There is no doubt that some preschoolers who are diagnosed with ADHD “grow out of ” their diagnosis. Normal preschoolers are generally somewhat inattentive, impulsive, and hyperactive compared to older children, so it is difficult for many parents, teachers, and health professionals to know when those symptoms add up to a disorder that will continue to cause problems later on. There is definitely a certain amount of misdiagnosis that goes with giving a child the label “ADHD” at an early age. Even the American Academy of Pediatrics acknowledges this difficulty. The big questions are, how many children will eventually outgrow their diagnosis, and which ones?
A new study published in Pediatrics sheds some light these questions. The study followed 3 to 6 year olds who were diagnosed with ADHD at a multidisciplinary clinic (that is, one involving more than one kind of specialist) after extensive evaluations. The 120 children were followed for 5 to 9 years and then their diagnosis was reevaluated. 70.4% of patients continued to have ADHD. Children were more likely to keep the diagnosis of ADHD if they were of low socioeconomic status or if their parents had a psychiatric diagnosis (including ADHD). The main finding of the study, however, was that the percentage of patients with persistent ADHD was higher in this study than with other studies of diagnoses made in the community (that is, by your ordinary pediatrician or family doctor).
Ideally, every child would be able to get a multidisciplinary evaluation at a referral hospital, but for many children this is an impossibility due to distance, insurance, or provider availability. There simply aren’t enough ADHD specialty clinics around for all the patients. So when should you go after that multidisciplinary evaluation for your preschooler?
- If it would change the treatment. If your child is having trouble at school or at home and your pediatrician is offering parent training, it probably won’t hurt if your child doesn’t have ADHD. If your child is being offered medication, however, you may want to push for a solid diagnosis, especially if you go through a couple of medications and they don’t work, because medications for ADHD carry a high risk of side effects in preschoolers.
- If your child has other problems besides pure ADHD. For example if your child has autism, anxiety, a sleep disorder, or tics, it might take a team of experts to sort out what is really going on.
- If the diagnosis is being suggested by your child’s school, but you disagree or are unsure.
- If your child’s other parent is not on the same page with you about the diagnosis or treatment plan.
For most other children, an initial diagnosis by a primary care doctor or specialist should be sufficient unless the conditions above arise.