ADHD or Attention Hyperactivity Disorder is a condition that causes children difficulties with controlling their behavior. This disorder is broken down into 3 symptom groups: hyperactivity, inattention, and impulsivity; allowing the types of ADHD to be further broken down. ADHD can be Hyperactive/Impulsive, combined with all Three symptoms, or inattentive only ("Understanding ADHD ... "). 


When the process of diagnosis begins, it usually starts with the parents and people closest to the child as well as their teachers, nannies, etc. Parents usually are asked to evaluate how their child is doing in school, are they happy at school, have the teachers mentioned any issues at school, does the child have issues with completing homework or work in class, are there any concerning behavioral issues with friends, at school, or at home? If a doctor or pediatrician gets certain answers to these questions they will then move on to determine a diagnosis. When ADHD is diagnosed it is considered a mental disorder, and The Diagnostic and Statistical Manual of Mental Disorders (DSM) is used to make a diagnosis. The process of Diagnosis ADHD is very crucial because of the way that ADHD is treated and managed with medication and a complete lifestyle change. To put that on a child who may not even have ADHD would be difficult and unnecessary. Doctors are supposed to work very hard to confirm and give an accurate diagnosis of ADHD by following a checklist including: symptoms starting before the age of 7, significant impairment of daily life, symptoms occurring in multiple situations, and lasting more than 6 months ("Understanding ADHD ... "). These criteria are very important because a lot of other mental disorders and health issues have similar symptoms and are misdiagnosed as ADHD leading to ADHD being too frequently diagnosed but also leading to a child being on unnecessary medications for life that have significant health risks. A pediatrician may partner with a mental health specialist to compare signs and symptoms and the context of them to accurately diagnose ADHD. ADHD can be commonly mistaken for or paired with anxiety or depression, aggression, sleep or seizure disorder, developmental disorders, or mental retardation. Other conditions that can coexist with Attention Deficit Hyperactivity Disorder are oppositional defiant disorder, mood disorder, depression, anxiety disorders, and learning disabilities ("Understanding ADHD ... "). Throughout the years, there have been many theories about a specific test for ADHD. Scientist and Doctors have disproven several tests including high lead levels in the bloodstream, continuous performance testing, brain imaging, brain wave tests, thyroid tests, etc. ("Understanding ADHD ... ").


ADHD comes with lots of issues in parenting. Parents may wonder if they should instantly medicate their child with psychostimulants, or work with lifestyle changes and holistic remedies to solve the issue. Most doctors recommend Medication for long-term benefits of the child. But what if your child is falsely diagnoses with ADHD at the first sign of similar symptoms and placed on medication? Recent ADHD research done at the Boston Children's Hospital along with the Mayo Clinic have shown that ADHD, a common childhood disorder, is starting to continue into adulthood (Walton). Our diagnostic technique for ADHD needs to be adjusted to represent the new generation and new strains on children (Walton). It also needs to be very specific in order to differentiate between ADHD and other disorders that are commonly mistaken for it. doctors need to figure out what is ADHD and what is not. Anxiety is most commonly mistaken for ADHD because it also causes kids issues with focusing. Anxious kids are "worried, preoccupied, and restless. But they're not really hyperactive" (Walton). This behavior may manifest itself the same way as ADHD therefore mistaking a diagnosis. This is why the diagnostic process of ADHD needs to be made more unique and specific therefore allowing children more accurate medication and treatments. Children may have attention problems but also have no ability to control their emotions and behaviors, placing them in a separate category and opening up a new diagnostic possibility. The symptoms need to be assessed as a whole instead of few symptoms that match the ADHD symptom list picked out of context and placing the child on medication. Improper care for someone with ADHD can lead to many problems at school, inadequate treatment, mis-medication, and insufficient parenting (Walton). 


The Center for Disease Control (CDC) has reported elevated rates of ADHD in the years since 2003. In 1980, ADHD was only prevalent at a rate between 3-5%. More recently in the years from 2003-2011 it is has increased almost 35% (Newmark). Doctors are unsure if this many children have always had ADHD or if something has shifted causing a larger prevalence in the disorder. Others are convinced the diagnosis has become more common due to insufficient diagnostic techniques. ADHD is "the most prevalent childhood disease second only to obesity" (Newmark). There are two large issues at hand: ADHD is over-diagnosed because doctors aren't adequately assessing children, and society is pressuring them to diagnose ADHD; as well as children are being demanded to do more than they were 30 years ago (Newmark). Attention Deficit Hyperactivity Disorder may depend on the child's environment socially, and educationally. The context of the diagnosis is important. Pediatrician's need to get a full understanding of what the child's environment consists of including the school and family situation that the child is in. This poses another issue regarding diagnosis: is there time for that? Do pediatricians have time to go through an entire lifetime of criteria to accurately diagnose a child with ADHD in the usual 30-minute well visit? They usually don't. "One-Third of children or more are reported to be taking psychostimulants because of the academic pressure to succeed" (Newmark). Teachers and parents add an extra burden on children that goes back to cause them to do anything to succeed. IF children are going to doctors who are not accurately diagnosing ADHD, complaining of the typical symptoms, a doctor will immediately give them medication allowing them to abuse it to succeed in school and get into a great college. The diagnosis is so important to regulate the disorder. The numbers are elevated because not everyone who is on ADHD medication actually has ADHD by the specific Criteria found in the DSM. Doctors need to be consistent across the board with their diagnosis and take the time to evaluate the children to the fullest extent (Newmark). 


Health insurance may be a main factor in why primary care physicians aren't doing in-depth testing for ADHD. Doctors are unable to receive authorization to to the psychological testing that is required for a complete diagnosis and end up making an "educated guess" from what they know. One step they can take to better the diagnostic process is to obtain a Psychiatric History from both parents of a child to better understand what the spectrum holds for the child (Walton). This allows preemptive treatment until the proper tests can be done and can be started at the child's first ever visit to the doctor to get be on the lookout for any issues down the line. 


The article "Is ADHD being over diagnosed? An Indian perspective" addresses the concern that the rise is ADHD rates is a global issue. 

his Table Shows the rates in increased ADHD medication in developed countries (Argawal). 

There are many possible issues for this change in rates of ADHD, but most supported is the idea that the "changing diagnostic criteria in DSM" affects how doctors and mental health specialists treat and diagnose ADHD; leading to inconsistencies over time (Argawal). A less supported argument that is more sociologically supported is the idea that Pharmaceutical company's commercial interests are causing health professionals to mis-diagnose to sell medications, in turn supporting the economy. There is little evidence to support this theory, however it is widely speculated in many cases of medication and diagnosis not just ADHD (Argawal). 

Further addressing the global impact of this ADHD epidemic is an Australian Study done in 2014 that surveyed the general public to determine their views towards using drugs to treat ADHD as well as depression. The study went even deeper to ask participants if they believed ADHD and depression, two of the most easily handed out diagnosis, are over-diagnosed (Partridge). The results of the survey showed that 78.3% of the surveyed public believed that "children are diagnosed with ADHD when they don't really have it" (Partridge). There is a global concern in the publics mental health literacy; meaning mental health is not as widely accepted and treatment for mental health is not taken as seriously because the public is unaware and uneducated. Therefore, when it comes time for your child or family member to receive treatment for a mental health disorder, parents are very quick to listen to the first doctor instead of getting all the information, getting multiple opinions, making sure they have an accurate diagnosis before putting their child on possible life-long stimulant medications (Partridge). 


In the last 10 years, ADHD has become almost as common as obesity. In the "1950s America, ADHD did not exist" (Stolzer). once it was introduced, mostly seen in boys, the first and only treatment was parental behavior modification. In 2006, almost 10 million children were diagnosed with ADHD. Is it possible for a disorder to evolve this quickly? It has become too common with no biological evidence to support a diagnosis this frequently. Doctors tell parents that "ADHD is the result of a chemical imbalance within the brain in spite of the fact that there is no scientific evidence" (Stolzer). A diagnosis of ADHD almost always leads to putting children on psychostimulants like Methylphenidate commonly known as Ritalin, or amphetamine commonly known as Adderall. These are classified by the FDA as schedule II drugs, which are in the same category and have the same risks for addiction as morphine, amphetamines, opium, and barbiturates (Stolzer). Do children need to be on highly addictive medications for a disorder they may not truly have? Not to mention the many side effects that come with these heavy medications. Methylphenidate has very serious withdrawal symptoms including "Irritability, suicidal feelings, headaches, and Tourette's syndrome" (Stolzer).  Even the company that produces Ritalin, Novartis, has acknowledged that they are unaware of the long-term effects and safety of putting children on Methylphenidate. On top of this, children's developing brains are more susceptible to chemical toxicity than others and the unknown long-term consequences of the addictive medications they are on could be detrimental (Stolzer). "There are no physiological, cognitive, or metabolic markers that would indicate the presence of ADHD" (Stolzer). 

