Are We Helping or Hurting Children: As the nation’s children grow to be more and more reliant on antibiotics and medication the problem only increases as generations go by. What is not realized or discussed, as much as it should be, are the consequences of over diagnosing children and the resulting medication treatments. Instead of making children stronger and healthier over-medicating and over diagnosing can cause children to be worse off by suffering the effects from drugs.
While there are numerous mental disorders that are relevant to the topic of over diagnosing and medicating I will focus on Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD). The most common disorders have similar treatment and diagnostic procedures from a general standpoint. The U. S government provides cited information and analysis using Mental Health Surveillance Among Children, about the overall treatment methods of diagnosed children, taking several studies about the mental disorders diagnosis and medication, as well as the prevalence of each.
The combined studies showed that of the six most major mental disorders, the most prevalent was ADD/ADHD which is almost double the recorded prevalence of the second most common disorder, behavioral or conduct problems (Centers for Disease Control and Prevention). In order to most clearly present the overall issue the other commonly diagnosed mental disorders will be generalized with the evidence of ADHD/ADD. To provide a more focused perspective of the mental disorder ADHD/ADD, one needs to examine a study in which data taken in 2003 and 2007 by the National Survey of Children’s Health (NSCH) reflects the increasing trends in ADHD diagnosis.
The study forecasts the prevalence estimates for 2011 and describes the trends. The results are as followed In 2011, 11% of children/adolescents aged 4 to 17 years had ever received an ADHD diagnosis (6. 4 million children). Among those with a history of ADHD diagnosis, 83% were reported as currently having ADHD (8. 8%); 69% of children with current ADHD were taking medication for ADHD (6. 1%, 3. 5 million children)…Prevalence of a history of ADHD, current ADHD, medicated ADHD, and moderate/severe ADHD increased significantly from 2007 estimates.
Prevalence of medicated ADHD increased by 28% from 2007 to 2011. (Visser, Susanna N. et al. 34 – 46) Although this report is an estimation, it clearly shows there is an increasing percentage of diagnosed cases and describes how this issue is so important, because it effects so many youth with just this one disorder alone. The argument being made is that a majority of these conditions are diagnosed without an understanding of the child’s future development and the over reliance on treatments of prescribed medication.
These are treatments in which prolong symptoms for conditions are reduced but stiil occur, when in reality, they could have been avoided with some early behavioral therapy methods. The Council of Scientific Affairs made a report for the American Medical Association concerning the diagnosis and treatment of ADHD in adolescents and children. Although, ADHD has official and revised diagnosis criteria, the report concludes, The diagnostic criteria for ADHD are designed to be used by a clinician familiar with childhood development and behavioral disorders.
Application of the diagnostic criteria requires time and effort to obtain a careful history from parents, teachers, and the child. As with almost all mental disorders, there is as yet no confirmatory genetic, radiologic, biochemical, neurophysiological, or neuropsychological test for ADHD, but such examinations may be helpful at times in evaluating presenting complaints suggestive of ADHD. (Goldman, Larry S. 1105-1106) The need for an official “long-term” diagnosis criterion is prominent.
Understand recent over-diagnosis is not a result of cruelly ignoring current diagnostic criteria, but perhaps instead it is the product of the criteria transparently requiring extensive time with the patient and knowledge of the patient’s history involving the symptoms that is essential to valid diagnosing. Dr. Samantha Smithstein, licensed clinical and forensic psychologist with over 20 year experience, wrote an article in Psychology Today called, “To Diagnose or Not Diagnose our Children; That is the Question” which indicates a possible reason for misdiagnosis in children.
In the article she explains, “In some cases, for example, the symptoms of ADHD can look similar to Bipolar disorder in children. Currently there is debate about whether or not Aspergers is simply a subset of Autism, another diagnosis that has increased a great deal in frequency. ” There are mental disorders which have large comorbidity, like that of ADHD and Bipolar disorder; consequently making over-diagnosing incredibly easy. Smithstein’s article also presents a seemingly overlooked, but reasonable counter argument she observes,
It may not be that we are inappropriately over-diagnosing, but instead that we are diagnosing appropriately for the first time. It wasn’t until the 1900’s that there were child labor laws and not until the 1960’s that child abuse laws were passed. Until recently, children were not acknowledged as legitimate people, with their own thoughts, feelings, and experiences. (5) The idea that over diagnosing is actually a positive effect of society being more concerned with children and their mental health is head turning, to say the least.
Admiringly, the claim has some logical foundation, but unfortunately there has not been any study to support nor disprove this claim. The lack of evidence for any claim within this controversy is a continuing issue. Due to an apparent lack of evidence, can we assess there is a possibility the criteria for diagnosing these disorders needs to be re-evaluated? Children who may not even truly have the diagnosed condition and then are subject to a continuous treatment of drugs and their side effects. ADHD medication side effect can vary depending on the specific medication and dosage.
Most common side effects of these medications are nervousness, suppressed appetite, insomnia, high blood pressure and heart rate, headaches, stomach pains and tics. There are other side effects from all stimulant medications. In a 5 year review of children taking psych stimulants Dr. Esther Cherland and Dr. Renee Fitzpatrick had 192 children diagnosed with ADHD and 98 children were treated with ADHD medication. They found the following results, Of the 98 treated with stimulant medication, 9 children developed psychotic symptoms.
Three children had amphetamine intoxication, 1 had psychotic symptoms, 3 had mood-congruent psychotic symptoms, and 1 was unclassifiable because information about the event was insufficient. (4: 1) The children showed reduce symptoms once they stopped taking the medication. Trying to terminate such treatments are problematic as well. The individual would have to readjust from effects which have been the norm to a life without the influence of drugs. This can be compared in lesser fashion to an alcoholic drying out and attempting to remain sober.
The effects the medication makes them feel creates a dependency to the medication. Most of the studies on the long-term effects of the drugs prescribed for ADHD are conducted by the drug companies themselves which then are likely biased to the benefit of the companies (Marilyn Wedge PH. D. “Are ADHD Drugs Safe in the Long Term? ”). Meaning solid evidence that is free from corporate biased is scarce, controlling action from being taken against over diagnosing and over-medication. New research was found in 2014 on Ritalin and how it affects the brain.
They found that though Ritalin can boost mental performance in the short term, longer term use can “adversely impact the brain’s plasticity, interfering with people’s ability to plan ahead, switch between tasks and be overall flexible in their behaviors. ” (Marilyn Wedge PH. D) Proving that medication for mental disorder, such as ADHD, undoubtedly reduces symptoms and is beneficial on a short term scale, but does not benefit to overcome long term adverse effects. The over diagnosis and over-medication of mental disorders, especially that of ADHD children are undoubtedly causing children to experience overall negative effects.
Coming from someone who has experienced this first-hand, the overall solution to these effects would be to rely on therapy to reduce, and possibly eliminate, symptoms of mental disorders. The pure fact that we just do not have the information available to be able to clearly assess the diagnosing and medicating of children should only strengthen our cautiousness. Parents, teachers, and doctors need to especially be aware of their options and understand what the best option is for their children, students, and patients in a long-term stand point.