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Diagnosis

• There's no physical test (such as a blood test) for ADHD.
• No single cause has been established.
• There's no standardised method of assessment – it's down to the clinician whether he uses written tests or makes a judgement based on what you and the teachers tell him. What one expert would classify as ADHD, another might not. Although methods of assessment are increasingly standardised the final diagnosis of ADHD depends on clinical judgement that may vary from one specialist to another.
• Other problems can cause behaviour similar to ADHD, such as hearing problems, dyslexia, family problems, anxiety and depression.
• ADHD can exist with other conditions and this can complicate the assessment process. There are overlapping areas with conditions such as language difficulties, dyspraxia, sleep disorders, autism spectrum disorders and Asperger's Syndrome – this is increasingly recognised by most specialists however and will be taken into account during assessment.
• All children have problems with self-control to some extent – where do you draw the line between normal and difficult behaviour?
• Our modern lifestyle, with greater use of technology, means we're used to getting information quickly and in bite-size pieces. Some experts feel children have a shorter attention span because of this lifestyle, rather than because of a medical condition.
• ADHD services tend to be underfunded and overloaded, so it can take a long time to see a specialist and get a diagnosis.

History

• drug or alcohol abuse by the mother during pregnancy
• psychological trauma at an early age
• minor head injuries or brain damage.

Influence of the US

• the definition of ADHD (used in the US) is wider than that of 'hyperkinetic disorder', which is the diagnostic term often used in the UK
• prescription guidelines are looser in the US, where stimulant drugs are prescribed for children under the age of six
• some US schools are insisting that children with ADHD must take medication or they will be excluded from school.

Media

Stimulants and parenting

• Are parents drugging children for an easy life?
• Are neurostimulant medications, such as methylphenidate, being overused? They used to be given to school-age children until adolescence, but are now being prescribed for younger children and for a longer period of time.
• Are older children misusing drugs, such as Ritalin? Ritalin is in the same drug category as amphetamines. It's claimed that in the US, older children who were having social problems and wanted to make friends sold their Ritalin in the playground. But with slow-release medication increasingly available, it's unlikely that children will have to take the drugs to school at all.
• Parental guilt surrounding medication. Parents worry that medication may make their child into a zombie or have terrible side-effects – are they bad parents for giving it to their child?

So where does that leave parents?

• If they don't get a diagnosis, their child will suffer.
• If they do get a diagnosis, they're either jumping on a trendy bandwagon or are bad parents, who are drugging their children to compensate for their own shortcomings.

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