What should the standard
be, then, for a proper ADHD
Hinshaw: It has to be at least several
hours. You have to get observations from
the school or at least ratings from the
teacher, normed ratings from parents
and a really good developmental history
of the child. These are things you can’t
do in a quick 10-minute office visit.
But the national standard is for very
quick diagnoses, which will certainly
lead to over-diagnoses, because you can
mistake all kinds of things for ADHD.
But paradoxically, it also leads to under-diagnoses because some doctors will say,
“He wasn’t tearing up the waiting room,”
or “She sat very still in the office, so she
can’t have ADHD.” Well, unless you see
the child doing homework or when other
people are giving directions, you’ll miss it.
We also need reimbursement for
these thorough assessments so we’re not
tempted to rule in or rule out ADHD on
the basis of very flimsy evidence.
Scheffler: Psychologists also need to
understand this academic pressure that
happens in the schools, and make their
diagnoses carefully because they may be
getting kids sent to them due to these
Psychologists are the gatekeepers, and
they have a lot of responsibility to look
into this and make sure they take the
time to look into the school, societal and
parental pressures while doing a careful
In addition, treating the kid
without getting the family and the
school involved is not optimal. The
problem with an ADHD diagnosis is
that it’s a catchall for lots of things.
It’s hyperactivity, it’s focus, executive
function and the like, but usually
the best treatment is to also consider
involving the family and teachers in
behavioral strategies to help improve
focus, and to have everyone lined up to
deal with this. n
Amy Novotney is a journalist in Chicago.
• Hinshaw, S. P. &
Scheffler, R. M. (2014). The
ADHD explosion: Myths,
and today’s push for
performance. New York:
Oxford University Press.
• Scheffler, R. M., Brown,
T., Fulton, B., Hinshaw,
S. P., Levine, P., & Stone,
S. I. (2009). Positive
ADHD medication use and
during elementary school.
Pediatrics, 123, 1273–1279.
• Visser, S. N., Danielson,
M. L., Bitsko, R. H.,
Holbrook, J. R., Kogan,
M. D., Ghandour, R. M.
... Blumberg, S. J. (2014).
Trends in the parent-report
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disorder: United States,
2003–2011. Journal of the
American Academy of Child
and Adolescent Psychiatry,
for Fall ‘ 14
PhD in Clinical Psychology
PhD in Media Psychology
Online Master of Arts
in Media Psychology
Commission on Accreditation, 750 First St. NE,
Washington, DC 20002, 202.336.5979).