Reflective Essay on Prevalence of Medication Treatment for ADHD

What is ADHD?

The controversy surrounding overmedication of children diagnosed with Attention Deficit Hyperactivity Disorder or ADHD is an ongoing contemporary issue. There are three categories of ADHD, Hyperactivity/Impulse (ADHD-HI), Inattentive (ADHD-I), and Combined inattentive and hyperactive impulsive (ADHD-C). Symptoms are usually identified by age four. Overall, I have found significant studies that confirm ADHD is under diagnosed. I was baffled to find this out as common as it is to hear the acronym ADHD. Working for Modesto City School for 20 years now, I thought ADHD was over diagnosed but after doing some research for my ADHD presentation I found that a lot of kids go under the radar and are never diagnosed much less treated in any way. Students with ADHD rather go as labeled “trouble maker” or the “day dreamer”. Now thinking back I can specifically think of a few students that I wonder now if they were in the category of overlooked students. ADHD affects the brain and so to no surprise it is common that students with ADHD have learning disabilities or other disabilities. The most common co-occurring with ADHD disorder is autism spectrum disorder, other co-occurring disorders are speech and language difficulties, learning disabilities, tourette’s syndrome and other tic disorders, as well as epilepsy.

Are Stimulants Overprescribed?

An article that I am going to discuss is titled: Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities. The study done examined epidemiological survey data obtained from 1,285 children and their parents across four communities. Analyses examined the frequency the children's ADHD diagnosis the extent to which medications were prescribed as well as the provisions of other services such as: psychosocial treatments, school-based educational interventions. Some children who had been prescribed stimulants did not meet full ADHD diagnostic criteria, but these children manifested high levels of ADHD symptoms, suggesting that the medication had been appropriately prescribed. Children with ADHD were generally more likely to receive mental health counseling and/or school-based interventions than medication.This study showed both the prevalence of the diagnosis within nonreferred populations and the extent to which various treatments such as: stimulant medication, mental health treatment, and educational interventions are used. The findings of this study were that 5.1% of children met the DSM full criteria across the pooled sampled. Only 12.5% of children meeting ADHD criteria have been treated with stimulants during the previous 12 months.

What was found was that medications are often not used in treating ADHD children identified in the community. This suggests the need for better education of parents, physicians, and mental health professionals about the effectiveness of these treatments. On the basis of the data collected it cannot be concluded that substantial `overtreatment` with stimulants is occurring across communities in general. In fact, per this study ADHD is undermedicated. The lack of knowledge regarding treatment for ADHD can be keeping these children from the help they desperately need.

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Prevalence of Medication Treatment for ADHD

Another article that I found interesting was Prevalence of Medication Treatment for Attention Deficit-Hyperactivity Disorder Among Elementary School Children In Johnston County, North Carolina. This was a study done to determine the prevalence of medication treatment for Attention Deficit-Hyperactivity Disorder (ADHD) among elementary school children in the North Carolina county. Parents of 7333 children from 1st grade through 5th grades in 17 public elementary schools were asked whether their child had ever been given a diagnosis of ADHD by a psychologist or physician and whether their child was currently taking medication to treat ADHD. Parens of 6099 children (83%) responded.

In this article they state the findings were 607 (10%) of children were given an ADHD diagnosis by a professional, boys were diagnosed 3:1 to girls. Of those diagnosed, 434 (71%) were receiving ADHD medication treatment. Treatment rates varied by sex, race/ethnicity, and grade. Per this study, if treatment patterns observed in this study are representative, the medication of ADHD is prevelent.

Food for Thought

Although I personally do not have a child that suffers from ADHD, I do work with and care for quite a few children who are diagnosed or may possibly suffer from this disorder. I personally feel that medicating young children for ADHD is wrong. The Centers for Disease Control and Prevention (CDC) agrees with me. They suggest parents of young children try behavior therapy first. The CDC states that 75% of young children with ADHD are receiving drugs as treatment. There are many other forms of treatment that in my opinion should be tried before medications are introduced. Other types of treatment include changing the child's diet, sugary foods are not recommended. Foods rich in protein such as lean beef, pork, poultry, fish, eggs, beans, nuts, soy, and low-fat dairy products can have beneficial effects on ADHD symptoms. Protein-rich foods are used by the body to make neurotransmitters, the chemicals released by brain cells to communicate with each other. Protein can prevent surges in blood sugar, which increase hyperactivity. Increasing physical activity can help improve attention and focus in children with ADHD. Exercise also produces endorphins, the ‘feel good’ chemical in the brain. Exercise also helps children get rid of restless energy, which is a symptom of ADHD. Also behavioral therapy with parents and children is a way to better deal with ADHD. Behavior therapy is an effective treatment for attention deficit-hyperactivity disorder (ADHD) that can improve a child’s behavior, self-control, and self-esteem. It is most effective in young children when it is delivered by parents. Experts recommend that doctors refer parents of children under 6 years old for training in behavior therapy before prescribing ADHD medicine. When parents become trained in behavior therapy, they learn skills and strategies to help their child with ADHD succeed at school, at home, and in relationships. This is also a way to educate parents of the disorder itself and help them better understand their child and what is going on internally with them. Parents will learn to understand how their child works rather than get upset at them because they are not like everyone else. Children with ADHD may exhibit one or many symptoms, however there is much more to ADHD than being hyper, impulsive, unorganized, fidgeter, talkative, dreamer or clumsy, children with ADHD are also creative, flexible, enthusiastic, spontaneous, energetic and are driven. Having ADHD is stigmatized as a “bad thing” but it is simply just not understood.

I use to think I knew what ADHD was however, I was wrong. Unless one really spends time and researches this disorder there are too many components to completely understand. Even though I feel much more knowledgeable about ADHD now, I am sure I have but scratched the surface of what ADHD is.

References

1. Jensen, P., Kettle, L., Roper, M.. Sloan, M.T., Dulcan,M. K.,Hoven, C., Bird, H.R., Bauermeister, J.J., Payne, J.D. (1999) Journal of the American Academy of Child & Adolescent Psychiatry. Are Stimulants Overprescribed? Treatment of ADHD in Four U.S. Communities, Vol#38 (Issue 7), 797-804.
2. Rowland, A.S., Umbach, D.M., Stallone,L., Naftel, J.A., Bohlig, M.B., Sandler D.P. (2002) American Journal of Public Health. Prevalence of Medication Treatment for Attention Deficit-Hyperactivity Disorder Among Elementary School Children in Johnston County, North Carolina https://ajph.aphapublications.org/doi/full/10.2105/AJPH.92.2.231