Through my blog, I help parents who have children with ADHD and teachers who work with these children. I discuss social skills as well as executive function skills, such as organizational skills.
Through my private practice, I teach children with ADHD to obtain positive social skills as well as to learn more effective executive function skills, such as how to plan their academic work by developing efficient organizational skills.
Friday, April 5, 2013
Read my comments in the New York Journal News on April 2, 2013 on the arguable overdiagnosis of ADHD. Send me your thoughts.
ADHD may be
overdiagnosed, Lower Hudson Valley experts fear
decades-long debate over how many children have attention-deficit hyperactivity
disorder — and whether those who do should be treated with medication — will
only intensify with a new study that shows ADHD diagnoses soaring across the
percent of all school-age children have received a medical diagnosis of ADHD,
including 20 percent of all high school boys, according to a New York Times
analysis of a new national survey done by the U.S. Centers for Disease Control
in the Lower Hudson Valley who deal with the diagnosis and resulting treatment
needs say the figures may indicate too many children are being classified with
impression is that it is definitely overdiagnosed,” said Eric Neblung, a
Nyack-based psychologist and president of the New York State Psychological
lot of times, the diagnosis is made by primary care physicians who aren’t
trained to do it,” he said. “Parents may say that their son or daughter has
trouble concentrating, and the physician will jump on it based on a quick
screening. It could be typical adolescent behavior or other things like depression
can’t see how one in five high school boys could have ADHD, a disorder
characterized by inattentiveness and impulsiveness that is attributed to
genetic and possibly environmental
consensus traditionally is that it’s 1 to 10 percent, but even 10 percent is
pushing it,” he said.
Times report, based on a CDC telephone survey of more than 76,000 parents
between February 2011 and June 2012, found that about 6.4 million children
between 4 and 17 had received a diagnosis of ADHD at some point. This would
represent a 16 percent increase from 2007, when the CDC did its last survey,
and a 53 percent upsurge over the last decade.
Times found that about two-thirds of all school-age children currently
diagnosed with ADHD receive prescribed stimulants like Ritalin.
CDC was not involved in the Times’ study, and a representative for the federal
agency said it did not have enough information to assess the report. The CDC
will have its own report analyzing the data
later in the spring. The agency’s survey sought information on children’s
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Rapoport of Chappaqua, the author of “ADHD and Social Skills: A Step-by-Step
Guide for Teachers and Parents” (2009), said that many will be alarmed by the
possible overdiagnosis of ADHD because they assume that children will be
medicated. But this doesn’t have to be so.
become hysterical because of medication,” she said. “But we should be trying
conservative methods first — teaching kids to self-regulate their behavior, to
recognize when their behavior is inappropriate or when their academic work is
ineffective. These kids struggle and need help, but they may not need
is no simple test for ADHD, so it’s up to individual pediatricians,
psychiatrists and psychologists to make the diagnosis.
lot of factors have come into play to drive up the number of diagnoses, local
experts said. Dr. Ronald Jacobson, chief of pediatric neurology at the Maria
Fareri Children’s Hospital at Westchester Medical Center in Valhalla, said that
it can be simpler
and cheaper to get a prescription for Ritalin than to seek ongoing counseling.
should insist that patients have a comprehensive evaluation, but you don’t
always see that,” he said. “You may want to think about therapy and counseling
and medication or all of those, but many families don’t have the resources or
care to make use of all options.”
rules governing prescriptions also have an impact, Jacobson said, and a new New
York law that takes effect in August will create a “real time” online registry
that tracks who prescribes drugs to whom.
may be more thoughtful about what gets prescribed,” he said.
of whether the growing number of diagnoses are accurate, the higher profile of
ADHD should produce more public awareness of the challenges facing children,
said Christine Reinhard, executive director of the Rockland County Association
for Learning Disabilities.
are not enough support services,” she said. “We need more services like
specialized tutoring and skills training to help them identify strategies that
might reduce the need for medication.”
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Fraum, a psychologist who provides counseling for attention deficit disorder
and hyperactivity in White Plains and Manhattan, said that it’s very difficult
to judge the numbers without having another survey for comparison.
if the numbers turned out to be true, I wouldn’t be surprised,” he said. “You
would be talking about a wide range. Not everyone with attention-deficit
disorder is hyperactive. There are a lot of daydreamers who are inattentive and
try to keep their restlessness down as much as they can.”
said that while school districts may resist the diagnosis, suburban parents can
be very aggressive
in seeking services that come in the wake of an ADHD diagnosis and other
accommodations such as “extra time on the SAT exam.”
Schulman, assistant director of special services for Southern Westchester Board
of Cooperative Educational Services, said that schools have to be careful about
how they explain children’s behaviors to parents and doctors.
is the message we send to parents when a student
may be behaving outside the norm?” he said. “We need to see if these behaviors
can be ameliorated in a simpler fashion without a diagnosis. If a child isn’t
sitting still, is it ADHD or is the child bored?”