained in the CFTMEA (Classification Française des Troubles Mentaux de L'Enfant et de L'Adolescent).  

They particularly look at the social context of the child and take a much more holistic view in trying to get to the bottom of the causes. They are also much less likely to treat the condition with ADHD meds as in the USA and will make great efforts to do ADHD testing according to the social context of the child. There will be much more counselling and behavior therapy.  The Americans will home in on the biological imbalance and attempt to treat that with mind altering drugs.

The figures of ADHD in France reflect this much safer and altogether more sensible approach.. The numbers are much lower but that has to be balanced with their definition of what ADHD actually is, which narrows the field considerably.

The consequences of not doing ADHD testing properly

So, the attention deficit disorder test must be properly carried out and all the questionnaires  are gone through if we are to avoid the alarming statistic that one in five children are misdiagnosed and have to go through life and college with the wrong label with all the consequences that brings. Now that is scary!

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