ADHD Diagnosis Controversy

CRegal Editor
  • Some people still question whether ADHD is a legitimate condition.  Some say ADHD is overdiagnosed; others say that ADHD is the product of bad parenting; while still others say that ADHD is completely fabricated.


    According to the American Psychiatric Association, ADHD is indeed a neurobehavioral condition.   It is characterized by "excessive restlessness, inattention, distraction and impulsivity," but there is no blood test, brain scan or performance evaluation that can definitively say whether a person has ADHD or not.  While there is no single test for ADHD, physicians and psychiatrists have developed sophisticated diagnostic tests to avoid misdiagnosis.   

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    According to Robb Mapou, Ph.D., it takes a comprehensive evaluation to diagnose ADHD, though there is no specific test for ADHD.  In addition to a lack of definitive test, according to ADDitude Magazine, psychiatrists, psychologists, family doctors, neurologists, social workers and master-level counselors are all able to diagnose ADHD.  With so many contributing factors going into a diagnosis and various professionals using different procedures to evaluate symptoms, some feel that the possibility exists for incorrect diagnoses.


    Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), an ADHD advocacy and education group, provides information on symptom and behavior "checklists" to be included in the evaluation process.  The packets include scales ranking types of behavior or the severity of symptoms to help parents or teachers fill out questionnaires that will help a counselor or physician make a diagnosis. Guidelines set by CHADD and the American Academy of Child and Adolescent Psychiatry recommend that information should also be gathered from a series of evaluations conducted by parents, caregivers, teachers, medical professionals and, in many cases, the patient.  The findings are then compared to the Diagnostic and Statistical Manual (currently in the Fourth Edition).  From here, one of the aforementioned people can diagnose a person with ADHD.


    Bruce Bracken, Ph.D., school psychologist and professor of Educational Foundations at The College and William and Mary, said that, despite no simple, single test to give a diagnosis, "there are standardized methods and standardized protocol for diagnosis - the IDEA, CHADD and APA all have a standardized procedure."  According to Bracken, these accepted diagnostic procedures and considerations have started to create a culture in which little is left exclusively to the discretion of the person diagnosing the condition.


    Bracken did say misdiagnoses do occur.  "The problem is that, in some cases, if someone is struggling with work, ADHD may be the first thing considered, though it could be anything from depression or simply being overwhelmed by the workload."  According to Bracken, the diagnostic criteria and standards should stop these people from gaining a diagnosis of ADHD. 


    After seeing significant improvement in understanding and acceptance since the founding of CHADD in 1987, the future looks bright for ADHD testing.  Bracken said that, going forward, "other forms of testing are going to become more prevalent to better evaluate patients [such as]continuous-attention type tasks -- moving past paper-and-pencil activities - including responding to stimuli on a computer, real-life attention tasks and contextual analysis of behavior."


Published On: August 19, 2010