A few weeks ago there was an article in the New York Times:. Too many patients have asked me about it to ignore it.
Doctors Are Still Figuring Out Adult A.D.H.D.
This New York Time’s article left me somewhat confused. The title is Doctors Are Still Figuring Out Adult A.D.H.D. But they aren’t. You can click the article below to read it yourself.
The article portrays doctors (and oddly, as usual, it seems to assume MDs are diagnosing ADHD when in reality Clinical Psychologists do most of the diagnosing of ADHD) and according to the article, they find it a confusing diagnosis. I’m not sure what part of the diagnosis we are all finding confusing. We have been using some very simple tools to diagnose ADHD, for the most part, they are questionnaires, and these questionnaires match up to the DSM-5 requirements for a diagnosis. One problem people have, but I don’t think any doctor, medical doctor or clinical psychologist, would find confusing is that sometimes it’s hard for us to find symptoms from someone’s childhood. This is easily explained: They may have had good ( meaning informed) parenting, and good teaching! Something that would, overall, make having ADHD in childhood a lot easier. Regretfully many parents, and surprisingly many teachers, are just not familiar with ADHD. Even though it is the most frequent health issue they are likely to deal with. For the most part, teachers are not trained in the basics of behaviour management.
A second issue that I see almost daily in my practice is that some individuals have ADHD, but it isn’t really having a significant impact on their lives when they are children. They may have attended a school that showed a gentle tolerance for differences that made life easy, and staff who provided support for students who has a neurological disorder that is best supported by external interventions.
When high school, college, work, and family arrive in their lives it can suddenly cause chaos. There isn’t a teacher giving gentle reminders, using visual supports and immediately correcting behaviours with a helpful and positive attitude.. Finding signs and symptoms of ADHD in the school records can be hard. But careful questioning and a comprehensive clinical interview often find all we need to know. The so-called “missing evidence of executive functioning problems,” seems to be more of an issue of an inexperienced MD than a problem with diagnosing ADHD.
Here in Canada, we use a specific set of questionnaires as the foundation of our adult ADHD diagnostic process- the CADDRA ADHD Assessment Forms. And make sure what looks like ADHD isn’t something else? Well, that too is right there in the DSM-5 where everything you need to make a firm diagnosis is right there in writing.
What is the biggest problem in diagnosing ADHD? No giving MD’s enough time to do a comprehensive exam. Usually, MD’s use a single form, the SNAP-IV. Even worse, they usually use a short version of the form. In a 15-minute appointment, they don’t have time for a patient to complete several comprehensive forms, including symptom checklists necessary to differentiate ADHD from other disorders, and certainly don’t have time to read and core all the forms. Hence….most of my patients are referred through their family doctors.
While the NYTimes article is interesting, I think it’s title is little more than “click-bate.” It shows a serious misunderstanding of what goes on in the real world. Articles like this convince people their situation is hopeless, and their medical providers are sure what they are doing. Not true. Taking the fact that WE DO A DIFFERENTIAL DIAGNOSIS as part of the diagnostic process means using the many pages of information in the DSM-5 to differentiate ADHD from other similar disorders. This article instead says your ADHD really could be something else! Be scared! Doubt your diagnosis. You doctor knows that, and uses a science-based process to make sure that doesn’t happen…..just as they do with almost every other disorder. The reason for these scare tactics are beyond me.If you think you have ADHD, see your doctor. If they have any concerns about the diagnosis, simpl ask if you should see a psychologist about this as well.
Here is the article:
https://www.nytimes.com/2024/05/20/well/mind/adhd-adults-diagnosis-treatment.html