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ADHD or Immaturity? Resources for Teachers & Parents to Divine the Difference

May 27, 2011 07:00 AM
by Anita Gutierrez-Folch
ADD-ADHD is the most commonly diagnosed disease in American children, but critics have long asserted that it is over-diagnosed. For teachers and parents, it can be difficult to discern the difference between immaturity and a treatable disease. Fortunately, the Web offers a bevy of outstanding, informational resources that help divine between the two, and cope with each of them.

ADHD Misdiagnosed

According to the Centers for Disease Control and Prevention, attention-deficit hyperactivity disorder (ADHD) is the most commonly diagnosed disease in children in the United States, with 4.5 million children between 5-17 years of age diagnosed as of 2006.

Given the lack of an objective medical test or exam to assess the presence of the disease, many researchers, such as Michigan State University economist Todd Elder, believe that ADHD in children is significantly over-diagnosed. In a recent study, Elder suggests that approximately 20 percent of cases have been misdiagnosed.

“Nearly 1 million children in the United States are potentially misdiagnosed with attention deficit hyperactivity disorder simply because they are the youngest—and most immature—in their kindergarten class,” notes the press release for the Elder study.

His results showed that he younger children had more than twice the probability of older children in the same grade to be diagnosed with ADHD and prescribed stimulants for its treatment. “If a child is behaving poorly, if he’s inattentive, if he can’t sit still, it may simply be because he’s 5 and the other kids are 6,” Elder says.

Dangerous Prescriptions

The main danger of misdiagnosing ADHD in children lies in the prescription of behavior-modifying stimulants such as Ritalin, which are commonly used to treat the disease. According to Elder, such stimulants may have “unknown impacts” on children’s health and development after long-term use. Furthermore, cost of these treatments in the U.S. is estimated at $320 million-$500 million a year, $80 million-$90 million of which is paid by Medicaid.

In 2008, the National Health Institute in the United Kingdom advised against the use of Ritalin and other stimulants for the treatment of ADHD, suggesting that behavioral therapy be employed instead, particularly for children under the age of 5. Colin Blakemore, Professor of Neuroscience at the Universities of Oxford and Warwick, suggests that liberally prescribing Ritalin without having a clear idea of the medication’s long-term effect might pose problems in the future.

ADHD or Immaturity?

Given that the biological basis of ADD-ADHD is still not entirely understood, the definition of the disease is very broad. It encompasses many different manifestations and symptoms, including hyperactivity, impulsiveness and difficulty focusing and completing individual tasks.

In a column for, Dr. William Sears offers an excellent suggestion on how to tell the difference between ADHD & immaturity: “Keep a diary … With immaturity, you will notice steady improvement as your child learns to settle into a school routine. On the other hand, true ADHD, if left undiagnosed and untreated, can become worse with time, resulting in your child developing a poor attitude about learning.”

Family Doctor, a site created by the American Academy of Family Physicians, offers an informative page for parents, including an instructional video. It states that for a child to be considered as having ADHD, several symptoms must be present, and persist for at least six months.

Related Topic: Kindergarten Red-Shirting

The results of the Michigan State study no doubt will cause many parents to wonder whether they should hold back a child whose birthday is just before the cut-off for entering kindergarten, a practice so prevalent it has a nickname: “kindergarten red-shirting.” We examined the issue in great detail in this earlier article.

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