A few weeks ago we talked about ADHD, asking if you had the feeling that this disorder was being hyperdiagnosed and it was pending to explain a little more thoroughly how the so-called Attention Deficit Hyperactivity Disorder is diagnosed.
Talking about the possibility that there are too many children diagnosed with ADHD can be done for one reason: the diagnosis is not objective. It is not a disorder that can be diagnosed as someone who diagnoses diabetes, hyperthyroidism or anemia, diseases that are reflected in altered results in a blood test. Nor can it be diagnosed with a cranial magnetic resonance, such as who is looking for a brain malformation, an infection or even a tumor. Simply put, there is no diagnostic test that determines that a child (or adult) has ADHD.
This makes the diagnosis subjective and is achieved through direct observation of the child, interviews with parents, information obtained from school, other family members and the results of some questionnaires.
The history of the child
When a child suffers from a disease or disorder an anamnesis is performed and in the case of ADHD it is also carried out. The history is a collection of data as complete as possible in which the child's development, medical problems he has had, allergies, medication he is taking and other data related to his environment are recorded, such as which school he attends, what course does it do, what comments do parents receive from teachers, what relationship do they have with classmates, relationship with other family members, how is the family environment, the relationship of the parents with the child, the relationship between the father and the made , if there have been recent changes at home, problems that stress the child, etc.
It is also explored if there is a family member in the family who has a psychiatric disorder or who directly has the same ADHD, in case there could be any hereditary factor.
The doctor, who can be a neurosurgeon, a psychiatrist or a neurologist, can use some questionnaires of ADHD symptoms and other problems (anxiety, depression, etc.), It is also advisable to have an idea of the child's intellectual level with a WISC test, to rule out possible learning problems and low or high IQ (if a child has a hard time following classes, they can get bored and stop paying attention, dedicating themselves to other things, including playing and disturbing, which is the same that can happen to a child who gets bored because he learns faster than his classmates).
Other tests
I have sometimes heard people explain to me that this or that child was diagnosed with hyperactivity because they "saw it" when doing an electroencephalogram. It is true that there are children who undergo this test, but it is not true that the intention is to make a diagnosis of ADHD, but to rule out some brain pathology (epilepsy, degenerative disorders, etc.), which motivate a behavior that could be oriented like ADHD.
Through the DSM-IV-TR
The DSM (Diagnostic and Statistical Manual of Mental Disorders, in Spanish "Diagnostic and Statistical Manual of Mental Disorders") is the Manual made by the Psychiatric Association of the United States that contains a classification of mental disorders, providing a complete description of each disorder to serve professionals as a diagnostic method.
The current edition is the fourth, which is called DSM-IV-TR. Being a manual whose content It comes from the consensus of several professionals without a scientific base that protects it, carries with it a great controversy.
This manual defines ADHD broadly and it specifies that the diagnosis requires symptoms of inattention (at least six symptoms) or hyperactivity (at least six, too). These symptoms must be present before 7 years of age in at least two environments of the child's life and must last at least six months.
To evaluate the symptoms, small questionnaires are carried out, from which the diagnosis is oriented, which must be confirmed with other criteria. We will talk about this in another post, to show in detail these questions and these criteria.
Photos | StormyDog, Chefranden on Flickr. In Babies and more | Is ADHD overdiagnosed ?, Clinical Practice Guideline for Attention Deficit Hyperactivity Disorder, One in four diagnoses of hyperactivity is wrong
