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Overdiagnosis and medication for attention-deficit hyperactivity disorder in children with cleft: diagnostic examination and follow-up.

作者信息

Richman Lynn C, Ryan Susan, Wilgenbusch Tammy, Millard Tom

机构信息

Department of Pediatrics, University of Iowa, Iowa City 52242-1083, USA.

出版信息

Cleft Palate Craniofac J. 2004 Jul;41(4):351-4. doi: 10.1597/03-047.1.

Abstract

OBJECTIVE

To examine the diagnosis of attention-deficit hyperactivity disorder (ADHD) in children with cleft to determine whether language-learning characteristics are taken into account when making this diagnosis.

DESIGN

Prospective examination of 177 consecutive patients. Objective behavioral ratings, cognitive assessments, and attention/impulsivity testing of 32 of the 177 children with nonsyndromic cleft lip and palate (CLP) who had previously been diagnosed as ADHD and were receiving medication were performed. the prospective 6- to 9-month follow-up examination was examined to determine the accuracy of prior and posttest diagnoses.

SETTING

University hospital-based cleft palate clinic.

MAIN OUTCOME MEASURES

Pretest/posttest design to determine accuracy of DSM-IV psychiatric diagnosis.

RESULTS AND CONCLUSIONS

The results show that the proportion of children originally diagnosed with ADHD (18%) was significantly higher than posttest diagnosis of ADHD (6% p <.001). Also, the frequency of pretest diagnosis of learning disorder (LD; 31%) was significantly different from posttest diagnosis (66% p <.01). The overdiagnosis of ADHD and underdiagnosis of LD in this sample of children with nonsyndromic unilateral cleft lip and palate appears to be due to lack of language-learning assessment.

摘要

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