ADHD and overdiagnosis

ADHD and overdiagnosis

What drives someone to seek a diagnosis for their child’s challenging behaviour? This episode of All In The Mind takes a close look at ADHD, asking whether modern medicine is getting the balance right between helpful diagnosis and harmful overdiagnosis. You’ll hear US journalist Alan Schwartz, author of *ADHD Nation*, outline how ADHD rose from a niche diagnosis to what he calls “a national disaster of dangerous proportions”.

He traces the history from early amphetamine trials in the 1930s, through Dr Leon Eisenberg and Keith Connors’ work with methylphenidate (Ritalin), to the widespread use – and misuse – of rating scales that turned rough screening tools into de facto diagnostic stamps. Ray Thomas, from the Centre for Research in Evidence-Based Practice, digs into the numbers.

She points out that ADHD prevalence in Australian children sits around 7%, yet medication prescribing can be 75 times higher in some regions than others. Her core message is clear: “We need to think critically. We need to treat generously.

But we need to diagnose cautiously.” Through the story of Ava, a three-year-old whose grief and early trauma were rapidly labelled as childhood bipolar disorder, Thomas shows how quick diagnoses and broad criteria can turn ordinary distress into lifelong psychiatric identities. Child psychiatrist Professor Florence Levy offers a contrasting, clinically grounded view.

She highlights how severely affected children and their families can see dramatic improvements with medication, while also acknowledging the lack of objective tests and the risks of relying heavily on subjective rating scales. Levy argues that a well-designed attention test could help bring more clarity to the controversy.

Across these perspectives, the episode raises a simple but challenging question: how can parents and professionals make sure children get the support they need without rushing into a label they may carry for life?