Experts say that a new FDA-approved screening tool for ADHD might lead to more accurate diagnoses of children ages 6 to 17 and help reduce overmedication — if used as intended as just one measure among many and if followed with proper treatment.
However, the iffy parts of the brain-wave test has raised concerns, given the history and disparities of many African-Americans diagnosed with Attention Deficit Hyperactivity Disorder. Parents and educators also worry about the stigmatization of rambunctious, but misunderstood, schoolchildren who are sent for screening unnecessarily and don’t have ADHD.
“Even with futuristic tools and test, there will always need to be clinically-focused diagnoses,” said Rahn K. Bailey, M.D., president of the National Medical Association and chairman of the Department of Psychiatry and Behavioral Sciences at Meharry Medical College in Nashville, Tenn.
“We remain cautiously optimistic,” said Bailey, who has served on the Professional Advisory Board of CHADD: Children and Adults With Attention Deficit Hyperactivity Disorder.
The U.S. Food and Drug Administration approved marketing of the device last week as just one component of a comprehensive medical and psychological examination, said Christy Foreman, director of the Office of Device Evaluation at the FDA’s Center for Devices and Radiological Health.
“The device requires that the clinician do an evaluation first,” added
Peter Como, Ph.D., a neuropsychologist in the same FDA office. It could help confirm the evaluation, they said, or help the clinician determine that more assessment is needed.
A Welcome Addition?
Dr. Bailey said medical professionals would welcome an additional method to help them diagnose patients more accurately and quickly. “This one does sound encouraging.”
Shane Perrault, Ph.D., a psychologist in Washington, D.C., who has ADHD and specializes in treating it, agrees. “I think generally it’s helpful,” Perrault said of the brain-wave test. “Is it more helpful than the paper and pen method? Maybe; maybe not.”
“Diagnosing ADHD is only part of the battle,” he added. “What kind of treatment do you put together for the patient?”
And that’s what concerns Karran Harper Royal of New Orleans, who became an educational advocate for other parents after dealing with ADHD in her family.
“I know what a hot market ADHD can be, and I worry about exploitation, especially in communities of color,” Royal said. “My concerns are that we know our children don’t often receive the same amount of treatment as their white counterparts, and I worry that doctors will rely too heavily on this new device rather than a full comprehensive assessment and evaluation.”
“At a time when we have to fight the stigma of mental health diagnoses and fight for treatment when a proper diagnosis is made, we do not need to complicate the diagnosing of ADHD by trivializing the screening process.”
According to the Centers for Disease Control and Prevention (CDC) in Atlanta, 5.4 million children have ADHD with twice as many boys diagnosed than girls. The percentage of children whose parents said they had been diagnosed with the neurobehavioral disorder jumped 22 percent between 2003 and 2007.
While the prevalence is racially comparable, CHADD reports, black children are less likely to receive treatment but more likely to suffer negative consequences at school. This can include punitive placement in special education, disciplinary actions and disproportionate referrals for medical evaluation, said Leslie T. Fenwick, Ph.D., a renowned policy expert and dean of the School of Education at Howard University in Washington, D.C.
Fenwick, a former kindergarten through 12th-grade teacher, attributes some of these consequences to “under-prepared, under-credentialed and sometimes overwhelmed teachers.”