Yesterday’s PediaBlog post about the increasing prevalence of ADHD struck a chord with pediatrician Ed King (Pediatric Alliance – St. Clair Division):

Your comments about a “banging a square peg into a round hole” resonate.

The recent CDC study you cite highlights many varied and important issues with our current “system.”  Our mental health care system, educational system, and medical system are all at various stages of evolution, struggling to deal with our rapidly evolving understanding of ADHD and learning issues in general.  There remain tremendous gaping holes in diagnosis and treatment.

Of the 10% diagnosed with ADHD, many providers would agree some is from over- diagnosis or misdiagnosis because a definitive diagnostic tool for ADHD is significantly lacking.  This can happen with any diagnosis: cancer, pneumonia, elbow fracture… Also, there are additional percentages of undiagnosed children and adults with ADHD/ADD.  Still, I find the CDC results hopeful because they show we are continuing to strive for better system.

The most important thing I would ask parents to consider is that if their child is really unhappy with school (more than just the average, “I would rather be playing”), then they should seek care from professionals who have experience with psychological AND educational issues.  Some pediatricians, psychologists, and school systems have more experience with this than others.  Keep trying.  Sometimes the answers don’t come easily, but with some effort the source can often be teased out.  For example: kids who are anxious can’t focus and look like they have ADHD, but kids with ADHD often get quite anxious because school is horrible.  It sometimes takes time and effort to get to the real diagnosis.

I would also caution parents to not necessarily be reassured when the school says, “everything is fine.”  Schools are not mandated to aggressively or proactively diagnose mental health problems per se.  And some school systems are strapped for resources and may often wait until there are serious problems before acting.  So, sometimes “everything is fine,” means, “your child is not bothering us yet.”  Or, it could mean your child is getting informal accommodations from generous teachers filling in the gaps in the “system.”

It is crucial we keep trying to improve the system because history has shown that there are some children (extremely bright, average, or otherwise) whose potential is being lost.


(Image: Dr. Edwin King –