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Is It Always ADHD?

ADHD is being diagnosed at high levels these days. Do they all really have this disorder? After 25 years of seeing alternative explanations many of the symptoms, I firmly believe the answer is no.

ADHD is being diagnosed at high levels these days. What started in the 1970’s and 1980’s as being a disorder that was rarely heard of, ADHD has progressed to a place where it’s hard to find a child who hasn’t had the label slapped on them or an attempt made to do so. The percentages are huge!

Do they all really have this disorder though? After 25 years of seeing alternative explanations of many of the symptoms, I question if the cause is always the same. I see the label ADHD as a catchall label for lots of different symptoms that can be caused by lots of other things.

I have always felt that ADHD medication has been handed out too fast. Since the medications have side effects and can change body chemistry, I believe every detail should be looked at before deciding to go that direction.

Being a parent coach, Child Psychologist and expert in this area, let me share a few examples of the kids I have worked with that confirmed my suspicions and taught me how lots of symptoms can have other explanations. See if any of these sound like kids you know.

DIFFERENT TRAINING:

A 10-year-old boy who was in 5th grade would get out of his seat without asking permission to do what he wanted to in the classroom. Despite repeated efforts by the teachers to get him to stay in his seat, nothing worked. The parents came to me because the inevitable ADHD diagnosis was bandied about and the teachers were pulling hard for ADHD medication. I did one meeting with the parents to ask about his history to determine what else might be going on. Turns out he was at Montessori for all the years prior to this one. Now, while I love the Montessori program and tell a lot of people to go there, there is a big difference in the way Montessori operates and the way the public school operates. Public school requires kids to sit and passively take instruction. Montessori wants the kids to follow their own instincts to learn what they are interested in. This child spent all the years prior to this one trained to get up when he needed something for what he was learning. The public school was a totally different way of doing things, but the child was operating on the past training. ADHD Medication would have been a huge mistake here and without my short intervention, I believe this would have been a disaster for this child.

HIDDEN ALLERGY:

A 7-year-old girl was doing OK with grades in school, but was having a really hard time sitting still. She was wiggling all day long and also having a problem remembering things she heard in class so she had to re-learn it at night, making homework really long and horrible. The school had already recommended that she be put on ADHD medication. The parents were absolutely against it. So the parents hired me as their private advocate to go into the classroom to do an observation to watch what was happening. I immediately noticed that she was scratching a lot. She would only stop for a couple seconds and then find somewhere else to scratch. When she was asked to answer a question, I noticed that she sounded like her nose was stuffed. I asked the teacher if this was common for this child, and she agreed it was, but said she had never really thought about it before. I asked the parents if it happened at home. They said they had never noticed it. I recommended a trip to the allergist who found allergies to be an issue, put her on Claritin for the school day, and voila-problem solved. Immediate improvement. Again, ADHD meds would have been a misdiagnosis and disaster.

BAD CLASSROOM:

A 6-year-old little boy was accused of getting out of his seat, crawling under his desk, not paying attention, crying, having behavior problems, and not knowing what to do on assignments in the classroom. Again, quick recommendation for ADHD medication, parents hired me to do an observation. I watched as the teacher gave instructions on the craft they were going to do. The directions were also on the board and the little boy was trying to write them down. Nothing unusual to begin with. When the teacher gave the go-ahead for the kids to go get their supplies to do the craft, the classroom erupted in a level of activity that scared even me. Kids running everywhere-some running in circles. Grabbing papers and scissors, some of which were flying. Kids bumping into each other and falling down. The noise level was crushing. Where was my little subject? Crying and crawling under his desk, to form a protective barrier around him from the chaos in this badly managed classroom. He was trying to finish writing the directions on the floor while crying. In my report, I recommended that the teacher be evaluated for ADHD and put on meds. Being a bit sarcastic here, but once again, a little one who narrowly averted body and mind altering chemicals based on misinterpreted symptoms.

One more…

PROCESSING HABITS THAT NEVER GOT TO GROW:

A 12-year-old boy was being recommended for ADHD meds because he could not pay attention in class, couldn’t do his homework on his own, would forget things constantly, and had to have constant help. This boy had a complicated history. Since he was very young, he had repetitive fluid in his ears and mini seizures that were not noticeable to an untrained person. As she didn’t want more meds, the mom wanted him to work with me. The ear fluid had been clear for a long time when he came to me and he was already on meds to control his seizures, but his skills hadn’t improved over the years. The explanation is simple: No one had ever practiced the right skills with him to catch him up. When we are babies, we are like sensory sponges taking in everything around us through our eyes, ears, touch, etc. If those are blocked by anything, those skills never get practiced and need to be trained and caught up. We did that with this child. Once he was able to automatically coordinate his visual, auditory, fine motor, etc. he improved greatly. The mom came in crying happy tears one day because he had actually REMINDED HER to wash his basketball uniform. Usually she had to remind him of everything. ADHD is not always the problem and more medication is not always the answer.

Many kids have a problem coordinating their visual and auditory skills from lack of practice and use. Most of them get accused of having ADHD. Compensation plays a part too. Kids who have fluid in their ears when young will learn to use their eyes instead because the other sensory skill was blocked off and not able to be used. Like all human beings, those kids compensate by depending on the strong skill, all the while allowing the weaker one to keep getting weaker. The ability to coordinate the skills together virtually disappears, creating frustration and looking like ADHD or behavior problems. We are survival creatures. If something doesn’t work well, we will find something to make up for it to move on. That can work for a while, but when the demands become greater and the weaker skill is required, you see problems.

If you don’t know what is causing the symptoms, you can’t be sure of the direction. Many problems can be helped without medication, in many cases, if the right investigation and training are done.

I was thrilled to be there and to be a part of helping these parents discover the truth about their kids and to help them avert a wrong diagnosis and a disastrous, misguided ending.

For these four stories there are hundreds of other kids I have met, who had different things impeding their ability to process information. They developed HABITS that began to look like symptoms of something else.

At least to me, it seems that over the last several decades and last several revisions of the Diagnostic and Statistic Manual, the definition of ADHD has grown much broader, to include many more people who are in need of medication. In light of the large amounts of people on medication, the many stories of kids dropping dead on the sports fields and the quick jumps to this diagnosis without a lot of investigation, I have a problem with that.

I just want to help parents and kids be sure about what else could be causing the symptoms before a misinterpretation gets made and potentially sends a child down a wrong and dangerous path.

 

Dr. Sherri Singer, Psy.D. is a Child and Family Psychologist and Parent Coach helping parents to help their kids avoid behavior problems, physical behavior, and ADHD symptoms without medication while developing fast processing speed, multi-tasking and memory skills. She provides low fee Skype online sessions and telephone coaching from anywhere in the USA. Contact her at http://www.happyfamilysite.com

 

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Deadcatbounce February 11, 2012 at 02:37 AM
I've stayed out of this fight up to now.   My son was diagnosed ADHD many years years ago and of course drugs was the treatment of choice by doctors and teachers.  After a few years I had enough, adderall  was only making my son stay up all night and act mopey.  I don't like drugs and feel doctors like to push pills on too many kids.  Drugs should be the very last option and behavior modification should be stressed.  I know of another kid that was diagnosed with ADHD and drugged.  Found out one year after drug treatment he was really dyslexic and the medication damaged his heart.  Too many doctors with sterling credentials push these pills because it is easy.  Easier than discovering a learning disability or realizing that many boys have a harder time sitting still than girls.   I have no problem with your column Dr. Singer, keep up the good work.
Susan Schaefer February 11, 2012 at 06:38 AM
Hi Dr. Sherri, I had an interesting thing happen with my son, who was diagnosed ADHD in 3rd grade along with a processing disorder and learning disabilities in language arts. He was on various medications for his ADHD, which really didn't seem to make a difference as far as I could see. We moved to CT the summer between 6th and 7th grade. Due to upheaval that came with moving, I got behind on filling my sons prescription so he was off his meds when school began. At his first IEP at his new school his teachers said they saw no reason for him to be on meds and we decided to keep him off unless his teachers recommended it. The teachers continued to believe he did not need meds. Now he is in 10th grade, has not been on meds, and is a solid B student. His high school has been very supportive in helping him become a successful student.
Susan Schaefer February 11, 2012 at 06:49 AM
However, I do believe ADHD exists and medication is necessary at times. I work with ADHD students teaching them executive functioning skills to help them compensate for the skills they lack and utilize behavior modification plans to help my students reach their goals. I also think it is diagnosed, and medication given, too quickly in many cases when there are other underlying reasons for various behaviors.
Hi Susan, Yes I think that the symptoms are more intense for some kids than others. My problem is it seems that it is the first thing that is thought about, and the only direction in many cases that gets followed up on. I am glad for your son, that things happened the way they did. I don't question whether kids are struggling with the symptoms as I have seen it over the last 25 years. My problem is in the way it is growing exponentially, how many kids I see being medicated and how many of those kids I have seen end up with a different problem than was actually thought. My article wasn't intended to say that ADHD does not exist, just that I think that parents need to be diligent about making sure they look at all possiblities to be sure of what the resulting treament is. All of us are multi-dimensional and to say that one thing is the only possibilty becomes very suspect to me and I just wanted to share that opinion with parents. Btw, Susan, I like your blog!
Patti February 11, 2012 at 06:30 PM
Reading all these comments it seems that all this has done is become a "pissing" contest instead of discussing what the real issue is. Yes, ADHD exists and yes, it is misdiagnosed. My son went through a battery of tests and was monitored constantly. Yes, he was medicated, but that was AFTER exhausting everything else first. I was lucky that I had a wonderful pediatrician and provided me with tons of material to read and research myself. I also have family who is in the medical field who could explain what something meant when I didn't understand the term. When he was old enough to understand the process he was given the choice of whether to stay on the medication or not. He did not do as well in school after ending the medication and chose not to attend college. He is a hard worker and knows the chances of him ever holding a desk job are next to nil....he needs to keep his hands busy or he cannot stay focused. These discussions, when handled properly, are good for parents so they know that they are other options, they can get 2nd even 3rd opinions to find out what is the proper way to treat their child. ADHD, whether with or without hyperactivity, is a very hard condition to diagnose and what works for one does not always work for another.

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