Treating Toddlers for ADHD is Crazy, but Don’t Throw the Baby Out with the Bathwater
Data released recently by the CDC, and reported in the New York Times, that more than 10,000 American toddlers are being medicated for attention deficit hyperactivity disorder (ADHD) has ignited a firestorm of indignation – as it should. One might argue that the practice borders on the unethical. Not only is medicating children this young well outside of the standard of care, but a 2012 research study published in the Canadian Medical Association Journal suggested that even in elementary school, children who are the youngest in their grade were 39% more likely to be diagnosed with – and treated for – ADHD than those children who are the oldest in their grade. It is likely that in at least some cases, immaturity should have been the real diagnosis. This makes the toddler report all the more frightening, in my opinion.
Everyone should be concerned about these “extreme” diagnoses. But parents, in particular, must be careful to not ‘throw the baby out with the bathwater.’ While a fairly continuous stream of media content warns parents about the overmedication of our children for ADHD, and about the abuse of stimulant medication by college students, little is said about what happens to those who have ADHD but get no treatment. This is a real loss, because the effects of ADHD on the lives of those who have it is well documented, and significant. Parents consider the possible side effects of medications commonly used to treat ADHD, but do not tend to consider the ‘side effects’ of not treating the ADHD.
Some ADHD Statistics
The CDC estimates that about 10% of American children may have ADHD. Some of that may be unnecessary diagnosis or misdiagnosis, perhaps due to immaturity or other factors. Even if that is the case, ADHD represents a major health issue with significant consequences, particularly if not treated. ADHD can negatively impact educational outcome, social skills, organizational skills, dating relationships, and more. Treatment does not always need to include medication. Recent studies have shown the benefits of parent and family training in improving the control of ADHD symptoms in children, for example, and regular exercise also provides noticeable symptom improvement. But treatment of some sort is often needed to be able to be in control of one’s own life when you have ADHD. I work with adults with ADHD.
Sadly, the vast majority of adults with ADHD (perhaps 89%) are still undiagnosed and have no idea they have it. They see the results, and know they are ‘different,’ but don’t know why. The issues that result from a lack of diagnosis and treatment are often heartbreaking – high rates of difficult marriages (and divorce), imprisonment, financial ruin, more accidents than others, lower educational attainment, and more. No parent, looking 20 years into the future, would wish that for a child.
So let’s continue to call treating toddlers for ADHD with medication the abomination that it is. But let’s also take this chance to say that we really do need to understand all sides of ADHD diagnosis and treatment. It would be too easy to just take this report, add it to the stream of media hype about pharma plots and say “this is just one more reason why ADHD isn’t real.” That is just not so. Parents deserve better information, and better medical attention for their children, than it seems these families are getting.
Melissa Orlov is a marriage consultant who specializes in working with couples impacted by ADHD. She is the award-winning author of two books on the topic, and the co-founder of ADHDmarriage.com with Edward Hallowell, MD. Orlov’s new book is The Couple’s Guide to Thriving with ADHD (Specialty Press). Ms. Orlov has been interviewed about ADHD and relationships by the New York Times, CNN, Today and many more. She is a cum laude graduate of Harvard College.