Pediatricians Cutting Corners in Diagnosing and Treating ADHD

Are physicians rushing to diagnose ADHD in our children, and relying too much on medication to treat it? New research says yes to both.
ADHD News Feed | posted by Janice Rodden

Previous research has shown that behavior therapy, combined with medication, is the best approach for treating ADHD. Yet a new study shows that physicians fail to assess symptoms thoroughly before making an ADHD diagnosis and rely too heavily on medication to treat it.

Researchers from the Center for ADHD, Behavioral Medicine and Clinical Psychology at Cincinnati Children's Hospital looked at 1,600 patient charts from 188 pediatric health-care providers in 50 socio-economically and demographically diverse practices across Central and Northern Ohio. The results, published in Pediatrics, found that across this varied group, 30% of physicians failed to consult the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) to determine if children meet all of the criteria for this complex diagnosis. In addition, only half of doctors gathered behavioral rating scales from teachers and parents to affirm their diagnosis and to determine if the prescribed treatment is working.

Both of these practices go against the American Academy of Pediatrics guidelines that explicitly recommend using the DSM-V to diagnose the condition and to use behavior scales. What’s more, while the AAP recommends a combined approach of medication and counseling as optimal treatment, the study showed that only 13% of children received behavior therapy—considered first-line treatment for preschool and grade school children —while more than 93% of the children received medication. The researchers suspect that the rating scales fall by the wayside because they are time-consuming to collect, and the process is not rewarded by the current appointment system. Typical appointments are only 10-15 minutes in length, which is often not long enough to make an accurate diagnosis.

When taking your child to be assessed, ask the pediatrician how she’ll determine if your child has ADHD. Make sure that she collects behavioral ratings scales to make the diagnosis and to assess treatment after it is prescribed. Ask if there are other measures the doctor takes to follow up on how the prescribed ADHD therapies are working.

Researchers suggest that parents talk with other parents of ADHD kids to get recommendations of practitioners who diagnosed ADHD accurately, and according to AAP standards of care.

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