Is ADHD underdiagnosed or overdiagnosed in the younger population?

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Published on Friday, 21 July 2023 13:45

Last Updated on 21 July 2023

Monica Costa

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There is now a greater awareness of ADHD than ever before but that prompts the question as to whether diagnosis of this condition is too easily confirmed or whether we are still missing people who should be diagnosed with it.

One of the obvious challenges when trying to evaluate a young adult is the fact that hormonal challenges and developmental changes to a young person’s brain can potentially cloud the issue. If you are asking, does my teen have ADHD? Here are some pointers to consider.

The general perception is that ADHD is overdiagnosed and overtreated by doctors, is that the case?

What is behind the rise in confirmed ADHD cases?

There has been a noticeable rise in the number of children aged between three and seventeen years of age who receive a positive ADHD diagnosis. In the space of a decade, the percentage of confirmed ADHD diagnoses has risen from about 5% of children sent for evaluation to more than 10%.

The obvious conclusion might be that doctors have become too eager to confirm a child has ADHD. The other possibility is that a child’s immaturity might be confused with ADHD symptoms. If that is the case, there is an argument for saying that there is an overdiagnosis problem.

Development skills and immaturity

The fundamental dilemma facing medical professionals is that they would not want to fail to identify someone with ADHD by taking a too cautious approach. At the same time, they would not wish to be too eager in confirming a young child has ADHD when other factors could be a key consideration for their behavior.

If you look at the typical attention span of a three-year-old, for instance, and their ability to focus their attention on something for any length of time, it is almost certain to be worse than the performance of a six-year-old child.

Immaturity could certainly play a role and could potentially result in an incorrect diagnosis of ADHD.

A recent study published in the official journal of the International Society for Pharmacoepidemiology (ispe) found that in a typical classroom, it was more likely that the youngest third of students were more likely to be receiving ADHD stimulant drugs than older children in the same class.

Taken in isolation, that statistic would suggest that there is a rush to make an ADHD diagnosis without waiting to see if immaturity is part of the problem.

 

Increased awareness

The counter-argument to consider is that there is an increased awareness of ADHD. With that in mind, it is not surprising there are more cases of this condition being diagnosed.

Greater awareness and improved efficiency in the diagnostic process are bound to fuel a rise in cases rather than it being a case of over-enthusiasm to conclude a child has ADHD.

Getting an early diagnosis can be very beneficial to a child’s development when they get the help and medication needed to cope with their condition.

 

It is hard to reach a positive conclusion about overdiagnosis. The best approach is to get a professional evaluation and weigh up all the facts before deciding what to do next if your child is found to have this condition.