By: Dr. David Rabiner

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Children with the inattentive type of ADHD (ADHD-I) show high rates of attention difficulties without the hyperactive and impulsive behavior shown by children with ADHD Combined Type (ADHD-C). The inattentive type of ADHD is quite common and is associated with significant impairment with school work, planning and organizational skills, processing speed, and peer relations. Even so, children with ADHD-I tend to be identified later than Read the rest of this entry »
By: Dr. David Rabiner
Is ADHD overdiagnosed? Despite widespread concerns that this occurs, a study that specifically addresses this issue has not been conducted in the US. Thus, although it is well established that many children with ADHD are never identified or treated, the extent to which children are incorrectly diagnosed with ADHD is not known. Read the rest of this entry »
By: SharpBrains
The new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is scheduled to be released in May 2013. This recent Dana Foundation article points out the need of a fundamentally different approach based on the new ways researchers use to study and understand mental illness.
The problem with the DSM-IV, our current shared diagnostic language, is that a large and growing body of evidence demonstrates that it does a poor job of capturing either clinical and biological realities. In the clinic, the limitations of the current DSM-IV approach can be illustrated in three salient areas: (1) the problem of comorbidity, (2) the widespread need for “not otherwise specific (NOS)” diagnoses, and (3) the arbitrariness of diagnostic thresholds.
Whatever the ultimate approach to the DSM-5, it is critical that the scientific community escape the artificial diagnostic silos that control so much research, ultimately to our detriment.
Key questions: How can we give the research community not only permission but also encouragement to rethink the classification of psychopathology? How can we encourage scientific innovation while ensuring that clinicians can still communicate with patients and families—and also with insurance companies, schools, and courts?
By: Dr. David Rabiner
Like all psychiatric disorders, ADHD is diagnosed based on the presence of particular behavioral symptoms that are judged to cause significant impairment in an individual’s functioning, and not on the results of a specific test. In fact, recently published ADHD evaluation guidelines from the American Academy of Pediatrics (AAP) explicitly state that no particular diagnostic test should be routinely used when evaluating a child for ADHD.
While most ADHD experts would agree that no single test could or should be used in isolation to diagnose ADHD, there are several important reasons why the availability of an accurate objective test would be useful.
First, many children do not receive a careful and comprehensive assessment for ADHD but are instead diagnosed with based on evaluation procedures that are far from optimal.
Second, although AAP guidelines indicate that specific diagnostic tests should not be routinely used, many parents are concerned about the lack of objective procedures in their child’s evaluation. In fact, many families do not pursue treatment for ADHD because the the absence of objective evaluation procedures leads them to question the diagnosis. You can read a review of an interesting study on this issue at www.helpforadd.com/2006/january.htm
For these reasons an accurate and objective diagnostic test for ADHD could be of value in many clinical situations. Two important conditions would have to be met for such a test to be useful.
First, it would have to be highly sensitive to Read the rest of this entry »