The topic of attention deficit hyperactivity disorder (ADHD) has stirred a lot of controversy, particularly of late. The move by the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) to broaden the definition for the disorder to include a larger amount of people—children in particular—has some scientists and doctors concerned about the risks posed by ADHD over-diagnosis. One of the leading risks on the minds of experts: unnecessary medication along with a de-valued diagnosis in those with serious problems.
Kenny Handelman, M.D., a psychiatrist and author of Attention Difference Disorder: How to Turn Your ADHD Child or Teen’s Differences Into Strengths in 7 Simple Steps, says over-diagnosis is a real concern.
“We know that ADHD medication and therapy can be very helpful for people who have ADHD. However, if someone is misdiagnosed, and they are taking ADHD medication, they can experience side effects and risks, and they would not be getting any benefits,” he says.
To avoid over- or mis-diagnosis, experts say a good evaluation is essential. “Sometimes, other conditions such as learning disabilities or anxiety can cause a child to exhibit symptoms that look like ADHD or a child with ADHD may exhibit other complicating conditions that require help,” says Steven Pastyrnak, M.D., the division chief of pediatric psychology at Helen DeVos Children’s Hospital in Grand Rapids, Mich.
So what’s a parent to do when other issues are ruled out and their child receives an ADHD diagnosis?
“The next step when your child is diagnosed with ADHD is to consider what are the treatment options,” says Pastyrnak. “In terms of treatment options, the best researched and most effective still tend to be medications.”
However, medicine is not the only answer.
Hyperactive behavior alone is not cause for medicine, says Pastyrnak. “And when ADHD symptoms are mild, there may be non-medication strategies that are effective in helping a child manage the school day, like using a wiggle seat, chewing gum or having access to other sources of sensory stimulation.”
Handelman recommends these steps to take a bird’s eye view and navigate the road immediately following the diagnosis and know if medicine is the best treatment for your child:
Get educated. In order to understand exactly what your child might be dealing with and all available options to treat the symptoms, Handelman suggests asking your child’s doctor a lot of questions.
“It’s critical that parents know what they are dealing with,” he says.
That includes knowing your child’s doctor was thorough and the criteria to diagnose ADHD were met. “Request test results be thoroughly reviewed and explained to you and if other medical causes were ruled out. Also ask if the symptoms of ADHD could be due to a learning disability or another psychiatric diagnosis like depression or anxiety and not ADHD,” says Handelman.
Other questions to ask your child’s doctor may include:
- What treatment options specific to my child’s behavior are realistic options?
- When is medication indicated?
- What are other non-medication related options?
- What are the risks and side effects of all treatments including medicine?
- What resources may be available at school or in the community to help?
Test drive different parenting and educational strategies. No two parenting strategies and approaches work for every child or teen with ADHD. “There are strategies to manage impulsivity and other symptoms specific to parenting a child with ADHD and not always the ‘intuitive parenting’ relied on to parent non-ADHD kids,” says Handelman. Your child’s doctor, therapist or school counselor can help you explore options to deal with your child’s specific symptoms and behavior.
Explore alternatives. “Support for using omega-3 fish oils, dietary changes and other alternative options is growing among the medical community. These may be integrated into a child’s treatment plan,” says Handelman. Talk to your child’s doctor about these or other alternatives like acupuncture, which may prove beneficial to your child.
Be open to tweaks in the treatment plan. “Children and teens go through different development stages and challenges, and there may be the need to continuously adapt treatment approaches to changes your child experiences as he matures and develops emotionally and physically,” says Handelman.
Don’t be shy. If at any time you feel the current treatment isn’t working, or you notice changes in your child’s behavior, don’t hesitate to speak to his healthcare provider. Helping a child manage symptoms of ADHD, as well as implementing parenting strategies, often requires a team approach. And Handelman says parents should absolutely consider their child’s doctor as a strong member of the team.