The Thing About ADD...

October 04, 2018

The thing about ADHD (or as it’s called more casually in the public – ADD), is that it’s pretty hard to challenge once the “diagnosis” has been given.

There are no legitimate tests that I know of for ADD.  Physicians primarily rely on rating scales, like the Vanderbilt, as a primary source for making a determination.

These scales involve opinions, not facts, usually from the parent on a set of behaviors that typically cluster on what is thought to be ADHD/ADD.

Here are a few of the items from the Vanderbilt Scales that usually will ring the “ADHD/ADD bell” inevitably leading to a diagnosis and recommendation to put the child on medication:

“Has difficulty sustaining attention.”

“Is easily distracted by extraneous stimuli.”

“Loses things necessary for tasks and activities.”

 So, let’s line up a few hundred 8 or 9 year old boys and ask their mothers (the fathers don’t usually know) how they would rate their kid on these items.  I would predict about 70% of the boys in that age range would be rated somewhat high on variables such as these.

What then?  Does this mean that most of these boys have a neurodevelopmental disorder and should be put on stimulant medication?

I recently read an article  that referred to the marked rise (16% increase over the last decade and a 41 percent increase from the previous decade) in diagnosis of ADHD.  Boys, in  particular, showed a significant increase in percentage being diagnosed.

We’ve gotten so casual with the diagnoses and the inevitable medical prescriptions.

People will think I am anti-medication.  I am not.

But, I am against the use of rating scales as the primary determinant of the “diagnosis.”  Rating scales are very helpful when used as part of a larger assessment that attempts to take many factors into consideration.  In fact, in all of the assessments I conduct rating scales are an important part of the evaluation.

However, it’s also my expectation that about 90% of the kids who land in my office are going to show high on these “ADHD/ADD’ variables.

Does that mean they should all be on medication?

Without trying very hard I could list 20 reasons that may be contributing to a child‘s inconsistent focusing or variable effort that are not related to an inherent neurobiological disability.  That is, kids have a lot of stuff (not scientific I know) that can help explain their “difficulty sustaining attention.”  (In a future blog we will list some of the “stuff” that masquerades as ADHD/ADD.)

Takeaway Point:

There is no definite “X-Ray” of ADHD/ADD. Before placing a child on medication, try and take the big picture and consider what else may be working..

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The Waves of Special EducationLabeling Missing the Mark
All comments (2)
  • "Mr. Annoying"
    October 05, 2018 at 6:17 pm

    Hi Ledgnick: I assume only you can see this reply. As I read your blog today, I couldn't help but consider the 3 items from […] Read MoreHi Ledgnick: I assume only you can see this reply. As I read your blog today, I couldn't help but consider the 3 items from the "Vanderbilt Scales" directly apply to our friend David when he taking on specific tasks like having a conversation with one person while in a group setting with other people around. Know what I mean ?? Read Less

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