Sunday, March 26, 2017

Increases in ADHD? The Most Obvious Reasons…

In all the many “news” stories one sees today about the soaring rates of ADHD diagnosis and dr. visits, no one seems to realize the obvious:

Parenting in today’s world is ever more complicated and difficult.  It never was easy.  There never was an “owner’s manual.”  ADHD kids are decidedly much more perplexing and difficult than their non-ADHD peers.  With the proliferation of “news” about ADHD, is it, therefore, any wonder that more and more parents with troublesome kids are taking them to the family doc?  As a retired ADHD-Specialist, I saw hundreds of such families.  Parents overwhelmed, stressed-to-the-max and scared out-of-their-wits with worry and bewilderment about what to do!  Parents pressured by schools, scolded by relatives and looked-at-askance by other parents. 

Most media stories these days place blame on “Big Pharma”, pushy schools, overwhelmed and “lazy” parents and our “quick-fix” culture.  These all miss the fundamentals.

This brings me back to the other “obvious”, but missed-by-most and glossed-over factor.  Namely, family-physicians are, by far, the one group of professionals that see more troubled kids than any other.  By far!  They have THE MOST influence over how troublesome kids get handled; how they get diagnosed with ADHD; whether they are given meds. or referred for therapy.

The AAP did a study in 2013 showing that over 90% of physicians DID NOT follow accepted guidelines for proper diagnosis of ADHD, and, DID NOT follow accepted guidelines for treatment.  How difficult can it be to surmise the outcomes of that:  misdiagnosis, under-diagnosis, meds. vs. behavior therapy, inadequate meds. monitoring, generally poor follow-up, frequent patient non-compliance and frequent treatment failure.  Why?  Mostly because these docs are not knowledgeable about ADHD, don’t have the required time to spend with patients/families and don’t have expertise with ADHD meds.  Many do not know, for example, that most ADHD patients have co-occurring conditions that must be identified; that behavioral therapy should be tried first or simultaneously with meds.; that monitoring of ADHD meds. is much different than with other meds.; or, that treatment follow-up must be frequent and regular.            

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