Psychology

It is stated that individuals are diverse, and they have various characteristics which separate them from other individuals. This is why Attention Deficit Hyperactivity Disorder (ADHD) is difficult to diagnose amongst children. It is necessary to state that while children are undergoing different growth stages, and sometimes they may get easily distracted, may become impulsive or may have difficulty in concentrating. While there are those children who seem to have symptoms of ADHD, it does not necessarily mean that they are afflicted with the condition.

The researcher aims to determine as to whether a clear and adequate diagnosis of ADHD amongst children is possible. Since it is given that certain characteristics may be mistaken for ADHD, it is necessary to determine whether ADHD may be properly diagnosed in order to avoid the possibility of a wrong diagnosis which may cause problems to the patient. For the purpose of this study, the researcher has chosen three articles which may give valuable information on whether ADHD may be adequately and properly diagnosed among children.

Summary and Critique of Articles
The first article is The Effects of Patient Characteristics on ADHD Diagnosis and Treatment A Factorial study of Family Physicians. According to Christopher Morley (2010), ADHD is an affliction which is prevalent in the youth of the United States it affects around 7 percent to 9 percent of individuals ranging from ages 4-17. However, despite the fact that a lot of individuals are suffering from the affliction, it still remains unclear on whether a proper  diagnosis and treatment occurring in primary health settings  (Morley, 2010, p. 11) is possible. This is important for most ADHD treatments are done in  primary care settings  (Morley, 2010, p. 11). However, Morley (2010) states that diagnosis and treatment of ADHD can be affected by outside factors. It is stated in the aforementioned discussion that ADHD diagnosis may be problematic because of the varying characteristics of individuals which may be mistaken for the affliction however, these characteristics may not be the only ones which can affect diagnosis. Morley (2010) states that various social factors, specifically insurance status and race may affect which children are going to be and not going to be diagnosed.

In the statistical data presented by Morley (2010),  the ADHD diagnosis amongst uninsured individuals lessen by almost half compared to the diagnosis amongst individuals who are insured. Apart from this, Morley (2010) states that if an individual, particularly a male patient, is uninsured, this will lessen his chances of being diagnosed with ADHD. It is, of course, necessary to state that such result from the statistical analysis needs to be studied further, as there are currently no available explanations on why such would occur. What is clear is that being uninsured lessens the male childs chances of being diagnosed with ADHD.

Another article related to this discussion is Validity and Clinical Feasibility of the ADHD Rating Scale (ADHD-RS) A Danish Nationwide Multicenter Study. This research states that it is necessary to establish the reliability of the rating scale used in the diagnosis of ADHD. The researchers conducted the study with a 873 children as sample, and they were assessed using the ADHD-RS they were rated by their teachers and their parents.

The results of the study states that the ADHD-RS is reliable, however, it must be taken into consideration that the researchers have stated that the diagnoses are not as reliable if they are not the results of a  randomized, controlled trial using standardized diagnostic tools  (Szomlaiski, Dyrborg, Rasmussen, Shumann, Koch,  Bilenberg, 2008, p. 401).

And the last article which deals with the discussion of whether ADHD may be adequately diagnosed is Adam Zolotors  Jill Mayers Does a Short Symptom Checklist Accurately Diagnose ADHD (2004). Zolotor (2004) states that it is necessary to evaluate whether the checklists used in diagnosing ADHD are reliable. A lot of experts suggest that such checklists may be subjected to personal interpretation and have limitations. Since the checklists are limited, they may not be as reliable as most physicians believe they are.

Zolotor  Mayer (2004) states that the checklist or the scale used for the diagnosis of ADHD uses the concept of the  effect size. This is the estimate of how normal or abnormal an individuals behavior may be. However, the findings of the research state that since the scales are limited and may be subject to interpretation, it would be possible to misdiagnose a patient. It must be taken into context that the one who is answering the checklist has his or her subjective perspectives regarding the patient. Apart from this, there are instances wherein the possible patient may be less disruptive and passive, and will not match with the checklist.

Conclusions and Recommendations
In analysis, of the aforementioned articles, it could be said that all three seem to have the underlying message that diagnosing ADHD is extremely difficult. It can be seen in Morleys discussion states that ADHD diagnosis is not merely determined by an individuals characteristics. In fact, it may be said that insurance plays a large factor on whether an individual may be diagnosed with ADHD, regardless of whether he or she really manifests the affliction. An assumption that may be made regarding such data would be that the factor of health insurance is far more important than the real situation. While the situation would not be amenable to various individuals, and may even raise ethical issues, it is necessary to state that the aforementioned discussion is, indeed, occurring. 

However, it must be taken into consideration that the Morley was not able to present information that would justify such actions of the physicians when it comes to creating pragmatic decisions when it comes to diagnosing ADHD. It is stated in the article that such information needs further investigation for it is not present at the moment. Therefore, it is necessary to expand the research in order to attain information regarding this issue. However, what the article clearly states is that there is proof that diagnosing ADHD may be as simple as people think it should be. In a sense, this article provides insight on whether ADHD may be accurately diagnosed or not.

It is also necessary to state that although Szomlaiski et al was able to prove that the ADHD-RS can be reliable, its reliability decreases in an uncontrolled setting. It must be understood that these questionnaires may not always be controlled, and the answers depend on the perception of the individual answering it. Zolotor  Mayers article supports this fact, for it could be seen that although checklists which are used to determine ADHD may permit the physician to collect information about patient, it does not necessarily guarantee that the checklist is foolproof, for it may be subject to other factors such as personal interpretation and various limitations. It is necessary to state that not all individuals who have ADHD have the same characteristics therefore, the checklist would fail its purpose.

In summary, the three aforementioned research articles show that diagnosing ADHD can be extremely difficult. There are various factors which may affect the diagnosis, from the one answering the ADHD-RS to the physician. While there may be instances wherein the diagnosis may be correct, it is necessary to always re-evaluate, since the future of the patient is at stake on whatever diagnosis he or she may receive.