Attention deficit disorder (ADD) and attention deficit hyperactivity disorder (ADHD) are increasingly common diagnoses among school-aged children. This poses the question is our society more aware of the condition or are children being over diagnosed or misdiagnosed? The diagnosis of ADD/ADHD also results in the prescription of ADHD medications to better manage the condition. Is ADD/ADHD being confused with other psychological issues that children experience such as dealing with a parent’s divorce or the death of a loved one? Is ADD/ADHD a label being issued to children who are struggling with academic issues or learning disabilities?
There are numerous scenarios that must be differentiated from a true diagnosis of ADD/ADHD. Regardless of the issue, children who appear distracted, cannot follow instructions, do not pay attention, seem overwhelmed, frequently interrupts conversations, or cannot sit still are likely to have a red flag held up over them seeking answers. The diagnosis of ADD/ADHD is not always straight forward and may vary significantly from one child to another, thus further complicating the diagnosis. Most cases of documented ADD/ADHD diagnoses include a physician reviewing a checklist of common signs and symptoms, feedback from school teachers, and parent observations and feedback.
The diagnosis of ADD/ADHD is subjective and evidence of this is relevant based upon reports from the Centers for Disease Control and Prevention (CDC). The CDC reports that the American Psychiatric Association states that 3-7% of United States school-age children have been diagnosed with ADD/ADHD. American parents report the contrary suggesting that as many as 22% or more school-age children in the United States have ADD/ADHD based upon survey results of parents. Physicians have reviewed this correlate and concluded that approximately 1 in 20 children have ADD/ADHD symptoms.
The incidence of ADD/ADHD diagnosis in Europe, Japan, and other non-American countries ranges around 5-7%. According to research performed in numerous national and international studies, the differences in diagnosis paradigms appears to be that the United States is more aware of this condition and recognizes it as a treatable disorder. In some cultures, labeling a child with ADD/ADHD is perceived as derogatory resulting in a negative psychological effect.
The actual diagnosis rules vary significantly between the United States and Europe. The primary differences in achieving statistical evidence of the prevalence of ADD/ADHD is a country related to the research methodologies. European researchers follow the ICD-10 which specifies that children must have issues in school, at home, be impulsive, lack attention, and be hyperactive. American researchers follow the DSM-IV. The DSM-IV is not as restrictive as the ICD-10 rules and possibly explains why Americans have such a higher reported diagnosis rate of ADD/ADHD. The DSM-IV essentially states that the child has several of the listed symptoms but not enforce the rule that all criteria must be met, as in the ICD-10 rules.
Japan reports a 7% of school-aged children have ADD/ADHD. Several reports explain that Japanese parents have been giving their school-aged children nutritional supplements to increase their attention capacity. The same DHA supplements that are becoming popular in the United States have been given to Japanese children for years. The belief is that if children lack the essential fatty acids, the less than optimal outcome would be ADD/ADHD. The Japanese consult a psychological evaluation when ADD/ADHD is suspected in their school-aged children. Solving the puzzle will naturally require a great deal of interaction with the child, professional consultation, physician involvement, school involvement, and patience. The successful treatment of ADD/ADHD generally involves ADD/ADHD medications and focus on developing educational strategies to optimize the child’s organizational skills and retention strategies.