Aug | 2013
The top reasons you or your child might be misdiagnosed with ADHD
Value of this blog: learn the warning signs of misdiagnosed ADHD to protect yourself, your family and or your child
My professional experience base: Over 10 years of work as a behavioral scientist, published researcher, child counselor, and healthcare advocate for those who have been misdiagnosed.
It is no secret that ADHD has been over-diagnosed in the United States. It is an “easy” diagnosis for doctors to give if a person has chronic problems with focusing or with hyperactivity. By “easy” I mean that you do not need a large variety of symptoms to qualify for this diagnostic category. In fact, you could have as few as six symptoms and be diagnosed with ADHD.
The problem is there’s a large variety of problems that camouflage themselves as ADHD and may never be identified.
Here in Tucson, I have probably treated over 80 cases where someone came into my office was diagnosed with ADHD but through careful assessment I determined that while there were “ADHD like” symptoms, there was a more accurate way of understanding the problem that indicated an ADHD diagnosis was not the most accurate one.
The below list represents the most common reasons ADHD is misdiagnosed that I have seen in my work “in the trenches” with adults and youth.
–Superficial assessment: Many healthcare professionals struggle to have the time to conduct the time-consuming assessment that is often necessary to definitively know whether ADHD is present. For example, in my work with children the minimal assessment I will conduct is intake interview of the parents, questionnaires given to the parents, interviewing the child, and questionnaire to the child, and questionnaires to two teachers and interviewing one teacher by phone. To me, that is a minimal standard.
-Undetected learning disability: many people go without having a learning disability identified, and when they try and learn new material they become so frustrated they can’t focus and look like they have ADHD. A thorough behavioral scientist will take the time necessary to not only look at the superficial symptoms, but will dig deeper to understand the history of the problem including what was the original problem. Often, because the original problem was never accurately identified and treated, the person simply got so frustrated they start to stop paying attention in school because it was so frustrating and in fact overwhelming. This happens all the time!
–Undetected anxiety: so many people who look like they have ADHD actually have impairing problems with anxiety that manifests as worrisome thoughts that constantly derail a person’s flow of consciousness. They have trouble focusing constantly because they continue to over focus on worries they have, so to the outside observer they look like they have ADHD.
–Pathologizing the highly energetic child/adolescent: with adults seem to often forget that as children mature they often outgrow what looks like a hyperactive behavior at the younger ages. Particularly in our culture where it seems as if “boys can be boys” sometimes parents or teachers overreact and want to medicate children rather than identifying ways to channel their energy. Some of our greatest inventors and leaders I am sure could’ve been (in accurately) diagnosed with ADHD and their early school years. In other words, just because a child cannot stay in their seat in school does not mean they have ADHD. This leads me to the next bullet point.
-Poor fit between school environment and child’s temperament, intellectual gifts, and high level of energy. This can often be the case with young boys or intellectually gifted students, who may also be highly active to the point where they can look “ADHD like” at times. Point of fact: children with sharper intellects often have more trouble staying focused because they find it general quirky alone boring. I have often discovered that a child who comes into my office is having focusing problems not because they have ADHD but because school is not challenging and so they are stimulating themselves by being social or trying to manipulate the sc classroom environment because that’s a more exciting challenge. I believe that in the future education will become even more individualized as the Internet off offers more tailored and self-paced learning environments. For now as parents and teachers, we must take seriously the need to tap into each child’s talents appropriately. You can always have your child assessed to see if they are gifted in a certain area.
Feel free to refer to an earlier blog I wrote about how and why you might have your child assessed for giftedness: https://www.doctorbrunner.com/why-and-how-you-might-have-your-child-assessed-for-giftedness-or-exceptional-talent/
-Desensitization (via addictive computer use) to low arousal situations: Youth or even adults being exposed every day for several hours to unhealthy amounts of artificially rich and “rapidfire” visual screen environments are being set up to fail! While neuroscientist’s are studying the negative effects of vast amounts of “screen time” on children’s brains, it is common sense and my professional experience that if you habitually expose the brain to artificially rich environments (video games, etc) then the brain will have trouble with “low arousal” (i.e., less visually rich, simpler, slower paced) situations such as traditional learning environments in the classroom. Think of it this way, once you as an adult find things that are really exciting for you to do, think about how hard it is to do things that are very boring and not stimulating.
Overexposing your child to artificially rich visual environments only sets them up to fail when they are in less stimulating environments . Curb your child’s access to rapid-fire technology!!!!! One way to do this is to ensure that a majority of their “screen time” is for educational purposes rather than video games.
What to do if you’re not sure if you or your child has been misdiagnosed with ADHD? You can always seek a “second opinion” and I suggest you find a credible behavioral scientists who will use not just interviews, but scientific questionnaire tools to gather information from multiple parties so that one person’s perspective is not trusted too much. That is the scientific gold standard!
A final note: There is an exciting new ADHD treatment that “goes beyond medication” called Cogmed, which I have used here in Tucson for many years. Cognitive is a evidence-based method for helping children and adults train their brain to be able to focus for longer periods. The exciting news is that the effects of Cogmed appear to last well beyond the time Cogmed is being used. The unique scientific foundation Cogmed rests upon is viewable here: http://www.cogmed.com/research. I have presented scientific information about Cogmed to the Pima County Medical Society as well as doing a talk at St. Joseph’s Hospital.
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