The develop in early childhood and continue throughout adolescence

The Controversy Over Attention Deficit Hyperactivity Disorder DiagnosesNilo LugoAustin Peay State UniversityIntroductionThe disorder Attention Deficit Hyperactivity Disorder (ADHD) and its method for being diagnosed has been the subject of controversy since the 1990s.  ADHD can be a serious disorder that’s symptoms may lead to a variety of different undesirable outcomes such as low self-esteem.  These behaviors usually develop in early childhood and continue throughout adolescence to adulthood if the proper management techniques are not acquired.  However, it is overdiagnosed very easily and may be used as an excuse for parental figures to gain medication to soothe natural juvenile behavior rather than dealing with the problem themselves.  The medication prescribed is also considered highly addictive and can be easily abused due to its overprescription to those with or even without ADHD.  These claims are backed up with statistical data that suggest the same information.  Along with overdiagnosis there is also misdiagnosis which can be much worse.  A misdiagnosis may lead to a child with a learning disability never receiving help for their disorder, then getting help for ADHD something they do not even have.  All these factors are just a few of the reasons why the diagnoses of ADHD is such a controversial topic.  Which is why it is important to understand that ADHD is widely medicated and diagnosed for little to no reason most of the time.DevelopmentThere is no known cause for ADHD and the risk factors considered to be associated withthe disorder have a very insignificant impact as well.  Environmental agents such as smoking,consumption of alcohol during pregnancy, and exposure to lead are possible correlations toADHD.  Brain injury has also been the focus at one point as well as sugar restricted diets. All ofthese have shown no noteworthy data to be sufficient confirmation, however, genetics seem toplay a possible role in ADHD in that “25% of the close relatives in the families of ADHDchildren also have ADHD” (NIMH, 1996).  Due to there being little evidence for predisposing factors for ADHD it is easy for doctors to diagnose without having proper evidence or any evidence at all.  A recent development by scientists, of a possible cause to ADHD, is the comparison of the brain of those who suffer from the disorder and those who do not.  Studies have shown the brain capacity of those with ADHD is 3 – 4% smaller than those who do not have the disorder especially in the regions of the brain that manage problem solving, advance planning, impulse restraint, and motor coordination (NIMH, 1996).  Along with this discovery, recent research has also shown the white matter in those with ADHD is also smaller in volume than those without the disorder.  Since the white matter thickens as the brain matures and as the child gets older this would explain the behavior in those with ADHD not correlating with the child’s actual age (Aoki et al., 2017).  Even with the possible links between these factors and ADHD it is hard to provide concrete evidence for how one has developed the disorder and makes it much easier for a doctor to give a false diagnosis or even misdiagnose without looking into actual cause for the disorder.Disorder ADHD is classified by the Diagnostic and Statistical Manual of Mental Disorders IV as neurobehavioral disorder that affects many aspects of a sufferer’s life by way of the three main symptoms: inattention, impulsivity, and hyperactivity.  Inattention refers to the incapability of maintaining concentration.  Several signs of inattention include being easily distracted, forgetting specifics of daily activities, losing items frequently, not paying attention or listening, and the inability to follow directions.  Hyperactivity refers to being excessively physically active.  Restlessness, constant movement, and the inability to stay seated or play quietly are signs of hyperactivity.  Impulsivity refers to a compulsion inducing a spontaneous act.  Various signs of impulsivity include not being able to wait turns, frequently interrupting others, and snatching items from others.  Yes many children exhibit these types of behaviors, however, for a diagnosis of ADHD signs and symptoms must appear in more than one environment before the age of seven and must be present for at least 6 consecutive months (NIMH, 1996).  These symptoms lead to academic underachievement, low self-esteem, and disastrous personal relationships with both families and peers (Clinical Practice, 2000).  Being more common in children and adolescents, ADHD can severely impact the growth and learning of those affected by it making it extremely difficult to attain academic achievement.  This disorder can be a very serious issue for some individuals impacting their performance and disable focus in a learning environment all together.   For these reasons it is important to distinguish between the actual disorder and those who are wrongly diagnosed with ADHD.MedicationPharmacological treatment used for individuals suffering from ADHD would be a methylphenidate hydrochloride known as Ritalin, which is a mild central nervous systemstimulant.  The generic brand of Ritalin is methylphenidate.  It is recommended that 2 to 3 dosesbe taken per day for a total of 10 to 60 milligrams of Ritalin, depending on the severity.  Children should not exceed 60 milligrams in a day (Norvatis, 2007).  The patient should inform the physician of any other medications being taken especially monoamine oxidase inhibitor, if the patient is experiencing anxiety, tension, or agitation, if vision problems exist, Tourette’s or a family history of it, heart conditions or problems, mental health issues, or a history of seizures. Children under the age of six should not take Ritalin (Norvatis, 2007).  The major side effects of Ritalin include suppression of growth, seizures, vision problems, aggression, materialization of new psychotic or manic symptoms, hypertension, and in some instances sudden death in both children and adults.  “Headaches, stomach aches, trouble sleeping, nausea, decreased appetite, nervousness, dizziness, and heart palpitations” are other side effects of Ritalin (Novartis, 2007).Medication Cont. One the the main concerns with the drug Ritalin is that it is highly addictive and easily abused.  The uptick in ADHD diagnoses has led to a severe over-prescription of Ritalin in the United States.  The International Narcotics Control Board (INCB) of the United Nations, which monitors drug addiction in the world, has become concerned with the abundance of the drug available in the United States (Breggin & Scruggs, 2001).  The United Nations Continued to add the fact that that Ritalin is mainly abused by those foregoing ADHD treatment.  They also released a statement with great insight into the situation, “With respect to abuse, according to estimates of the Drug Abuse Warning Network (DAWN) of the United States, the number of methylphenidate-related emergency room mentions for persons aged 10-14 has since 1990 increased more than 10 times and in 1995 reached the level of cocaine-related mentions for that age group” (Breggin & Scruggs, 2001).  These statistics speak volumes for the situation and can be easily prevented by a more accurate testing process for those who have may or may not have ADHD.  Unfortunately, the overdiagnosis of ADHD has led to the overprescription of Ritalin and thus made an overly avoidable problem difficult to remedy at the time being without proper awareness.Non-Pharmacological TreatmentOne non-pharmacological treatment for those who suffer from ADHD is cognitive-behavioral skills training. This is a great alternative to the highly addictive Ritalin and can be a more long lasting solid solution to one’s disorder.  The standard cognitive behavioral therapy program includes learning the effects of ADHD and developing strategies necessary to cope with those effects. This would include providing structure and boundaries, providing simple instructions, maintaining a schedule, breaking larger projects into smaller portions, reducing distractions, and encouragement of good behaviors. Patients can eventually implement coping mechanisms in order to maintain control over the effects experienced. Of course many of these tasks would need to be implemented and monitored by the parents of the ADHD child.Overdiagnosis The overdiagnosis of ADHD has been a very controversial issue in the field of psychology in recent decades.  From 1997 through 2006 the annual increase for those diagnosed with ADHD was 3% (Shire, 2007).  This increase in diagnoses was caused by a variety of reasons.  One is that many of those who are diagnosed with ADHD are children and adolescents brought to the doctor by their parent and/or guardian.  Often these parental figures demand ADHD medication for their child.  However, in reality their child may just be going normal immaturity and not ADHD (Kopelwicz & Newmark, 2013).  According to the Diagnostic and Statistical Manual of Mental Disorders IV the symptoms of ADHD must persist for six months for someone to have the actual disorder; the question of how long these symptoms have been occurring is normally asked toward the parent and can easily be fabricated to ensure that medication is acquired.  This can be a problem for those with the actual disorder as they may be thrown in this group and given medication with no other treatment for their own disorder and thus be misdiagnosed.Overdiagnosis Cont.The statistics back up the theory that ADHD is overdiagnosed in children.  Hispanic children are least likely to be affected as compared to non-Hispanic white and black children (Pastor & Reuben, 2008).  Seeing as that in Hispanic culture rules are a very firm and parenting is very strict it is likely that immature behavior is treated as such and no medical attention is required because of this.  In addition, those living in a mother-only family environment are more likely to be affected by ADHD than those living in two-parent environments and those mothers whose education level were in the median of a high school diploma were more likely to have children who suffer from ADHD.  However, in older children the most educated mothers had children with ADHD (Pastor & Reuben, 2008).  These statistics suggest that single mothers have a higher chance of having ADHD than children being raised in a two-parent household.  This seems to be due to the fact that a single mother may have trouble keeping control of their child’s immature acts and seek out medication to put an easy end to these behaviors.  Also those mothers whose education level were in the median of a high school diploma were more likely to have children who suffer from ADHD.  However, in older children the most educated mothers had children with ADHD (Pastor & Reuben, 2008).  This seems to defeat the points previously made but it only supports it even more.  Well educated mothers are more likely to understand the difference between juvenile acts and actual ADHD so they know when to go to a doctor to seek help rather than those who go just to get medication.  They may also be able to distinguish ADHD from another disorder deterring a misdiagnosis which is another serious problem regarding ADHD diagnoses.Misdiagnosis Many are disorders are often confused for ADHD and thus misdiagnosed as such leading to many problems for these children with another disorder.  Often times inattention is used as a defining factor in diagnosing ADHD.  Although, inattention may be useful in diagnoses for ADHD, it is also a common symptom of Obsessive Compulsive Disorder (OCD) (Spiro, 2017).  OCD may cause a student to lack attention in class due to children trying to control their compulsions leading to them being diagnosed with the wrong disorder and treated for ADHD when they don’t even have it.  Learning Disorders may also be confused for ADHD.  More than 50% of children with a learning disorder have inattention.  Their lack of attention in classes or in their at home reading caused by a learning disorder may be confused with ADHD and can easily have them misdiagnosed with ADHD.  Another disorder associated with inattention is Post-Traumatic Stress Disorder (PTSD) which is also a common misdiagnosis of ADHD and much more serious than OCD.  PTSD may be caused by a traumatic event that should be addressed with the child for further treatment, but if the disorder is labeled as ADHD it will be treated as ADHD and the child may take years or never recover from their PTSD.  Those are only two of the multitude of misdiagnoses there are for many other disorders such as autism and depression (Spiro, 2017).Conclusion ADHD is a very common disorder with millions diagnosed with it every year and is categorized as a developmental disorder and includes persistent functional problems affecting virtually every aspect of a sufferer’s life.  If not properly managed, ADHD can contribute dramatically to academic failure, unemployment, complications with relationships, and in some instances criminal activity.  The method of diagnosis has been subject for debate for decades.  The overdiagnosis of ADHD is a serious problem that has an impact on the sufferer and on the economy with all the medication that is prescribed.  The overprescription of medication used to treat ADHD, specifically Ritalin, has caused many adolescents to develop addictions and have easy access to their addiction through a regular prescription for a disorder they may not even have.  Statistics show certain demographics regarding parental status, race, and education have an effect on the diagnosis of ADHD in children further proving the point that it is severely overdiagnosed and leads to issues for all.  Despite this, ADHD is often overdiagnosed for children because of parental figures and guardians mistaking immature behaviors for ADHD.  These children may also be misdiagnosed leading to treatment that is not only unnecessary, but also dangerous in that it doesn’t treat the main disorder that a child may have whether that disorder may be a learning disability, OCD, and PTSD.  Both of these main factors are what aid in the problem with ADHD diagnoses in America today.  The controversy of ADHD diagnoses continues to remain a very important topic in the psychological and medical community for decades and continues to propose problems.ReferencesAoki, Y., Yoncheva, Y. 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