ADHD Tip - ADHD As A Medical Diagnosis And ADHD As A Mental Health Diagnosis

ADHD in it's most traditional existence is thought to be genetic and biologically based. Most research and common beliefs suggest that ADHD results from difficulties in specific chemical processes in the brain.

And yet despite the research, and major theories in psychology and medicine, there seems to be no cure for ADHD. In fact, the most common method of treatment, medication does not even alleviate all symptoms or behaviors observed in children with ADHD.

No medical cure...

At the same time, it is widely held in popular belief that ADHD is heavily a behavioral disorder that falls under the category of mental health and mental illness or disorder.

In the mental health community, ADHD is largely treated also by medication, but is typically treated or suggested to be treated by some sort of psychotherapy, or one-on-one individual treatment with a psychologist, therapist, social worker, or counselor.

Medical versus mental health

In the simplest form, a medical illness is typically treated systematically by a "proven" treatment course that has been tested, researched, and perfected over many years.

Consider a broken leg:

You can feel the pain.


You might see a deformity.


Doctors can view the break on an x-ray.

While I am no medical doctor, I believe we can all agree that a broken leg is typically treated by being placed in a cast. The cast provides protection to the leg, and allows the body to heal.

In most cases, once the break has healed, the cast comes off, and the medical condition has been successfully treated.

Now take ADHD:

Biological or behavioral, ADHD is both a medical condition and mental health illness. Deeply rooted in the brain, symptoms of ADHD can manifest behaviorally through difficulties in chemical processes. As such, children can display restlessness, inattention, hyperactivity, "acting out," and many other types of behaviors.

The only problem:

ADHD does not have a simple cure like the broken leg discussed above.

We cannot see ADHD symptoms as clearly as we can view a broken leg. Although cat scans can show different areas of the brain, there are still questions to be raised about the many different diagnostic criteria, as well as the many different presentations of ADHD.

Medically, we treat ADHD with medication, and in many cases, medication is not enough. Symptoms persist, and we hope that the medication will eventually stabilize the child's behavior and remove the major symptoms.

Unfortunately, with any condition or illness that is largely rooted in our brains, or in mental health, there is no one cure to follow.

First off, research has shown that there is no one particular type of talk therapy that works better than the other.

This is a fact.

Not to mention, ADHD and the related symptoms that follow, typically appear differently and to varying degrees child by child. The issue is further complicated as we know that children develop differently than their peers.

Age, maturity, sibling order, and many other factors influence how a child develops.

Should it then surprise that ADHD exists somewhere on the spectrum between medical diagnosis and mental health diagnosis?

Even if we can confidently diagnose ADHD, treating it with medication is not a guaranteed win. Successful treatment of ADHD typically involves some combination of medication and talk therapy.

But, I am going to tell you that ADHD, true or not, will most always be clouded by ongoing, underlying problems that exist in the child's life, family, and immediate environment.

For that reason alone, we can not medically treat, or pretend that we can treat, symptoms of ADHD.

To learn more about ADHD and what might really be impacting your child, I invite you to visit and sign up for your 7 part mini-course on the dirty little secrets behind ADHD.

I would also like to invite you to ask your most pressing question about ADHD and how it could be affecting your family and your child.

ADHD diagnosis and beyond

Shashi DeHaan’s son was in Grade 1 when she first noticed something wasn’t right.

It was spring and, seemingly all of a sudden, he didn’t want to go to school anymore.

“He just refused to go,” DeHaan, 39, recalled. “It was like, you’re physically having to carry him in.”

After trying everything they could think of?staying with him for a bit longer, having his father walk him to school instead, even bribing him?they took him for counselling, where it was suggested he had anxiety issues.

“Now we know the anxiety was due to ADHD (attention-deficit hyperactivity disorder).”

But it would be another three years before her son, who DeHaan asked not to be named, received a formal medical diagnosis of the disorder.

Until then, DeHaan and her husband struggled with his recurring meltdowns from not wanting to attend their South Burnaby school, his fear of reading out loud, and hearing him put himself down for his performance in school, even though he was meeting academic standards.

DeHaan is frustrated that in the end, the diagnosis came as a result of the family paying $2,000 to have her son tested.

But with the diagnosis came the understanding that ADHD doesn’t always involve hyperactivity and can affect a person’s self-management skills, including the ability to organize, manage time and get homework done.

As he was expected to do more homework, he became overwhelmed and shut down, his anxiety increasing higher.

Meanwhile, he knows he is intelligent and can do better than he’s shown in the classroom. He’s meeting learning outcomes, “but he’s frustrated because he knows he can do more but he can’t because of ADHD.”

The attention deficit causes him to get bored easily and in turn, make careless mistakes in his work, which then combines with his perfectionism to cause his anxiety, DeHaan explained.

“ADHD is holding back his potential from his intelligence.”

Figuring out what the problem was has resulted in some progress. While his doctor is still trying to find the right dosage of medication for his needs, and counselling is dealing with the anxiety issues, he seen some accommodations at school but only because DeHaan was able to have him designated by the school district as “gifted.”

He doesn’t have to do as much writing because of a motor delay, he spends more time with a computer, he can take tests in chunks of time instead of all at once, and the amount of homework he gets has been reduced, all while still being required to meet academic standards.

Still, DeHaan is frustrated that he doesn’t qualify for more one-on-one support in school.

DeHaan noted that if her son had ADHD combined with behavioural problems or a learning disability, he would qualify for added funding and supports.

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British Columbia, along with Ontario and Quebec, were recently given a failing grade by the Toronto-based Centre for ADHD Advocacy, Canada (CADDAC) for their education ministries not providing accommodations in the way children with ADHD are taught and evaluated?unless they have additional disorders or learning disabilities.

Heidi Bernhardt, CADDAC’s national director, said not dealing with the issue can have major impacts on these children’s lives. Studies have show that children with ADHD have a much higher dropout rate, and lower rates of not only getting into post-secondary education but completing it.

Adults with ADHD who end up in work they find boring end up moving from job to job, she said.

ADHD affects about five per cent of children in Canada, or one to three children in every classroom, she said. “It’s prevalent, it’s there.”

Unfortunately, many misconceptions remain.

“For many years, people falsely believed that all a child needed was to take a pill and everything would go away,” Bernhardt said.

Current research shows ADHD significantly impacts “executive functioning” which includes organizational skills, time management, problem solving, foresight and hindsight. And the impacts get worse as these children get into the higher grades.

Ironically, Bernhardt said, many universities recognize ADHD as a disorder that qualifies for accommodations for the student.

The trick is to get to university first, and to deal with the stigma that still remains.

Bernhardt knows of parents who refuse to tell teachers of their child’s ADHD diagnosis because of both the stigma involved and the fact they don’t believe there are any supports available in the school system. Some will go looking for a learning disability to try and get the accommodations.

As a former psychiatric nurse, Bernhardt said she recalls 30 years ago people didn’t take clinical depression seriously, putting it down to laziness or people just having down days. That’s no longer the case.

“They don’t get that with ADHD yet.”

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Raising awareness of ADHD and how it manifests itself is one of the greatest challenges in the school system, said Deborah Simak, Burnaby school district’s district principal for learning support services.

Recognizing the disorder is the first step. The district then provides assistance to students on a very individualized basis.

“It’s not a cookie-cutter approach,” Simak said.

Students identified as not meeting expectations in the areas of academic outcomes, social competence and who might show interfering behaviours, such as frequent trips to sharpen their pencils, would then be considered for specific interventions. The level of intervention increases according to the need, said Simak, who estimated up to one per cent of Burnaby students have ADHD, including those with additional learning disabilities and disorders.

She stressed that the district does not require a formal ADHD diagnosis to respond to a child’s needs.

Education Minister George Abbott said in an emailed statement that while ADHD is not specifically designated as qualifying for additional special-needs funding, that’s because not all children with the disorder are affected the same way.

“It’s important to point out that our system in British Columbia is responsive to the individual needs of students; there is no one-size-fits-all solution for students with special needs, including those with ADD or ADHD,” Abbott said.

“In B.C., we have a funding formula that addresses categories of behavioural and learning needs. These categories are determined by the extent of need and not necessarily limited to diagnoses of particular disorders.”

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Vision Revision For ADHD Diagnosis

POSTED: 4:12 pm MST December 1, 2010UPDATED: 4:14 pm MST December 1, 2010NEW YORK -- It may be common, but the stats are still staggering. Last year, 4.5 million U.S. kids were diagnosed with attention deficit hyperactivity disorder or ADHD. That?s more than seven percent of all children in the U.S. But a new study shows more than one million of those kids may be misdiagnosed. Once she starts reading, Katy Kluck can't stop, so mom was puzzled when Katy started struggling with schoolwork. "I couldn't really focus because there were so many questions on the page," Katy Kluck said. "Once they heard that Katy could not focus, immediately they said well, she has an ADD problem,? Ann Kluck, Katy's mother, said. Afraid of using meds, Ann did some research, which led her to an optometrist. "One of the questions we ask parents is to decide whether it's an organic attention problem or maybe more related to a vision problem," Daniel Press, O.D., a developmental optometrist at Family Eyecare Associates, explained. Exams found Katy's eyes didn't work well together, the words moved and turned blurry. She decided to kick-off eight months of vision therapy. Vision Therapy consists of a workout using computer gaming, training the brain to use both eyes together. "One of the eyes sees the red target, the other one only sees the blue target, so if you're going to do this well you have to use both eyes well together," Dr. Press said. Vision experts say 60 percent of kids labeled as problem learners actually suffer from undetected vision problems, but some have doubts. The American Academy of Pediatrics says vision therapy may give parents and teachers a false sense of security that a child?s problems are being addressed. "I was always the kid who was falling behind in class," vision therapy patient, Caroline Moore, said. Caroline Moore says vision therapy worked for her. "My grades skyrocketed back up!" Moore said. So did katy?s. "It makes me feel good because I'm getting good grades," Katy Kluck said. Lack of proof or legit solution? One mom found the answer in her child?s eyes. Vision therapy is not typically covered by vision insurance, but many major medical plans do cover this therapy. Six months to one year of therapy sessions can range from 25 hundred to five thousand dollars. ADHD -- THE BASICS: ADD and ADHD are psychiatric disorders characterized by inattentiveness or hyperactivity and compulsiveness which hinder a childs' academic or social performance. Because there is no objective clinical test to confirm ADD or ADHD, the diagnosis is based on a set of subjective symptoms. If children exhibit any six of nine characteristics in either category, they are labeled ADD or ADHD. In an effort to help children who are struggling at school because of their short attention spans, many parents, teachers, and doctors make the assumption that these children have ADD and start them on medications. Unfortunately, they are often treating the symptoms and not the real cause. High distractibility and difficulty remaining on task are not the sole domain of ADD. (SOURCE: childrenvision.com) THE PROBLEM : Children with undetected vision problems can exhibit symptoms similar to ADD. Studies show that approximately 20% of school-aged children suffer from eye teaming or focusing deficits which make remaining on task for long periods of time difficult. Like those with ADD, children with vision-based learning problems are highly distractible, have short attention spans, make careless errors, fail to complete assignments, and are often fidgety and off task. However, their inability to remain on task is caused by the discomfort of using their eyes for long periods of time at close ranges, not true deficits in attention. Unfortunately, parents and teachers are not trained to recognize the difference and these children are often misdiagnosed. (SOURCE: childrenvision.com) THE CONNECTION: The connection between eye teaming problems and attention deficit disorders was recently documented in medical journals. The latest research study found children diagnosed with ADHD were three times as likely to have a ?convergence insufficiency? than children in the rest of the population. Dr. David B. Granet, director of the Ratner Children's Eye Center of the University of California in San Diego and a nationally known pediatric ophthalmologist, explains that because this kind of eye teaming problem causes children to have difficulty keeping both eyes focused on a close target, it becomes more difficult for them to concentrate on reading, one of the ways doctors diagnose ADHD. As a result of his research, Dr. Granet says no child should be diagnosed with ADD or ADHD until their visual system has been checked. The reason, the chance of a misdiagnosis is simply too great. (SOURCE: childrenvision.com) The following are comments from our users. Opinions expressed are neither created nor endorsed by TheDenverChannel.com. By posting a comment you agree to accept our Terms of Use. Comments are moderated by the community. To report an offensive or otherwise inappropriate comment, click the "Flag" link that appears beneath that comment. Comments that are flagged by a set number of users will be automatically removed.

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Birth dates, school enrollment dates affect ADHD diagnosis rates, study shows

ScienceDaily (Aug. 17, 2010) ? Rising rates of attention deficit hyperactivity disorder (ADHD) and large differences in diagnosis rates have led to fears that the condition is often being misdiagnosed. A new study from North Carolina State University demonstrates that these concerns are justified. The researchers found large discrepancies in diagnosis and treatment rates based on small differences in children's dates of birth.

"The question we asked was whether children who are relatively young compared to their classroom peers were more likely to be diagnosed with ADHD," says Dr. Melinda Morrill, a research assistant professor of economics at NC State and co-author of a paper describing the study. "To answer the question, we looked at children born shortly before the kindergarten eligibility cutoff date and children born shortly after the cutoff date and compared the rates of ADHD diagnosis and treatment."

The researchers figured that children born just a few days apart should have the same underlying risk of having ADHD. So finding a significant difference in diagnosis rates between children born only a few days apart is strong evidence of medically inappropriate diagnosis.

Morrill explains that the study shows that children born just after the kindergarten cutoff date were 25 percent less likely to be diagnosed as having ADHD than children born just before the cutoff date. "This indicates that there are children who are diagnosed (or not) because of something other than underlying biological or medical reasons.

"We believe that younger children may be mistakenly diagnosed as having ADHD, when in fact they are simply less mature," Morrill says.

Morrill stresses that "we are not downplaying the existence or significance of ADHD in children. What our research shows is that similar students have significantly different diagnosis rates depending on when their birthday falls in relation to the school year."

For the study, the researchers examined data from two national health surveys and a national private health insurance claims database to evaluate rates of ADHD diagnosis and treatment in children. The data sources covered different time periods ranging from 1996 to 2006.

The paper was co-authored by Morrill, Dr. William N. Evans of the University of Notre Dame, and Stephen T. Parente of the University of Minnesota.

Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.

Story Source:

The above story is reprinted (with editorial adaptations by ScienceDaily staff) from materials provided by North Carolina State University.

Journal Reference:

Evans et al. Measuring Inappropriate Medical Diagnosis and Treatment in Survey Data: The Case of ADHD among School-Age Children. Journal of Health Economics, 2010; DOI: 10.1016/j.jhealeco.2010.07.005

Note: If no author is given, the source is cited instead.

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