American Academy of Pediatrics Issue First Set of Guidelines for ADHD
CAROL LIN, CNN ANCHOR: Doctors are concerned overactive children are being misdiagnosed. Children who don't need the drug Ritalin are getting it, and many who should get it are not. So the American Academy of Pediatrics is issuing the first guidelines for Attention Deficit Hyperactivity Disorder. Medical correspondent Rhonda Rowland has details.</s>RHONDA ROWLAND, CNN CORRESPONDENT (voice-over): It looks like a pharmacy, but it's a school nurse's office at Big Creek Elementary in Forsyth County, Georgia. Most of the students lining up for medication are taking Ritalin, a stimulant drug used to control ADHD, Attention Deficit Hyperactivity Disorder. A several-fold increase in Ritalin prescriptions over the past decade has many specialists wondering: Is ADHD being overdiagnosed?</s>DR. PETER JENSEN, COLUMBIA UNIVERSITY: Yes, overtreatment and overdiagnosis does happen, but the much bigger problem to my mind is that many children are still being missed and ignored.</s>ROWLAND: The figures are staggering: Experts say, more than a 1 1/2 million missed and ignored, children who could benefit from treatment are not getting it.</s>JENSEN: The problem is the real, when we get into the real world, because the pediatrician may not have time, the doctor may not be trained to make the diagnosis, there may be pressures in a school system.</s>ROWLAND: So children can get the right diagnosis, a team of specialists has published specific new guidelines in the journal, "Pediatrics." Six to 12-year-old children should be evaluated by a primary care doctor, such as a pediatrician, if they exhibit: inattention, hyperactivity, impulsivity, academic underachievement or behavior problems. And in addition to a thorough physical exam to rule out other medical problems, pediatricians should look into school performance and behavior; family functioning; and how the children adapt socially and to school.</s>DR. MARTIN STEIN, AMERICAN ACADEMY OF PEDIATRICS: Perhaps most importantly we're going to ask pediatricians to acquire information both from parents and schools. It's insufficient to have data just from the parents during an interview in an office setting.</s>ROWLAND: Researchers emphasize one office visit is not enough to make a diagnosis, at least two or three are needed.</s>ROWLAND: After getting the right diagnosis, the next challenge is getting the right treatment. Guidelines are expected early next year. In the meantime, a recent study shows children with ADHD do best with a combination of treatments, including stimulant drugs like Ritalin, behavior therapy and parent training -- Carol.</s>LIN: Rhonda, clarify for us then, with all these reports out saying that there are pre-schoolers who are over-medicated, how does that jibe with this report that not enough kids are being diagnosed with ADHD?</s>ROWLAND: Well, certainly, there has been concern that too many pre-schoolers are now getting Ritalin, and the major problem with that is there have not been studies done on these young children to see what perhaps the long-term effects are. So, therefore, we don't know if we are rushing to these drugs too quickly without trying some other interventions. As far as older children, there have just been some anecdotal reports that perhaps too many are getting the diagnosis. There's really only been one big study done looking at this, and it was done in a community in Virginia with 30,000 children, and they found that 17 percent of white boys were actually diagnosed with ADHD. Now, doctors say, on the flip side, they think that there are perhaps other areas where too few children are getting Ritalin because they know that there are about one and a half to two million children who are now getting Ritalin, whereas about three to three-and-a-half million total could be benefiting. So perhaps, again, you have about one-and-a-half million who could be getting treatment here. So the main thing is, for parents, is to make sure that your child is getting the right diagnosis so you can avoid the overtreatment or under treatment.</s>LIN: And you make a good point in your report, more than one visit to the doctor in order to make that determination.</s>ROWLAND: Exactly.</s>LIN: All right, thanks so much, Rhonda.