Are practitioners to be blamed for unnecessary assessments and over-diagnosis in children with ADHD ?
Irish authorities have shown concern regarding the possible over diagnosis of many children, labelling them with ADHD, early in their lives.
ADHD and ASD are very real conditions affecting hundreds of children and adults. The numbers are increasing drastically.
Increased number of diagnosis by the doctors suggest that the prevalence of ADHD and ASD has been increasing. ADHD is now recognised as a genuine disorder, and autism has been on a significant rise since the last decade.
The NCSE, National Council for Special Education is concerned and highlighted the issue of “diagnosis for dollars”, also acknowledges this.
With the rise of these neurobehavioral disorders, it has also been noted that many children, all over the world are labelled into the spectrum.
Children may suffer from varied emotional and behavioural issues. At times, these can be just phases of growth or some other ailment affecting them.
NCSE suggests that practitioners in Ireland should take note of this mislabeling and warns that some practitioners are pushing to ‘fit’ the child into the ADHD symptom category.
This over-assessments of behavioral issues or emotional abilities among children gets encouraged due to the system used for assessments of children for their needs of additional resources.
NCSE believes that many doctors attempt to arrive at the diagnosis to avail easy help of the concerned child. They tend to act as an advocate for the child, however, diagnosis for a patient and advocacy for a family are two different scenario and therefore, should be treated as thus.
Some professionals also do it for “Diagnosis for Dollars”, moniker observed. It is high time that relevant professionals react to the situations and assess the situation correctly.
An assessment is generally carried out for a child facing social and developmental issues. The key aim of the assessment is to inform the parents of the child about how they can help their child, and the various help available for them.
Additional resources should be allocated after the approvals of relevant educational authorities, who helps parents in guiding them to choose the right resources.
NCSE have further argued that over-assessments may not help a child, rather may affect their self esteem negatively as they attempt to partake in society.
By having a child over-assessed for the sake of gaining access to supports could have adverse effects, as the temporary issues could become everlasting.
Gross inefficiencies in the current system is to be blamed for these issues, says NCSE.
It is a result of the guidelines, which states that a child needs to be assessed by a psychiatrist and be certified for learning difficulties to gain access to additional resources.
These diagnosis at times are carried out on a large scale by private consultants by financially sound parents as the costs of having assessment can cost as much as €1,000.
On the other hand, having a child diagnosed by public assessment (NEPS) may take as long as a year.
It is wrong to blame parents to avail the help of private diagnosis since the public systems are not well coordinated which leads to long waiting lists.
Schools in affluent areas, meanwhile, also take advantage of the situation as they apply for increased financial support before the beginning of the academic year, in accordance to the increased number of ADHD students enrolling in the junior year.
This means that there are lesser benefits for schools in less affluent areas.
To counter the scenario, the NCSE has proposed for a reformed system. It has been decided that access to resource will no longer depend on formal diagnosis of behavioural issue and learning disabilities.
This will take the private psychiatrists out of the picture, thus lessing the number of students who are made to ‘fit’ into the ADHD label.
As expected, this suggestion does carry its own flaws.
A concern has been raised that this new system gives more viability to the resource teaching in schools depending on the demography of their catchment and the socioeconomic standard.
However, the real concern is that this whole issue has arisen from the lack of quick, easy to access public support system or families with ADHD. That is a major concern which needs to be addressed before taking any lasting decisions.