and another from Dr. Luloff
Mark
Depending on who you talk to, ADHD (Attention deficit hyperactivity Disorder) is either the most common neurodevelopmental disorder affecting our children (10% of all Children in School) or the most overdiagnosed and abused label put on our children...and the most common reason for overmedicating kids, sometimes as young as 3 years of age.
In order to eliminate any abuse or excess/inappropriate medication parents need to first be sure that the diagnosis of ADHD is accurate and appropriate. When is an overactive or impulsive child stepping over the line of normal into one of dysfunction? The only way to be sure is to have a complete evaluation that includes feedback from adults who regularly interact with the child (parents, teachers, coaches, child care workers etc), a full medical evaluation by the child's health care provider and a neurological exam either by the child's regular provider or by a specialist.
An MRI or CTscan is not necessary, nor are the many expensive (and poorly predictive) "ADD" computer tests. Once a diagnosis is made, and confirmed, the next step is to assess the level of dysfunction/lack of success the diagnosis imposes on the child. In most studies only about 20-30% of children with the diagnosis of ADHD required chronic medications, and medication should never be the first strategy employed for any child.
Behavioral and educational management plans coordinated between parent, school and behavioral therapist should always be the first step in any treatment plan. Only when these plans fail or where the level of dysfunction is so severe that medication should come into play.
So, what to do? Be an informed consumer (or provider) and ask the right questions and if you don't have all the answers seek the advice of a specialist in ADHD Medications are appropriate for some children but not for all and should never be used as the sole therapy. Their role in the treatment of ADHD needs to be re evaluated at regular intervals to determine their effectiveness and to identify any possible side effects.
Marty
Marty Luloff MD FAAP
SVHC Pediatrics