[senco-forum] ADHD diagnosis

The article below states that 80% of children diagnosed with ADHD will be

>> The  article below states that 80% of children diagnosed with ADHD will be
>> placed on medication... is this correct?

> Of course it is, It's in print.

...on the other hand the number of children who have ADHD -- those who
would meet the diagnostic criteria if accurately assessed -- should
NOT be confused with the number of children who in practice receive a
clinical diagnosis of this condition. This distinction is very
important. Let me explain why:

Up until comparatively recently it was widely accepted the incidence
of children with Tourette Syndrome (TS) was somewhere between one in
1,000 and one in 2,000. In other words this condition was pretty rare
compared with say the incidence ADHD.

However when TS researchers started researching whole school
populations they discovered the real incidence of TS being revealed by
their studies was somewhere between one in 100 and one in 50 ...yes
that's more than a full order of magnitude greater than the commonly
accepted incidence up until that time! Furthermore follow up studies
revealed this was NOT a freak result, as other researchers came up
with incidences statistically consistently with this first research
study. So what was going on?

Well it turned out all previous estimates had been extrapolated from
the clinical population only -- based on the clinical records of
children who'd actually been diagnosed with this condition. In other
words all previous estimates were predicated on the false assumption
almost every child who met the diagnostic criteria for Tourette
Syndrome would also get this diagnosed as a matter of course.

Anyway it turns out the most significant finding revealed by these
newer studies is the uncomfortable fact that TS is a chronically
under-diagnosed condition! ...by around a factor of 20 no less! In
other words for every 20 children who actually have TS, a full 19 of
them on average will fail to obtain this diagnosis! In practice either
their symptoms are missed or dismissed by the diagnosing doctor, or
very often these are attributed wrongly to to some other condition.
Furthermore many parents may also regard their child's TS symptoms not
serious enough to warrant seeking out a medical diagnosis.

So what has this to do with ADHD diagnosis? Well prior to this study
it was also assumed a high proportion of children with TS required
medication for their condition, principally a consequence of the fact
it's mainly the most severe cases of TS that get diagnosed. Well the
same also applies to ADHD. Furthermore parents are less likely to seek
a diagnosis of mild ADHD especially if they have qualms about the use
of medication. This is not surprising given it's well known this is
the most often used (and most effective) first-line approach to
treating this condition.

So read what you like into the statistic "around 80% of children
diagnosed with this condition will be placed on medication". But don't
omit to add the caveat this takes no account whatsoever of the likely
substantial proportion of ADHD children who never receive a diagnosis
of this condition ...all of whom will of course NOT be put on
medication.

David Bowles