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Misleading reporting about overdiagnosis of ADHD in children

The recent article published in The Daily Telegraph (10 March 2016) with the headline ‘ADHD is vastly overdiagnosed and many children are just immature say scientists’ is another example of certain areas of the media challenging well established and convincing evidence regarding the genetic and environmental aetiology and its interplay in the development of attention deficit-hyperactivity disorder (ADHD).

The study in question in The Journal of Pediatrics examined a sample from Taiwan — not the UK. Studies in other countries, be that Taiwan or the United States, do not migrate well because the UK operates a different system, with robust diagnostic protocols and increasing use of objective quantitative computer-based quantitative behaviour testing. Prevalence data in the UK is 3%. This is 2% below what the National Institute for Health and Care Excellence (NICE) estimates, suggesting that ADHD is underdiagnosed in the UK.

Eric Taylor, emeritus professor at King’s College London and a retired child psychiatrist, has published international prevalence variations and the UK context, explaining why there are variations and possible overdiagnosis in the United States (Therapy Today 2013).

The Taiwan study citing the correlation between August born children and ADHD diagnoses suggests many children are just immature and therefore misdiagnosed. The suggestion that ADHD is the result of immaturity or bad parenting is unhelpful and irresponsible journalism, and may result in vulnerable children being denied essential assessment and support in line with NICE guidelines. The growing number of UK children being diagnosed in their teenage years suggests that under diagnosis of young children is a cause for concern.

The subtext of the article in The Daily Telegraph is that of a purely psychosocial model that views self-regulation and emotional inhibition (behaviour) as a purely learned response, distinct from a more medical model that also emphasises the role played by neurophysiology (i.e. that all children are not born with the same neurocognitive capacity and therefore do not mature, behave or learn in the same way or at the same pace).

ADHD is one of many reasons why some young people in some instances behave inappropriately. Indeed, children with neurodevelopmental disorders such as ADHD often have characteristics of other conditions, such as autism. Although I personally welcome intelligent and informed debate about how we socialise, parent and educate children with additional needs, continued dismissal of ADHD as a diagnostic entity is reprehensible. Moreover, the relentless criticism of parents of children with ADHD and the sometimes necessary use of medicines for their children only serves to compound the challenges families face.

It is time the mainstream media accepted the scientific evidence and moved on from this controversy, focusing instead on ensuring that children with ADHD are given access to the right treatment at the earliest age and given the opportunity to develop their enormous talents, creativity and intelligence and recognise the contribution they can and do make to society.

Tony Lloyd

Chief executive officer

ADHD Foundation 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2016.20200910

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