ADHD Treatment

If your child as attention deficit hyperactivity disorder—ADHD--you might have found it’s not so easy to get your child diagnosed and then started on medication. That’s because, according to new research, many pediatricians don’t want to treat the problem.

ADHD is the most common psychiatric condition affecting children; estimates of prevalence in childhood range from 5 - 10%. Approximately 50% of children with ADHD are never diagnosed.

Fourteen year old Charlie Torsiello knew he was struggling in school. “I was constantly distracted with other things. Looking around the room not paying attention,” says Charlie. He has ADHD: attention deficit hyperactivity disorder.

His mom Susan knew, from experience with a previous child, exactly what was wrong, but her pediatrician wouldn’t treat either Charlie or his brother. “When we suspected my older son had ADHD, he sent us to Schneider’s directly to be evaluated because they have the lengthy interview process. He did not feel at that time that he felt comfortable.”

Charlie’s story is a common one.

According to a new survey of pediatricians, many parents are told by their doctors they have to see a specialist to get help for their children’s ADHD problems.

Dr. Andrew Adesman, Chief of Developmental Pediatrics at Schneider Children’s Hospital, New York, says, “Many pediatricians are reluctant to start children on medication in spite of the fact that medication has been shown to be the single most effective treatment for ADHD. Many of the pediatricians were willing to take over the care once a specialist has started the medicines. It may be uncertainty about which is the right medicine, it may be concern about making the decision about whether medication is really indicated.”

To change this, five years ago the American Academy of Pediatrics published guidelines to help primary care pediatricians properly diagnose and treat ADHD. It even put out this beautifully laid out toolkit for physicians to walk them through process.

But still, the new research shows primary care pediatricians still don’t want to deal with ADHD and its treatment. Eighty two percent of the pediatricians surveyed say they generally refer their patients to specialists. But 14 percent said they absolutely refuse to initiate medications and they refuse to follow the medications after they’ve been started. Some even have misconceptions about the guidelines. For example, 83 percent incorrectly believe that routine lab work is recommended. It isn’t. So, the physicians think the diagnosis is harder to make than it really is.

“The American Academy of Pediatrics believes primary care pediatricians can and should assume responsibility for ADHD diagnosis and treatment,” Dr. Adesman advises.

Fortunately for Charlie, his mom got him to Dr. Adesman who got him on the medication he needs. “I started concentrating better, started getting higher grades and everything,” says Charlie.