With the number of children being diagnosed and prescribed stimulants for Attention Deficit Hyperactive Disorder (ADHD), it is important to stop and investigate the negative side effects associated with these medications. Studies show that the over 15% of high school students have been diagnosed with the disorder, and the number of children taking these stimulant medications has risen to 3.5 million from 600,000 in 1990 (Schwarz). Many parents see no imminent problems with the immediate decision to put their children on these medications as doctors and drug companies advocate that there is little to no harm done to children and that the negative side effects are very minimal. It is said that since these drugs have been used for over 60 years with little to no casualties, they are completely safe and should be continued to be used with no questions (Hallowell). However, many psychologists are testing alternatives to these medications, claiming that behavior-related treatments are safer and more effective. Because of the proven negative effects, it is crucial to today's society that extensive testing be performed on children that are proposed to have ADHD before they are even considered being prescribed medication. 

There are some children that can positively benefit from medication and make it highly considered as a valid treatment. For instance, a child's behavior may interfere with his learning to the extent that he won't advance to the next grade if action isn't taken. If a child's behavior is determined to be a result of ADHD and not some other cause, a low dose of ADHD medication can be prescribed for a trial period (such as a one-month period) (Rettner). 

While investigating twin studies, we can see the symptoms of ADHD and prove that it is a real disease. Their results showed that parents with ADHD are more likely to produce offspring with the disease. The authors investigate ADHD subtypes, sex differences, comorbidity rates, diagnostic aspects and environmental influences on ADHD (Freitag). Looking at these twin studies creates a legitimacy for the disease. Many people that have been given a diagnosis for ADHD struggle with finding legitimacy for their condition because of the prevalence of the disease in today's society. Studies like the one listed above, and many others show that this disease is real and important to diagnosis, though the prevalence of misdiagnosis is what is stealing the legitimacy from it. A TIME magazine article points out that many people may say that ADHD does not exist or that it is a result of bad parenting in actuality it is not a modern disease, it dates back to 1763 (Foley). There are many other factors that can contribute to inattention, rather than solely ADHD. 

Findings show that 80 percent of kids who try stimulant medication for ADHD treatment show positive outcomes and that there is no other medication for a psychiatric condition that has this high of a response rate (Miller). A positive view of medicating children, claims that medication is like a pair of eyeglasses; completely safe and effective. Parents should not feel guilty or ashamed to treat their children with stimulant medication, in fact it should be the first resort (Hallowell). There are very legitimate points that come along with the avocation for administering stimulant medications to children with ADHD. These medications can show very steady incline in learning and behavior in children and can be very helpful to parents and teacher when dealing with children who are unruly and have a lot of trouble paying attention. Though there are varying levels of these behaviors. 

 ADHD can be seen as a cluster of symptoms, that when presented together can be diagnosed as Attention Deficit Hyperactive Disorder (Foley). The most common way to treat these symptoms such as inattention, hyperactivity, and impulsivity (WebMD). Because of the variation of symptom levels, it is important that treatment of the symptoms vary as well. Treatment by way of stimulant medications is important for some children diagnosed with ADHD, though not all should be immediately given a prescription for these medications. 

Another important area to view when investigating the prevalence of misdiagnosis is a journal article presenting an international study that focuses on the relationship between birth month and prescription to ADHD medication. Children that are young for their age often present symptoms of ADHD but may not actually have the condition. This study was based in the Netherlands and investigated over 2000 children between the ages of 5 and 12. There was a strong correlation found between birth month and prescription to stimulant medications. This continues to prove the idea that many children are misdiagnosed and improperly prescribed stimulant medication (Krabbe). Even when not misdiagnosed is, many children who are taking medication for ADHD could do as well or better with alternative treatments that have fewer side effects (Koplewicz). 

In addition to the idea of misdiagnosis, it is important to examine the short and long term effects of stimulant medications to the brain and lifestyle. Some short term side effects include; Heart problems, High blood pressure, Glaucoma, Stroke, Depression, Bipolar disorder, Anxiety, Tic Disorder, and Mental health disorders (Dodson). Appetite loss is a very common side effect in young children. This is something that can impact the life of a young child greatly. During the crucial years of growth and development, many children are not able to gain enough nutrition because of this appetite suppression caused by stimulant medications. Long term effects can include negative impacts on the brain. Children who are inappropriately diagnosed with ADHD, or those who have other mental health conditions, may be at increased risk for mood disorders or aggressive behavior while on the medication (Rettner). 

"Our grandson has been on the medication for over a year now and I see a major personality change. He is uptight. We miss the old free-thinking, active boy that he was pre-medication."  -- Sue (Koplewicz). Simple statements like this from those whose loved ones are affected by the negative effects of stimulant medications should be enough to show the importance of only using them when necessary. 

One reason for the over diagnosis of ADHD is that it is often diagnosed without the type of thorough history and examination needed for an accurate assessment. This would involve talking to parents, the child and teachers, as well as reviewing school records and other testing. Instead, many children are diagnosed after a visit of 15 to 20 minutes with a pediatrician or other professional (Koplewicz). Many other problems, such as learning disabilities, anxiety, or a child being gifted (Hartnett), can cause symptoms that can be easily misdiagnosed as ADHD. Too often, doctors do not take the time to investigate these possibilities before making an immediate diagnosis, as stated before, as little as 15 minutes can be spent on diagnosing a child and prescribing them with stimulant medication. 

An article examining the argument that the two groups, gifted and ADHD children, often exhibit similar behaviors can be useful again for misdiagnosis. These behaviors have different explanations but can be easily mistaken for one another. The piece presents a study in which graduate students were presented case studies of various children and asked to provide a diagnosis. Every student provided the solution of ADHD and did not consider that the child could be simply gifted. The lack of bias in this study simply proves that it is quite simple to make this misdiagnosis. This is important to back up the idea that extensive testing is necessary when making a diagnosis of ADHD. 

Another source of mis or over diagnosis of ADHD is because of the constantly increasing demands on children and families that didn't exist a generation ago. Todays  parents and children are constantly being rushed around and expected to participate in everything there is to offer. Kids need to play every sport, join every club, participate in family activities, and are still expected to do well in school. With all of this on the minds of today children, adding in the ever present electronic distractions, it is easy to see how a diagnosis of ADHD and a simple pill to fix it can become an easy choice for parents and doctors alike. "I was put on these meds back in the '90s for a year. I still can't recall anything from that year. It's just a fog of disjointed images and events. Now? I went to college and am a functioning, productive member of society. Losing a year of my childhood wasn't necessary."  -- Bolt (Kopelwicz). This is another quote that comes directly from someone affected by stimulant medication. 

Another article poses the question 'should children receive medication for ADHD?'. It provides examples of the negative effects on children. The author states that medication cannot make up for skills or address learning problems. Many children are given stimulant medication inappropriately. They conclude that it is important to weigh all factors before deciding to medicate a child with ADHD. The number of articles and quotes regarding the topic of misdiagnosis and negative effects should show the importance of looking deeper into the prescribing of stimulant medication to children that may be misdiagnosed to begin with. 

Scwarz in his article in The New York Times aims to attack pharmaceutical companies in whole and address the rise in ADHD diagnosis as well as the rising number of stimulant prescriptions to medications such as Adderall and Vyvanse. He states there is too much of a desire to find and treat those with ADHD which is leading to these number, Schwarz also discusses the recent rise in diagnosis in adults as well as the drug companies' tactics to normalize the disease as well as the medications.  A jump from 60,000 to 3.5 million since 1990 is enough to raise major concerns for misdiagnosis. 

A simple solution to this problem is more extensive testing of children who present symptoms of ADHD. It should not be as simple as walking into a doctor's office and telling a family physician about your symptoms and receiving a prescription that same day. Some benefits of more extensive testing may include the elimination of long-term negative effects to the brain, the elimination of the risk of dependence, and the elimination of easy access of others to stimulant medications of which they are not prescribed. This has become a major issue. Many teenagers are seeking friends that have been prescribed stimulant medication and taking these pills which they do not need when they wish to study or party at a more elevated level. If less drugs are circulating, it will be harder for these teens to obtain stimulant medications that are damaging their bodies. 

With the decrease in prescribing on stimulant medication using the method of more extensive testing, there are very practical alternate treatment options. One being classroom intervention. One of the most detrimental places we see the effects of ADHD is in the classroom, so it is logical to begin treatment at the root of the problem. Children with ADHD cause many disruptions to teachers and fellow classmates because of their inability to focus and often require special attention that the teacher may not be able to provide. Many students may need something further than classroom intervention, like special attention from trained specialists within their schools who know exactly how to work with children with the condition of ADHD. Studies show that there is an obvious positive benefit to the child with ADHD as well as their classmates when classroom intervention is used (Gaastra). 

Behavioral treatments are also very important, though they can go hand in hand with stimulant medications, they can also be very effective on their own. Parents need to practice behavioral interventions in the home. It may also be necessary for some children to see a behavioral or cognitive therapist in order to control the behaviors associated with ADHD and be able to function just as their peers do in day to day life. 

Another article suggests that natural treatments can be beneficial to solving ADHD. Dr. Friedman of Cornell proposes that there is a natural cure to ADHD. He proposes A.D.H.D. may not be a disease, rather a set of behavioral traits that don't match expectations. He provides treatment examples in which people change their environments or routines to help with treating their ADHD to increase pleasure center reactions. "Compared with the rest of us, they (those diagnosed with ADHD) have sluggish and underfed brain reward circuits, so much of everyday life feels routine and under stimulating."(Friedman) Rewards stimulate the release of dopamine in your brain and trigger the thought "this is important, I should pay attention". The problem with ADHD isn't the makeup of the brain itself, it's the lack of interest these people have for the world we live in. Many with the condition ADHD can hyper focus in on one thing because this is what they find to be interesting. Children especially, can pick and choose what is fun for them and what they opt to pay close attention to. Because of the way that novel experience effect dopamine levels in the brain, it is important that those with ADHD especially put themselves in new and exciting situations so that they can keep their pleasure centers rewarded and reduce the symptoms of the condition. Friedman shares examples of adults with ADHD that simply made changes to their personal lives that cause their symptoms to vanish. 

"What we, in our short-sightedness, view as a childhood deficit because of its interference with classroom function can often yield our most beautiful manifestations of human thought and diversity later in life"(Willingham). 

In conclusion, because of the drastic rise in diagnosis of ADHD in the recent years, and the most common treatment being stimulant medication, something needs to be done. Extensive testing before making a diagnosis and prescribing medication to a child is the solution for this epidemic. The harm that we are doing by medicating so many of todays children is simply irreversible. Having so many dependent adults will cause problems in the future that are unable to be foreseen today. Consulting with parents, teacher, and social workers that personally know and work closely with a child is necessary before making a diagnosis. The next step, after a diagnosis, should be an implementation of classroom intervention and behavioral therapy. Medicating a child should be the very last resort. We cannot fail to recognize that stimulant medications can be extremely beneficial in the treatment of children with ADHD. Although because of the negative short and long term side effects, it should only be used when absolutely necessary. When stimulant medications are used, dosage should be monitored closely in order to protect the best interest of the child. When we have something that is effecting so much of society, why is it being ignored or put off as unimportant? It is time that parents and doctors reevaluate the way they see the condition of ADHD and how they treat it. Extensive testing may prove to be a little more extensive than the current route, but in the end it will save the lives and brains of countless children that are being mistreated or misdiagnosed. 

