Experts Call Lack of Consensus on ADHD a Major Health Problem

The medical community is still unclear about the best way to diagnose and treat attention-deficit/hyperactivity disorder, the National Institutes of Health said last week. More than 2 million schoolchildren have ADHD, and many of them take strong medications to control their behavior.

The lack of a generally accepted method of diagnosis, treatment, and follow-up for those children is “a major public health problem,” a panel of medical experts convened by the NIH said in a statement released last week.

Currently, there is no diagnostic test for ADHD, which is characterized by impulsivity and inattentiveness. Children with ADHD often have difficulty sitting still in school or performing tasks that require concentration for more than a short time. Panel members estimate that 5 percent of school-age children in the United States have been diagnosed with ADHD.

But, the experts say, many children have been misdiagnosed with ADHD and are taking medication that is not needed.

Some medical treatments, such as the drug Ritalin, have proved effective for ADHD patients in the short term, the panel said.

But researchers have yet to examine the benefits and risks of any ADHD drug beyond a 14-month period.

There is also scant research on how beneficial long-term therapeutic treatments might be and how counseling should be combined with medical interventions as a treatment.

Because it is important to take medications such as Ritalin regularly to ensure effectiveness, doctors who prescribe medication for ADHD children should communicate better with the educators who monitor treatment while children are in school, the report urges.

The group also called for more training to help teachers recognize and understand behavioral problems often associated with ADHD and to learn skills to better interact with hyperactive, inattentive children in their classrooms.

A Parent’s Frustration

Janice Bond, who lives in Chattanooga, Tenn., is pleased with this push for a more consistent system of care. Her 13-year-old son, Jeremy, was diagnosed with ADHD when he was 5 and has been taking Ritalin or other prescribed stimulants since then.

Ms. Bond said she has been frustrated with educators in the past over what she said was an insensitivity to her son’s condition.

“The education system could do a better job of recognizing ADHD in students and recognizing their needs,” said Ms. Bond, who is a member of Children and Adults with Attention Deficit Hyperactivity Disorder, a nonprofit advocacy and support group with 35,000 members worldwide.

Gary Marx, a spokesman for the American Association of School Administrators, said last week that it was important for schools and educators to know about health conditions that affect students.

But, he added, “it’s inappropriate to think that because a child has [ADHD] that we relinquish the responsibility to have a learning environment that allows other kids to get an education.”