A person is a person, no matter how small.

Childhood is one of the most important stages of

the human life. I want you to think about your childhood and how you were. Some of you
would say that were a little impulsive or restless and as you group turns out that was just a
quality of you. But what would you think if by this quality you were diagnosed and labeled with
a disease and because of that you were treated different by your peers, teachers and even
your parents. This happens to the majority of kids that are diagnosed with attention deficit
hyperactivity disorder. This is a disorder that makes it difficult for a person to pay attention
and control impulsive behaviors.

However, nowadays a child that is considered impulsive, active, or absent minded has this
neurological condition. In 2011, the Center of Disease control and Prevention reported that
the prevalence of ADHD in children ages 4 to 17 years was 11%, with 6.4 million children
diagnosed with this disease and 4.2 million taking psychostimulants. What is more concerning
is that the prevalence of ADHD increased by about 35% just from 2003 to 2011, and there is no
indication that this increase would change.

One of the reasons of this increase is the inadequate evaluation and social pressure for
treatment. Making a diagnosis of ADHD takes time. It is not a matter of just filling out a
standardized form and giving a trial of medication. Pediatricians and primary care providers
are aware of the pressures to make a diagnosis and prescribe a stimulant. Teachers are
demanding it to parents, as are parents whose resources of time and energy are limited.
Nowadays, parents are too busy to discipline their children and a medicated child is easier on
the teacher.

In Iceland, a country with a high use of psychostimulants, investigators found that the
youngest third of the class was 50% more likely to be diagnosed with ADHD and prescribed
psychostimulants. What these studies tell us is that we are unable to distinguish those children
who have ADHD from those who are simply immature. I think it is much more likely that we
are misdiagnosing children who are simply a little young for the demands that are being placed
on them.

A significant increase in the demands being made on our children is other reason for an
overdiagnosed ADHD. When are generation were in kindergarten, all that was required was to
be able to eat, sleep, and play. Kindergarteners are now expected to learn to read. Of course,
most of them can do so—although studies indicate there is no overall cognitive benefit to this
earlier training—but there are some children whose neurodevelopmental level is just not high
enough for this level of challenge.

For this, let me ask you a question what if we asked a few hundred of 2-year-old children to sit
still and focus on learning to read? How many would fit the diagnostic criteria for ADHD? It
sounds absurd, but this is what is happening in our kindergartens.

Preventing overdiagnosis requires multiple approaches; one of them is by training teachers

and parents in behavioral modification. This approach emphasizes the use of positive
reinforcement (rewarding) for responsible or adaptive behaviors. Punishment can be
appropriate when delivered less often than positive reinforcement and in a calm, non-physical
manner (e.g., loss of privileges). Similar strategies can be applied in school. Another one is by
improving access to comprehensive evaluations. Psychologists, pediatrics ans people that are
involve in the medical field need to make a deep evaluation, not only focused on the kid, but
also evaluate the context that he or she developed in.

In summary, I do believe that we have an “epidemic” of overdiagnosis of ADHD, the roots of

which are deeply ingrained at many levels in our society. We will have to decide whether to
treat more of our children with long-term psychostimulants or work together to find a
different approach to this persistent problem.