Liz posted a shoutout for comments over the weekend on this editorial published by USA Today on 3/22/06.
The problem with the article is that it uses misleading statistics.
When 63% of children in a single Virginia school district are diagnosed as having ADHD, it seems clear that, at least in some locations, they are. This invites side effects, such as insomnia, tension, or drug dependency. It also means the true problem might go untreated. [emphasis added]
Reading that sentence leads one to conclude that over half of the children in one school district have been diagnosed with ADHD. But the facts are different.
I am assuming the article refers to this study conducted by Dr. Gretchen LeFever, where she reports that 8-10% of schoolchildren, grades 2-5, in the district she studied were diagnosed with ADHD. This is far different from the 63% number mentioned in the USA Today article. Further, I haven’t found a way to interpolate her numbers to arrive at the 63% conclusion.
As far as I’m concerned, USA Today should print a prominent correction of the factual misstatements in their editorial and stay away from reporting if they can’t accurately report simple statistics.
As for Dr. LeFever, her conclusions were challenged and the school district subsequently placed her on leave pending an investigation. The outcome of the investigation absolved her of any wrongdoing or misstatement of the data.
If one takes the time to really read the entire paper, she makes some conclusions worth considering. Here are a couple:
We agree with others (Sameroff, 2001) that the overuse of psychotropic medications is a stopgap measure that is tantamount to placing the problem exclusively “in the child” rather than addressing the more complex issue of working to adapt the child and environment to each other. When it appears to be cost effective and efficient to “fix” the child through use of medication, society is unwilling to expend resources to design more development-enhancing environments that are responsive to the needs of behaviorally demanding children.
I do see this as a trap of ADHD medications, which is why I’m such a vocal advocate for thorough evaluation by an experienced professional (psychiatrist or psychologist) familiar with ADHD in all settings.
She also recommends trying behavioral approaches first. I agree. Here is her accompanying conclusion:
” If the child has not responded adequately after 6 months of behavioral intervention, other treatments ought to be considered, including empirically supported drug interventions. “
Her concluding paragraph is one I definitely agree with:
ADHD is diagnosed and treated differently in communities across the United States, as evidenced by the 30-fold variation in per capita rates of Ritalin use. The probability that ADHD is diagnosed appropriately in some communities should not serve to dismiss concerns about overdiagnosis in all communities…The fact that ADHD is clearly overdiagnosed in some communities and among some groups of children (e.g., one in every three white elementary-aged boys in southeastern Virginia) is lost in nationwide estimates of ADHD drug treatment. It is essential that mechanisms be established to track rates of child mental health diagnoses and psychotropic drug treatment and its outcomes among American children. Until we have a better understanding of these issues, it is appropriate to be judicious in our use of psychotropic medications and cautious about dismissal of concern about ADHD overdiagnosis.
Here’s what I think: The study wasn’t the problem. How it was reported was the problem. The reporting intentionally spun LeFever’s conclusions into something more than they were. On its face, this study simply concludes that there are disparities in how ADHD is diagnosed in different regions, and it’s worth giving some attention to consistency in diagnosis and treatment approaches. I certainly think that’s a valid conclusion and by no means screams that ADHD is flatly overdiagnosed.
And most importantly, in no way does it suggest that 63% of children in one school district were diagnosed with ADHD. That’s just plain wrong. Perhaps they left out a decimal?
Technorati Tags: USA Today, ADHD, overdiagnosis, Ritalin
p.s. As Liz pointed out, ADHD is not a learning disability. It can cause learning difficulties but is not classified as a learning disability. It is, however, classified as a disability under ADA.
Related Articles:
- apa.org – Medicating ADHD: Too much? Too soon?
- Are ADHD Medications Overprescribed?
- WebMD: Are Stimulant Medications Overprescribed or Misprescribed?
Update: This is why it’s so important to aim at the diagnostic aspect of ADHD instead of the medication itself: “Doctors Can Be So Easily Manipulated“
