To begin with, Attention Deficit Hyperactivity disorder abbreviated ADHD has been a disorder common to school age children and adolescents. In this context, children with ADHD lack the ability to stay focused on a task and cannot sit still. As well, they have to think before acting in every situation along with the fact that they rarely finish their tasks. It has been argued from research findings that if the disease is not treated, long term effects of problems with socializing may be inevitable. As such, there are also some other disorders that may come along with this disorder. They incorporate disorders such as depression, emotional problems and poor self esteem. In the same line of thought, depressive and anxiety disorders, conduct disorder, drug abuse and antisocial behavior equally occur.
So to speak, it has been stipulated by research that in North America 3 to 5 percent of school age population has been prescribed psycho-stimulant drugs (Neven, Anderson & Godber, 2003). Likewise, Australia and United Kingdom have also experienced dramatic increases of the number of children and adolescents diagnosed with ADHD. In connection to this point, it is important to bring out the definition that has been provided by DSM-IV which is a diagnostic manual published by the American Association. It is a manual that has been accepted internationally and thus it provides the criteria for assessment and diagnosis of most mental disorders. In line with this, it puts it that ADHD manifests itself in three core manifestations. As such, these core manifestations are given as inattention, hyperactivity and impulsiveness (Neven, Anderson & Godber, 2003).
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Research Findings and Discussion
Following this point, there is need for diagnosis as well as good treatment of ADHD owing to the effects it has. As a matter of fact, efficient treatment of ADHD is closely linked to a good diagnosis of the same. Research findings show that there has been a problem with the diagnosis of the ADHD children and thus many have ended up being over or under diagnosed. In the same manner, ADHD diagnosis for clinicians has been an aspect of great concern since ADHD symptoms are often camouflaged by comorbid disorders (Findling, 2008). It has been a big problem to distinguish between the symptoms of oppositional and conduct disorders from those of ADHD. This is why it is important to carry out a differential diagnosis with ADHD so as to eliminate the errors that arise out of the presence of other disorders.
In the light of the mistakes that clinicians often commit, it is important to point out that ADHD is characterized by the early childhood onset of an enduring pattern of inattention and/or hyperactivity and impulsive behavior. According to Findling (2008), diagnosis of ADHD children requires background information from parents, teachers and the child in order to measure symptom severity. This is meant to ensure that the behavioral pattern is consistent. Ryan & McDougall (2009) asserts that no single professional able to provide the breadth and depth of the assessment required in order to accurately diagnose ADHD and this is why input from teachers and parents among others is essential.
More to this point, it is advisable that diagnosis of ADHD be carried out by mental health or pediatric specialists. This is accomplished by means of following a full clinical and psychosocial assessment of the child or young person and their family thereof. Nurse's practice in this case should view children with ADHD as whole and as such diagnose them from a holistic point of view. Rees (1997) points out that there are several types of professionals who make the ADHD diagnosis. As a matter of fact, school age and preschool children are often evaluated by a school psychologist or a team that is made up of the school psychologists and other specialists. In line with this, psychiatrists can be used to diagnose along with the child psychologist. Doctors employ a step by step method while making a diagnosis of ADHD.
In this sense, the first task is to gather information that will enable the doctor to rule out other possible disorders. This is then followed by checking the child's school and medical records. In this case, the doctor will ensure that he or she tries to ascertain any other home or school-related cause of the behavior and as such, it is also established how both the teachers and parents deal with the child. Equally important, doctors employ teacher rated scales more often as they are deemed accurate as compared to parent-rated scales (Ryan & McDougall, 2009). In US, it has been argued that teachers should be directly involved in the process of diagnosing ADHD, a factor that is employed in UK as well.
In reference to Ryan & McDougall (2009), there are two major frameworks of diagnosis that are commonly used by doctors. They involve the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of mental Disorders (DSM). Both ICD and DSM identify inattentive, hyperactive and impulsive symptoms (Neven, Anderson & Godber, 2003). The models are actually categorical which means that there is a minimum threshold for symptoms that must be met before the diagnosis is taken. Sometimes it has been argued that some children may not meet the criteria and thus monitoring in this case may be employed. Therefore, it is evident that there is no single test that is the most reliable for an ADHD diagnosis of children.
Arguably, Diagnosis of ADHD assumes the psychiatric assessment which primarily rules out other potential disorders in order to avoid over-diagnosis or under-diagnosis. Other accompanying examinations may be physical, laboratory and radiological. DSM-IV manual has criteria 1A and 1B. Under criteria 1A, if the child has six or more symptoms for duration of the past six months, to a point which is upsetting and improper for developmental level, then the child can be diagnosed with ADHD (Ryan & McDougall, 2009).
The six symptoms the child should meet at least are symptoms describing inattention. This is if the child is incapacitated to give attention to close details. Accordingly, when the child is spoken to directly may not be responding, unable to concentrate in tasks, trouble in organization, not able to use a lot of mental effort, easily distracted and forgetfulness among others may be considered for ADHD if this has been for the last six months. A hyperactivity-impulsivity symptoms which may persist for six months with the six or more syndrome symptoms being diagnosed, then ADHD can be diagnosed under criteria 1B. Along with this, DCI-10 can be used to diagnose ADHD but it is however limited since it has no provision for ADHD and thus ADHD is diagnosed as hyperkinetic disorders (Ryan & McDougall, 2009).
Research also puts it that doctors diagnose based on the guidelines of DSM in most cases and as such, the guide divides the disorder in three types. They involve the inattentive as earlier on explained, hyperactive/impulsive type or the combination of the two types. Generally, if a child exhibits at least six symptoms from a list that includes fidgeting and excessive climbing and running about, then this can be considered as hyperactive.
Research further states that DSM has provided room for differential diagnosis. This is to suggest the fact that subgroups can be made identification of within the broader categories. For example, it may happen that some children only meet criteria for attention but not hyperactive-impulsive problems (Neven, Anderson & Godber, 2003). It has also been stated that the criteria of DSM provides that some impairment is present in two or more settings. Such settings may be home and school with a combined aspect of clinically significant impairment in social, academic or occupational functioning. More to this, the presence of some of these symptoms before the age of seven can be significant for the diagnosis (Neven, Anderson & Godber, 2003, p.1-3).
Munden & Arcelus (1999), asserts that diagnosis of ADHD calls for a broader assessment by collecting the necessary information from parents, teachers and the child. A complete assessment of ADHD which constitutes the diagnosis involves a doctor carrying a careful reviewing of the Child's symptoms and their medical, psychiatric, psychological, educational, personal and family histories (p.69). In combination with this, the information is collated with that which is obtained from reports, interviews by others, clinical observation and examinations. This implies that there is no simple way of diagnosing ADHD among children and thus this poses a great challenge.
It is important to state that the history of symptoms and their consequences are important in the diagnosis. Equally, there is need for medical history, information from other professionals, forensic history, physical examination and investigations and behavioral rating scales among others which necessitate the diagnosis of ADHD among children (Neven, Anderson & Godber, 2003). From this point of view, there is much that is needed in order for diagnosis of ADHD to be done.
Conclusion and Recommendations
In summation, the diagnosis of ADHD is an important factor that should be carried out with efficacy in order to ensure efficient treatment. As such, there is much input that should be done in order to carry out an effective diagnosis. Owing to this factor, many doctors, not willing to go through all these diagnostic steps, end up under-diagnosing or over-diagnosing. At the same time, DSM-IV criteria and DCI-10 do not provide enough base for diagnosis since ADHD is influenced by a variety of factors. It is therefore highly recommended that more research be carried out by employing diverse sources of information in order to come up with a standard way of diagnosing ADHD. At the same time, DSM-IV and DCI-10 should be upgraded in order to count for ADHD definition.