Wrong diagnosis of ADHD rampant in city, seek 2nd opinion, urge experts

Four-year-old Aakash K had been experiencing speech delay and his parents have been running from pillar to post to ensure he gets the best treatment. While doctors were unsure of the exact condition, some attributed his behaviour to be a result of Attention Deficit Hyperactivity Disorder (ADHD), for which he was prescribed therapy.

Stating that the therapy was being carried out by occupational therapists in the city, his mother Vinitha Krishnan said, “For the last two years we have visited several doctors and counsellors for his condition. Some doctors said that he has ADHD but did not give us a report to confirm it. On the other hand, our paediatrician said that his hyperactive nature and unwillingness to interact could be ignored as he would soon grow out of it. But since nobody seems to be sure about the diagnosis, this is a constant source of worry for us. Aakash continues to undergo therapy but we are not sure if it’s helping.”

Meanwhile, psychologists in the state claim that they have been witnessing a surge in the number of cases where kids without ADHD have allegedly been diagnosed with it. Dr Jayanthini V, a city-based child psychiatrist, said, “Around 90 per cent of children diagnosed with ADHD are actually normal. Unnecessary diagnosis of the condition due to their hyperactivity has become quite common.”

Echoing the same, Sonia Mathew, a counsellor, said, “Of late, people, not experts, have taken it upon themselves to determine whether a child has ADHD or not. The main reason for this over diagnosis is the lack of any kind of research on what causes this condition. Medicines merely give a symptomatic relief and parents are satisfied with that. But the answer lies in therapy.”

Stating that all children who are hyperactive cannot be diagnosed with ADHD, Dr Jayanthini said, “One should know what is normal and what is not. It is difficult to draw the line. Just because some children are hyper active, many tend to believe that they have ADHD. An experienced person will know if there is a problem and how to treat it.”

According to her, only five to ten per cent of the children diagnosed with the condition actually have it, she said. “Symptoms of ADHD include inattention, impulsiveness and hyperactivity. If not treated early, it can lead to further problems. But, if medication is prescribed for children who do not actually have ADHD, it can have a negative impact on the child. I myself do not depend merely on what the family says. I get reactions from the family, teachers, psychologists and analyse the child myself before declaring whether they have the condition or not,” Dr Jayanthini said.

She added that if the children’s condition is severe, they would be prescribed medication. But if the condition is mild, behaviour therapy would be adequate and in some cases, medication is prescribed with therapy. “Diagnosing a regular child with severe ADHD and prescribing medicines for it can prove to be extremely harmful. The child is likely to become violent and lose appetite. It is therefore important to get a second opinion if your child has been diagnosed with ADHD,” the doctor added.

Describing her experience, Aakash’s mother said, “All his sessions took place behind closed doors. We noticed him hitting himself on his hand and head at home and realised that there was something fishy. It was then that we realised that it was not safe for him to be sent for therapy behind closed doors.”

While it is against the law to provide therapy to a child behind closed doors, most centres are found doing just that. Seema Lal, a psychologist and researcher, who is currently pursuing her post-doctoral studies on a similar topic, said, “There are a number of centres that abuse children in the name of therapy and they get away with it because there is nobody to regulate them.”

A team of three women from Kerala, including Seema, had filed a Public Interest Litigation after a mother spoke up about a therapist in a centre in Kochi who broke her son’s hand during therapy. “It was only then that we realised that the government has no data or means of tracking these centres. We have therefore demanded that these centres be monitored, and registration be made mandatory. The High Court had also passed an on September 14 to ensure that a samithi (committee) be formed within three months to monitor all these centres. We have not heard of the formation of such a committee till date,” Seema added.

With parents shifting their responsibilities to the therapists, it is seen as a convenient option for people to make some extra bucks in the name of therapy. “Parents tend to think that therapists know better and as a result, refrain from questioning their exclusion from the sessions. but, children refrain from talking about their sessions and they also lack an understanding of the abuse,” she added.

“Even if their children manage to bring it up, parents refrain from complaining about the abuse as they do not trust their ‘disabled’ child. They merely shift the kids to other centres, which is not a challenge anymore, owing to the fact that such centres are found on almost every street,” said Seema.

While efforts have been made in Kerala, activists here also demand that steps be taken to ensure a change by our government. “It is important that the unnecessary blooming of therapy centres be checked. The therapists in such centres are no different from quacks,” said Counsellor Sonia Mathew.