Attention Deficit Hyperactivity Disorder (ADHD) is an often misunderstood condition due to common misconceptions. This neurobehavioral condition is usually first diagnosed in childhood, often lasts into adulthood, and is marked by an ongoing pattern of inattention and/or hyperactivity and impulsivity.
The symptoms, such as difficulty remaining still for long periods of time and being easily distracted, are common to all young children in general, but those with ADHD exhibit hyperactivity and inattention that is noticeably greater than expected for their age and create problems functioning at home, in the classroom, or with friends.
According to the American Psychiatric Association, five percent of American children have ADHD—but the Centers for Disease Control estimate that 10.6 percent of American children between the ages of four and 17 have the disorder. Partly because of the myths and misconceptions about ADHD—and in an effort to provide information that is reliable—October was declared ADHD Awareness Month in 2004 by the U.S. Senate.
ADHD is one of the primary diagnoses seen by clinicians at Gándara Center’s In-Home Behavioral Services (IBHS), according to IBHS Director Melissa Morrissey.
In the 2019 Fiscal Year (June 30, 2018-July 1, 2019), of the 1,192 clients enrolled in the Children’s Behavioral Health Initiative (CBHI) program at Gándara Center, 400 clients were diagnosed with ADHD (33.56 percent) and received services in the agency’s Brockton, Fitchburg, Holyoke, Roxbury, Springfield, New Bedford, and Taunton locations, according to Gándara Center’s Clinical Operations Department.
Disparities in Diagnosis and Treatment
In the past 20 years, the number of children diagnosed with ADHD has nearly doubled, which many attribute to the condition in the past not being studied as extensively and therefore often went unrecognized. Indeed, the term ADHD didn’t appear in the Diagnostic and Statistical Manual of Mental Disorders until 1987. Nowadays, neuroimaging studies provide visible evidence of the ways the disorder affects the brain. “In the past, I don’t think there was enough education for parents about the disorder and what it means, so many children in the past were simply seen as kids with behavioral issues rather than what was really occurring with the ADHD,” said Morrissey.
According to a study released in 2017 by the University of Iowa Stead Family Children’s Hospital, the significant increase in ADHD diagnoses over that past two decades was partly due to its climbing rate among minorities: the rise was most pronounced in minority groups, suggesting that better access to mental health treatment through the Affordable Care Act may have played a role in the increase.
But disparities in access to mental health care for minorities persist. Nationally, studies have shown that people of color—black and Latino in particular—are still much less likely to get clinical treatment for ADHD for several reasons, including a lack of knowledge among minority parents, the lack of bilingual mental health providers, and the need for cultural familiarization in clinical practices.
Morrissey said that in some cases the condition is also underdiagnosed because it can appear like other medical conditions, including anxiety disorders, oppositional defiant disorder, learning disabilities, and bipolar disorder. “I think it tends to have similar features of other disorders, which may make it underdiagnosed at times,” said Morrissey.
Of the 400 Gándara Center In-Home Behavioral Services clients diagnosed with ADHD, more than half of them (210) have a co-occurring disorder such as a mood, depressive, or anxiety disorder (190 clients were diagnosed with having just ADHD). Korie Johnson, director of education support services for the Gándara Youth Development Center in Holyoke, said many of the youth that come to the center have ADHD and suffer from trauma. Traumatic events in childhood can lead to anxiety disorders that can co-occur with ADHD.
Misconceptions about ADHD
“A common misconception about ADHD are that ‘it’s all in your head’; or that the person can control it,” said Morrissey. Actually, it is all in the client’s head—in that ADHD is a neurobiological condition, but the disorder can be successfully managed with proper treatment. In addition, she said many people think that there is only one type of ADHD when in fact there are three main categories: inattentive, hyperactive-impulsive, and combined. There are also different levels of ADHD severity.
Morrissey said there is also the misconception that “if you have trouble focusing, it means you have ADHD,” she said. “This is not true. There are many factors that contribute to one not being able to concentrate.” These include stress, anxiety, depression and lack of sleep.
There is also the mistaken belief that children simply outgrow ADHD in adolescence, according to Morrissey. While it diminishes for many in the teenage years, half or more carry it into adulthood. “Only boys have ADHD” is another myth, she pointed out. Both boys and girls can be diagnosed with ADHD, but it is more prevalent among boys (13.2 percent) than girls (5.6 percent), according to the CDC.
“Another misconception is that you must be hyperactive and unable to sit still to have ADHD,” said Morrissey. In fact, symptoms of inattention alone are enough to be diagnosed with ADHD—not all clients with the disorder are hyperactive. Also, some people mistakenly believe that all patients need is medication to address ADHD issues, when the reality is that best practice includes cognitive behavioral therapy combined with medication maintenance.
Some of the ways Gándara’s CBHI services help support families with children diagnosed with ADHD—and help families navigate special accommodations for them in school—include implementing behavioral interventions such as task analysis, daily routines, check lists, and setting reminders. “Gándara Center staff also assist parents in navigating the educational system in order to get the proper testing and supports the children may need,” said Morrissey.
ADHD doesn’t necessarily have to hold a person back: some of the world’s top athletes, entertainers, and businesspeople have the disorder, including Michael Phelps, Justin Timberlake, Will Smith, and Charles Schwab. They found success because they and their families learned all they could about ADHD—and then took charge of a treatment plan that works for them.
Want to know more about ADHD and ADHD Awareness Month? Visit adhdawarenessmonth.org.