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Loughran, Sandra

doi:10.1023/a:1023391708850

Cited by 20 publications

(5 citation statements)

References 9 publications

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“…57,96,97 Four of 5 phenotype change studies reported stable or declining ADHD symptoms in the population, making it unlikely that the expansion was associated with an actual increase in ADHD symptoms over time. 1,21,98,99 Sixteen studies that investigated diagnostic inaccuracies as a reason for variation reported potential underdiagnosis because of false-negative diagnosis 1,21,38,104,105 and potential overdiagnosis because of false-positive diagnosis, 54,93,100,106,107 often occurring simultaneously. 11,64,65,[101][102][103]…”

Section: Large Reservoir Of Potentially Diagnosable Adhdmentioning

confidence: 99%

“…5,36,132,138,152 Eleven studies used changes in impairment as a proxy for severity. Eight of these studies confirmed that impairment levels, adverse outcomes, and benefits of medication substantially Mental health professionals from China and Indonesia rating same attention difficulties higher than mental health professionals from US and Japan (1) 97 Phenotype changes (5) Trends over time (5) No increase in clinically significant symptoms (4) 1,21,98,99 Increase in youths with clinically significant symptoms (1) 100 Increase in subthreshold symptoms (1) 1 Diagnostic inaccuracy ( 16) associated with Over-and underdiagnosis (16) Potential over-and underdiagnosis occurring (6) 11,64,65,[101][102][103] Potential underdiagnosis attributed to false-negatives (5) 1,21,38,104,105 Potential overdiagnosis attributed to false-positives (5) 54,93,100,106,107 Spectrum of disorder (22) indicated by subtheme Implications of extent of symptoms over time (13) Continuous association between increasing symptoms and increased risk of various later adverse outcomes (13) [108][109][110][111][112][113][114][115][116][117][118][119][120] Subthreshold prevalence (8) Many youths with subthreshold symptoms (6) [108][109][...…”

Section: Many Additional Cases On the Milder End Of The Adhd Spectrummentioning

confidence: 99%

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Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2021

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IMPORTANCE Reported increases in attention-deficit/hyperactivity disorder (ADHD) diagnoses are accompanied by growing debate about the underlying factors. Although overdiagnosis is often suggested, no comprehensive evaluation of evidence for or against overdiagnosis has ever been undertaken and is urgently needed to enable evidence-based, patient-centered diagnosis and treatment of ADHD in contemporary health services. OBJECTIVE To systematically identify, appraise, and synthesize the evidence on overdiagnosis of ADHD in children and adolescents using a published 5-question framework for detecting overdiagnosis in noncancer conditions. EVIDENCE REVIEW This systematic scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Extension for Scoping Reviews and Joanna Briggs Methodology, including the PRISMA-ScR Checklist. MEDLINE, Embase, PsychINFO, and the Cochrane Library databases were searched for studies published in English between January 1, 1979, and August 21, 2020. Studies of children and adolescents (aged Յ18 years) with ADHD that focused on overdiagnosis plus studies that could be mapped to 1 or more framework question were included.Two researchers independently reviewed all abstracts and full-text articles, and all included studies were assessed for quality. FINDINGS Of the 12 267 potentially relevant studies retrieved, 334 (2.7%) were included. Of the 334 studies, 61 (18.3%) were secondary and 273 (81.7%) were primary research articles. Substantial evidence of a reservoir of ADHD was found in 104 studies, providing a potential for diagnoses to increase (question 1). Evidence that actual ADHD diagnosis had increased was found in 45 studies (question 2). Twenty-five studies showed that these additional cases may be on the milder end of the ADHD spectrum (question 3), and 83 studies showed that pharmacological treatment of ADHD was increasing (question 4). A total of 151 studies reported on outcomes of diagnosis and pharmacological treatment (question 5). However, only 5 studies evaluated the critical issue of benefits and harms among the additional, milder cases. These studies supported a hypothesis of diminishing returns in which the harms may outweigh the benefits for youths with milder symptoms. CONCLUSIONS AND RELEVANCEThis review found evidence of ADHD overdiagnosis and overtreatment in children and adolescents. Evidence gaps remain and future research is needed, in particular research on the long-term benefits and harms of diagnosing and treating ADHD in youths with milder symptoms; therefore, practitioners should be mindful of these knowledge gaps, especially when identifying these individuals and to ensure safe and equitable practice and policy.

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Section: Large Reservoir Of Potentially Diagnosable Adhdmentioning

confidence: 99%

Section: Many Additional Cases On the Milder End Of The Adhd Spectrummentioning

confidence: 99%

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

et al. 2021

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“…Increasing teachers' knowledge about potential signs of problems and offering encouragement to identify and refer affected children can also result in elevated rates of "false positive" cases (i.e., children who do not actually have the identified problem; Loughran, 2003). Potential over identification is not a benign consequence, because it can result in (1) significant family stress, (2) inappropriate labeling of children which can impact behavioral and academic expectations, and (3) delivery of unneeded services.…”

Section: Volume 11-numbermentioning

confidence: 99%

“…Research has demonstrated that KG teachers are able to identify socioemotional problems in their students; however, there are often gaps in teachers' knowledge about behavioral and emotional problems, and variability in comfort and confidence with the role of problem identification and referral, resulting in limited identification and referral skills for these types of problems (Green, Malsch, Kothari, Busse, & Brennan, 2012;Loughran, 2003;Reinke, Stormont, Herman, Puri, & Goel, 2011). KG teachers in developing countries with more limited mental health training resources are likely even less well equipped for this role.…”

mentioning

confidence: 99%

Empowering Preschool Teachers to Identify Mental Health Problems: A Task‐Sharing Intervention in Ethiopia

Desta¹,

Deyessa

Fish

et al. 2017

Mind Brain and Education

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ABSTRACT-In Ethiopia there is a severe shortage of child mental health professionals. Identification and intervention for young children's mental health problems is crucial to improve developmental trajectories and reduce the severity of emotional and behavioral disorders. Teachers can play an important role in early problem detection. This role is particularly impactful in developing countries with limited mental health care resources. However, teachers' knowledge about mental health varies dramatically. This study tested the influence of a training intervention to improve teachers' ability to accurately identify preschool children's emotional and behavioral problems in 24 schools in Addis Ababa, Ethiopia. Sensitivity and specificity of teacher identification, and overall agreement with an established measurement criterion (Strengths and Difficulties Questionnaire) were examined 2 years following training compared to preintervention baseline, and a nonintervention control group of 12 schools. Results indicate that the teacher training was significantly

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“…Policies of this kind are generally not considered in discussions about early childhood. However, there has been evidence of increased discipline referrals in the early grades (Rusby et al, 2007) and a corresponding increase in the diagnosis of attention deficit hyperactivity disorder (ADHD) (Loughran, 2003). For affected families, discipline policies can have a significant impact on parents' interactions with schools.…”

Section: The Rationale For Partnershipmentioning

confidence: 99%

Partnership in Integrated Early Childhood Services: An Analysis of Policy Framings in Education and Human Services

Nichols

Jurvansuu

2008

Contemporary Issues in Early Childhood

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There is currently movement internationally towards the integration of services for young children and their families, incorporating childcare, education, health and family support. Shifting service provision towards partnership between services, and between these services and families, has been the subject of policy formation at various levels. As part of a study into the first year of operation of integrated children's centres in South Australia, a policy analysis was undertaken surveying policies in two domains: education on the one hand and human services (incorporating health) on the other. This analysis found different policy framings of partnership operating in the two domains. Additionally, the policy landscape is layered with old and new constructions of the relationship between families and services. The authors argue that the terms within which policies frame partnership, families and services should be the subject of debate and also dialogue involving those practitioners whose role it is to make integration work on the ground.

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Untitled

Cited by 20 publications

References 9 publications

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

Overdiagnosis of Attention-Deficit/Hyperactivity Disorder in Children and Adolescents

Empowering Preschool Teachers to Identify Mental Health Problems: A Task‐Sharing Intervention in Ethiopia

Partnership in Integrated Early Childhood Services: An Analysis of Policy Framings in Education and Human Services

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