Should Children be diagnosed with ADHD/ADD under the age of ten years?
Introduction
Attention deficit hyperactivity disorder (ASHD) is a very common disease in children. It is one of the most common disorders in children and can usually prolong to the adolescent years and adulthood. The most common symptoms for the disorder in children include overactivity, difficulty in paying attention, and difficulty in controlling the child’s behavior. According to the National Institute of Mental Health, children with ADHD have delayed development of the brain, which is averagely at three years in brain regions for thinking, planning, and paying attention (NIMH, 2012). ADHD is classified into three sections based on the symptoms portrayed by the patient. The three categories include hyperactivity, mostly inattentive, and a combination of both. While the exact cause of the disorder is not known, health experts associate it with various factors such as; brain trauma, genetic factors, the social environment, and nutritional factors. Cigarette smoking and consumption of alcohol during pregnancy exposes the child to ADHD. Diagnosis and treatment of ADHD in children has always been an issue of controversy to doctors and health experts. While the diagnosis of ADHD in children above the age of four years is medically allowed, children below the age of ten years should not be diagnosed as more often than not, children have been misdiagnosed with ADHD for showing age-appropriate behaviors.
Since the proper diagnosis methods have not yet been established, and the issue remains controversial to doctors, then it is not appropriate to diagnose children for ADHD. Due to the lack of specific diagnosis for the disorder, the condition can easily be mistaken, and this could lead to incorrect medication (Tharu, 2012). Most experts who have conducted research on the issue agree that the diagnosis of children for ADHD is very difficult. One such study is the study by Arnold et al. According to the study, the diagnosis of the subjects was one of the most difficult tasks in the entire study (Arnold, 865-870). The subjects that were used for the study had very different causes of the condition, with some having symptoms of impulsivity while others had the symptoms of inattentiveness. This made the diagnosis not only a tedious task but also a confusing one (Arnold, 865-870). Nonetheless, the subjects still had behavior characteristics that needed to be addressed. As such, implementing behavioral therapy to the subjects would be more appropriate than diagnosing ADHD as the treatment will be concentrated on treating only one problem that may not even be the issue.
Psychotherapy, behavioral interventions, education plans, and parental training have proven to be very effective methods in containing ADHD. These methods have been proven to be safer than medication as they have no side effects on the children and bring a personal touch to the treatment of the disorder as many stakeholders are involved in trying to help the child with the disorder (Tharu, 2012). Instead of relying on diagnosis, parents and teachers should be keen in observing children that exhibit abnormal behaviors and use psychotherapy as a mode of treatment. Behavior therapy helps enhance the child’s skills in organization as well as problem-solving while increasing their awareness of the surrounding environment (Tharu, 2012). The use of psychotherapy is particularly important as it reinforces the behavior and trains the affected children of combative measures that last even without medicine.
The stimulants that are prescribed by doctors after children have been diagnosed with ADHD have been found to have no lasting benefits to the child. Instead, medications are more likely to cause attention deficit when used on children aged below ten years. Medication is only helpful to the children in helping meet the needs of the classroom without helping meet the other social needs of the children. This leads to various problems in the future life of the children, especially in demonstrating social skills. To avoid this, parents should be keen to observe abnormal behaviors in little children and use behavioral therapy instead of relying on the diagnosis for the ADHD disorder (Young, 116-133). Parents should try and limit the choices of their children as much as they can so as to limit motivation. This can be done by limiting every aspect of the life of the child, for instance, play and clothes to only a few choices. A routine of activities should also be maintained by the parents. For children with hyperactive symptoms, parents should ensure that a schedule is maintained for the child’s daily activities (Young, 116-133). This way, the child will experience minimal new tasks each day, lowering the hyper activeness.
Multiple research studies have argued the need to diagnose children below the age of ten years with ADHD. They have provided the efficiency of diagnosis and the use of medication in addressing the disorder. However, they still stress that psychological therapy must be used together with the medication for the medication to be effective (Wells, 483-505). If medication cannot be effective without the use of behavioral therapy, then there is no need for the diagnosis of ADHD in children below the age of ten years. Instead, parents and other stakeholders in the child’s life should be trained on how to identify the abnormal behaviors that are related to ADHD. The parents should then be equipped with skills that are needed to control ADHD in their children if and when detected (CDC, 2011). This will ensure the success of this method of treatment.
For children below the age of ten, behavior therapy should always come first. Only in extreme cases should a parent consider taking a child for diagnosis and consider medication as a form of treatment (Marks, 1-3). However, this should come after having tried behavioral therapy for a period of six months without the condition of the child getting any better. Even then, most health experts for children will urge you not to give up on behavioral therapy even after considering other types of medication (Wells, 483-505). Another reason why children below the age of ten should not be diagnosed with ADHD is that not all medications that are prescribed after the diagnosis are FDA approved for children below the age of ten (Marks, 1-3). Nonetheless, a lot of doctors still prescribe drugs for young children. According to experts, while ADHD medication does work, it works less predictably in children below the age of adolescents than in older children. Additionally, the side effects from the use of the medications are more severe in children below ten (Marks, 1-3). Children can experience negative side effects such as weight loss, delayed growth, and anxiety. All these can be avoided by making the children under the age of ten ineligible for diagnosis with ADH
While the treatment of ADHD on children below adolescent age has been an issue of varied research, no clear mode of medication has yet been established for curing the disorder in children. Nonetheless, stimulant medication has shown some positive benefits in helping control children with the disorder. The most common types of medication that are prescribed by health providers are stimulants and non-stimulants (Young, 116-133). However, some researchers have noted that these medication treatments could lead to various long term effects on younger children. These unforeseen effects that have been linked to the use of ADHD medication for young children are reason enough to avoid diagnosing children below the age of ten with ADHD. This is because once diagnosed with the condition, most doctors often go-ahead to prescribe these medications to the children.
On the other hand, studies have shown that medication boosts learning. Numerous research studies have shown that children who start medication before their fourth decade show a slight drop in mathematics compared to the significant deviation of children who started their medication later (Tharu, 2012). This shows that the use of medication has reduced symptoms that they can be able to control more easily through the help of parents and their doctors. According to Dr. Tharu on Network for Health Indian journal of July 7th, 2012, those pediatric cases where children start medication earlier before four years may be able to score better academically compared to those who commence medication late (Tharu, 2012). Despite the many negative reports on the use of stimulant medication for the children under the age of ten, the study by Dr. Tharu showed that the diagnosis and use of medication on children under the age of ten actually had positive impacts on the academic performance of the children.
According to the guidelines set by the American Academy of Pediatrics (APP), children as young as four can be diagnosed with ADHD. This age is considered as it is when children will be most likely to show symptoms of the disorder (Reiff, 2005). At that age, children are already active and impulsive; hence it is easy for parents to identify ADHD in their small children. Some of the signs and symptoms that are easily noticeable by parents include the inability to settle down, talking in excess, and impatience (Marks, 1-3). Generally, kids with ADHD are excessively active all the time. While attentive parents and teachers may identify symptoms that make them suspect ADHD, this is not enough, and a doctor’s full evaluation is needed for diagnoses (Marks, 1-3). Just because a child is hyperactive, it does not necessarily mean that they have ADHD. For instance, when children get frustrated for having other conditions, for example, hearing and sight problems, they may exhibit behavior similar to that of a child with ADHD (Marks, 1-3). Testing is, therefore, necessary to rule out other possibilities.
Conclusions
Although the American Association of Psychiatrists (APP) allows children over the age of four to be diagnosed with ADHD, children under the age of ten years should not be diagnosed with the disorder. This is because it often results in misdiagnosis as a lot of symptoms can be easily confused. Furthermore, proper diagnosis methods have not yet been established, and the issue remains controversial to doctors. Due to a lack of specific diagnosis for the disorder, the condition can easily be mistaken, and this could lead to incorrect medication. Additionally, medication has been found to have negative short term and long term effects on younger children and should, therefore, be avoided. Instead, parents and teachers and other stakeholders in the children’s life should be trained on how to identify abnormal behaviors in younger children that are associated with ADHD. They should also be made conversant with the behavioral therapy treatment method as it remains the best method of addressing the issue in younger children.
Work Cited
Arnold, L. Eugene, et al. “National institute of mental health collaborative multimodal treatment study of children with ADHD (the MTA): Design challenges and choices.” Archives of General Psychiatry 54.9 (2009): 865-870.
Marks, Hedy. “ADHD in Preschoolers: How Young is Too Young? ADHD in Preschool Kids”. Retrieved from https://www.webmd.com/add-adhd/childhood-adhd/features/adhd-in-preschoolers#1
Wells, Karen C., et al. “Psychosocial treatment strategies in the MTA study: Rationale, methods, and critical issues in design and implementation.” Journal of Abnormal Child Psychology 28.6 (2000): 483-505.
Young, Susan, and J. Myanthi Amarasinghe. “Practitioner review: Non‐pharmacological treatments for ADHD: A lifespan approach.” Journal of Child Psychology and Psychiatry 51.2 (2010): 116-133.
Reiff, Michael I. ADHD: What every parent needs to know. American Academy of Pediatrics, 2005.
Tharu, R. (2012, July).”Should Young ADHD Children be Medicated?”Medindia Network for Health. Retrieved on December 6th, 2013 from http://www.medindia.net/news/healthwatch/should-young-adhd-children-be-medicated-103732-1.htm
Arnold, L. Eugene, et al. “National institute of mental health collaborative multimodal treatment study of children with ADHD (the MTA): Design challenges and choices.” Archives of General Psychiatry 54.9 (2009): 865-870.