According to a new study released online August 17, 2010 and published in the upcoming issue of the Journal of Health Economics, nearly 900,000 children under age 18 may have been misdiagnosed with attention deficit hyperactivity disorder (ADHD). Not only is misdiagnosis of ADHD in young children a potential danger to their health, but it also costs parents, insurance companies and Medicaid millions of dollars each year in unnecessary medication.
Study on ADHD Diagnosis in Children
Todd Elder, assistant professor of economics at Michigan State University and author of the study, found that younger children who are simply not as ready to start school as their older counterparts are more likely to be diagnosed and treated for ADHD than older children in the same grade level. Using data from the Early Childhood Longitudinal Study Cohort of 12,000 children, Elder studied the rates of ADHD diagnosis and subsequent medication between younger and older children in the same grade. He found that the younger children in kindergarten were 60% more likely to be diagnosed for ADHD than the older children in that grade. As the same group of children reached the fifth and eight grades, the youngest children were more than twice as likely to be prescribed medication than the older children. From the data collected, Elder feels that 20%, around 900,000, children have likely been misdiagnosed as having ADHD.
Age Discrepancies in Schools May Cause Misdiagnosis of ADHD
School systems around the U.S. vary in the cut-off date in which a child can start school and this can lead to classrooms filling up with children who may have up to a two-year age difference. If the date cut-off is in August or September, children starting kindergarten can be ages five to six, with some at the beginning of age five and others near the end of age six. That length of time between ages can make a big difference in how a child behaves in the classroom. “If a child is behaving poorly, if he’s inattentive, if he can’t sit still, it may simply be because he’s five and the other kids are six,” says Elder. Elder feels that teachers, parents and medical professionals should take this into account when diagnosing a child for ADHD.
Elder also feels that a teacher’s perception of a child’s abilities and behavior are often the catalyst in having a child evaluated for ADHD. While teachers cannot diagnose ADHD, often it is their opinions on the child’s behavior that encourages parents to have the child evaluated. If the child is younger than the rest of the students, Elder feels their disruptive behavior has more to do with their emotional and intellectual immaturity compared to the older students than as symptoms for ADHD.
Diagnosing ADHD in Children
Diagnosing ADHD in children involves displays of multiple symptoms of hyperactivity and inattention that persist for six months or more in at least two settings, normally home and school. According to the National Institute of Mental Health, it is normal for all children to display periods of inattentiveness and impulsive or hyperactive behavior. A diagnosis should not be made unless the child displays these behaviors to a higher degree than other children of their own age for more than six months.
Medication for ADHD is yet another issue that worries Elder. Not only is misdiagnosis of ADHD costing $320 million to $500 million a year in unnecessary medication, but $80 million to $90 million of those dollars are funded by Medicaid. And more importantly, it is not yet known what the long-term effects of taking stimulants will have on a child’s health.
Because ADHD is the most commonly diagnosed behavioral disorder in children in the U.S., it is also the topic of much public debate over whether it is under-diagnosed or over-diagnosed. Since there is no actual test other than checking behavior, it is difficult to have a definitive diagnosis. Elder hopes that the medical community will look more closely at the age of a child in comparison to his classroom counterparts before making a diagnoses.
Sources:
ScienceDaily.com “Nearly One Million Children in U.S. Potentially Misdiagnosed with ADHD, Study Finds” Retrieved August 17, 2010.
Center for Disease Control and Prevention “Summary Health Statistics for U.S. Children: National Health Interview Survey, 2008” Page 5. Retrieved August 17, 2010.
National Institute of Mental Health “What are the symptoms of ADHD in children?” Retrieved August 17, 2010.
Deanna Lynn Sletten - Deanna Lynn Sletten has been a freelance writer for newspapers, regional magazines and websites for 20 years. She specializes in the ...
