Have you ever asked yourself why every child is diagnosed with a mental disorder today?
Some behaviors cause more concern than others, especially in children. All behaviors occurring in any context can trigger a misinterpreted conduct in a significant place or setting. Mental health problems are sometimes identified by a clinician without the proper full history of the patient physical examination, investigation of blood tests, EEG and a period of behavioral observation. As soon as the child demonstrates some unusual behavior is immediately identified as autism, ADHD, ODD, bipolar disorder among others by pediatricians, teachers, clinicians, etc.
Have you ever heard these phrases:
- Your child is not normal.
- His or her behavior is not from a normal child.
- You need to take him or her to the doctor because your child is not functioning according to the rest of the children in my class.
- Your child is not talking how the rest of the children are.
- Your child is autistic.
- Your child is hyperactive so he or she has ADHD.
- Your child is bipolar.
Furthermore, not having the proper specified mental health training or diagnosing from a short interview can lead to improper diagnosis and what is worse to recognize the proper illness the patient has. This is a major problem in the United States, especially in Miami, Florida. Children are being misdiagnosed with ADHD, ASD, ODD, bipolar disorder, among others. Temper tantrums and swift changes are now excuses for a clinician to diagnose children with any of the mentioned disorders. The evaluations are being based on observations and not on proper full-blown evaluation. It is vital to increase the awareness of the need to improve the reliability and validity of the diagnostic methods used today (Bouras, Holt, 1997).
Not all children grow and develop at the same rate. Some children learn to read at the age of five, some at six and some even later. There is a work of difference between what is a normal behavior in a child and what is a normal behavior in an adult. Temper tantrums and swift changes of mood are not considered normal in adults, but they are very usual for a child. Instead of jumping to a psychiatric diagnosis, the child must be in speech therapy, social skills classes, behavioral therapy, and tutoring which is can be more of a safety help (Wedge, 2011).
Having differences is not the same as having a disease. Diagnosing children with psychiatric disorders is even more problematic and potentially harmful than diagnosing an adult. One psychiatrist might diagnose a child with ASD, another with ADHD, another might say the same child has oppositional defiant disorder ODD, and a fourth doctor might diagnose the child with bipolar disorder. What is considered normal and what is considered a “mental disorder” depends on the current attitudes of a society, not on scientific evidence. Psychiatric diagnoses such as ADHD, bring hidden benefits to a child’s family, teachers and school. In some states, a child diagnosed with ADHD is granted significant financial aid for college based on his or her “disability.” A child with a serious diagnosis such as bipolar disorder and autism may be eligible for disability benefits which goes to the parents. Because psychotropic drugs sedate children, they become easier to manage in the overcrowded classrooms. Which makes a psychiatric diagnosis and medication of children beneficial to stressed-out teachers. Schools profit from psychiatric diagnosed children since they receive more money for children with psychiatric disabilities. Worst of all children who have been labeled with a psychiatric diagnosis grow up believing that there is something wrong with them. That they are somehow “abnormal.” Hours spent on a psychiatrist’s office can take a toll on the child self-esteem. The children will believe that they must take the medication in order to behave and feel like a normal child. The way labels are being used; for example, “My son is ADHD” or ‘My daughter is OCD” the child will believe that the problem is a permanent attribute, rather than an issue of situational stress (Wedge, 2001).
There are several reasons why children may be misdiagnosed as autistic. Autism Spectrum Disorder (ASD), is a complex neurobehavioral condition that includes impairments in social interaction, developmental language, and communication skills combined with rigid, repetitive behavior. It covers a large spectrum of symptoms, skills, and levels of impairment. ASD ranges in severity from a level 1 thru level 3.
Level 1 requires support in place, deficits in social communication cause noticeable impairments. Difficulty initiating social interactions and clear examples of atypical or unsuccessful responses to social overtures of others. May appear to have decreased interest in social interactions. An example is a person who is able to speak in full sentences and engages in communication but whose to-and-fro conversation with others fails, and whose attempts to make friends are odd and typically unsuccessful. Restricted, repetitive behaviors cause significant interference with functioning in one or more contexts. Difficulty switching between activities. Problems of organization and planning.
Level 2 requires substantial support, marked by deficits in verbal and nonverbal social communication skills; social impairments apparent even with supports in place; limited initiation of social interactions; and reduced or abnormal responses to social overtures from others. An example is a person who speaks simple sentences, whose interaction is limited to narrow special interests, and how has markedly odd nonverbal communication. Restricted, repetitive behaviors of inflexibility, difficulty coping with change, or other restricted/repetitive behaviors appear frequently enough to be obvious to the casual observer and interfere with functioning in a variety of contexts. Distress and/or difficulty changing focus or action.
Level 3 requires very substantial support, with severe deficits in verbal and nonverbal social communication skills cause by severe impairments in functioning, very limited initiation of social interactions, and minimal response to social overtures from others. An example is when he or she does, makes unusual approaches to meet needs only and responds to only very direct social approaches. Restricted, repetitive behaviors, the inflexibility of behavior, extreme difficulty coping with change, or other restricted/repetitive behaviors markedly interfere with functioning in all spheres. Great distress/difficulty changing focus or action.
Symptoms of autism typically appear during the first three years of life. Some children show signs from birth, others develop normally at first but slip suddenly into symptoms when they are 18 to 36 months old. It is not recognized that some individuals may not show symptoms of a communication disorder until the demands of the environment to exceed their capabilities. Children with autism have trouble communicating. They have trouble understanding what other people feel. This makes it very hard for them to express themselves either with words, through gestures, facial expressions, and touch. A child with ASD is very sensitive with pained by sounds, touches, smells, or sights that seem normal to others. Children who are autistic have repetitive stereotyped body movements such as rocking, pacing, and hand flapping. They have unusual responses to people, attachment to objects, resistance to change in their routines, aggressive and self-injurious behavior. There are times they seem not to notice people, objects, and activities in their surroundings. Some children with autism may also develop seizures and in some cases, those seizures may not occur until adolescence. These children with ASD have a cognitive impairment to a certain degree. Which is characterized by delays in all areas of development. People with autism show uneven skill development. Children have problems in certain areas but they may have unusual developed skills in other areas like drawing, memorizing facts, creating music and solving math problems. For these reasons, ASD children tend to test higher even in the average or above-average range on nonverbal intelligence tests (Bhandari, 2008).
Previous disorders are now classified under the umbrella diagnosis of ASD or a social communication disorder which includes: Autistic disorder, Asperger’s syndrome, Pervasive developmental disorder (PDD), Childhood disintegrative disorder and Rett syndrome. What causes autism is unclear, research suggests that arises from abnormalities in parts of the brain that interpret sensory input and process language (Bhandari, 2008).
Drugging children for ADHD had become an epidemic. More than 5 million United States children were diagnosed with ADHD as of 2007. About 2.8 million had received a prescription for a stimulant medication in 2008. The ADHD diagnosis does not identify a genuine biological or psychological disorder. The diagnosis from the 2000 edition of the “Diagnostic and Statistical Manual of Mental Disorders,” is simply a list of behaviors that require attention in a classroom like hyperactivity, impulsivity, and inattention. These are spontaneous behaviors in normal children. When those behaviors become age-inappropriate, excessive and disruptive the potential causes are limitless. Children who are suffering from bullying, abuse or stress may also display these behaviors in excess. By making an ADHD diagnosis, is ignoring what is really happening with the child. ADHD is almost either Teacher Attention Disorder (TAD) or Parent Attention Disorder (PAD). These children need adults in their lives to give them improved attention (Breggin, 2011).
Stimulant drugs work by suppressing all spontaneous behavior in normal children. The drugs do nothing to improve learning or psychosocial development. Why are the ADHD diagnosis and the use of stimulants so prevalent in America? Starting in the 1970s, drug company marketing had focused on selling the diagnosis and the drugs to American parents and teachers. The National Institute of Mental Health, the American Psychiatric Association, and even the American Neurological Association have promoted the ADHD diagnosis and stimulant medication, which leads to considerable business for mental health clinicians. Everywhere that ADHD and stimulants are promoted, they substitute for needed modern reforms in education and family life. In all cases so-called ADHD, the diagnosis is harmful. The child instead needs a real medical, psychosocial educational evaluation and the child quickly will respond to improved teaching and parenting. “We are diagnosing and drugging millions of our children instead of providing them the improved educational and family life that they truly need” (Breggin, 2011).
Bipolar Disorder Misdiagnosis.
Bipolar disorder is also often misdiagnosed. Diagnosis of patients with bipolar illness can be challenging as most of these patients seek treatment only for depressive symptoms. More and more often the first episode of mood disturbance is depression rather than mania. High comorbidity of bipolar disorder with other psychiatric and medical diagnoses also makes diagnosis difficult. Research also supports high comorbidity of bipolar disorder with panic disorder, obsessive-compulsive disorder, social phobia, eating disorders, attention deficit hyperactivity disorder (ADHD) and axis II personality disorder (Clin, 2004).
Bipolar disorder is a complex illness to manage and its misdiagnosis results in further treatment complications. Initial misdiagnosis results in a delay of appropriate treatment which in turn increases the risk of recurrence of episodes. The most common misdiagnosis for bipolar disorder patients is unipolar depression (Bowden, 2005). An incorrect diagnosis of unipolar depression carries the risk of inappropriate treatment with antidepressants, which can result in manic episodes triggering rapid cycling. The delay in the start of mood stabilizers in bipolar disorder has been associated with increased healthcare costs, which include increased suicide attempts and higher rates of hospital use. Most suicides in patients with bipolar disorder have been reported to occur in the depressive phase. Misdiagnosed patients have been reported to lead disruptive lives. With the onset of bipolar disorder being common in adolescent years this would have a negative effect on the development of interpersonal skills, education, and earning potential. Physical examination with relevant lab work is important, especially in cases with an atypical presentation, to rule out any non-psychiatric condition contributing to the symptoms of bipolar illness. There are several diagnostic instruments, but none of them have been found to replace careful diagnostic evaluation (Baldassano, 2005).
My advice before taking your child to get a mental diagnose is to research first of why the child is acting and behaving that way. As a parent, you are the only person that really knows your child. Keep in mind there is very little research concerning the over-diagnosis of children and adolescent mental disorders. A factor that most clinicians do not take into consideration is the overlapping of symptoms of different mental disorders. This occurs due to heuristics, disregarding differential causes of observed behavior, which misleads to symptoms by caregivers and differential interpretation of diagnostic criteria by examiners. Keeping in mind that many children’s lives are being ruined every day with an improper diagnosis. It is clear the validity and reliability of diagnostic methods for our population needs, to be improved immediately (Holt, Geraldine, 1995).