We wanted to deepen the ADHD, and for that we are going to interview, to begin with, the psychologist Antonio Ortuño, who will explain to us how he is diagnosed and what alternative treatment to the medication could be performed in his opinion and that he performs in his professional practice.
The controversy raised by Dr. Eisemberg's statements about the non-existence of ADHD and discovering that, for example, in France, diagnoses are minimal, has made us think that it is important to offer different forms of care and a general reflection on this problem.
Antonio Ortuño is a clinical psychologist With more than twenty years of experience, he is the author of the book "Smart Families" and Babies and has already interviewed him last year on the optimal way to make decisions in the family, which is where he specializes.
Who should diagnose ADHD?
A few years ago I was invited to a Congress of Psychiatry on hyperactivity, and I was surprised that in practically all the papers they defended that they are the only ones who can diagnose the “disease”.
Its action was basically to make the diagnosis according to the DSM (Manual of Psychiatric Diagnosis) and prescribe the appropriate medication. Approaching the problem from a single discipline seems to me a mistake. Neurology, Clinical Psychology, Neuropsychology, Pedagogy ... are disciplines that also have much to say.
Do you think she is overdiagnosed?
I give you an example. A recent study states that in a College of 200 students, in the United States there would be 18 children diagnosed with hyperactivity, while in France only one. Overdiagnosis depends on where the problem is focused, if the etiology of the disorder is biological or contextual.
Can you explain it in more detail?
Yes, Mireia, of course. This means that American psychiatrists attribute the hyperactivity disorder to biological causes (the child has hyperactivity), while his French colleagues attribute it to psychosocial causes, to contextual educational keys (the socio-educational context generates hyperactivity).
Very interesting what you explained to us, Antonio. From what I understand, it would be better to start with a psychosocial approach, intervening in the environment, and not medicating, right?
This is of vital importance, since the treatment in the first case focuses on applying medications to children, to “pathologize” behaviors that are normal in childhood, while in the second case it is indicated as intervention subjects to parents , training them in parenting skills, since parents have a responsibility to generate an appropriate educational context.
But working with parents requires much more effort than prescribing a drug.
Depending on the approach, is it less diagnosed or overdiagnosed?
If you agree with the first approach, the diagnosis is desperately sought, and therefore you will be increasingly overdiagnosed. If you agree with the second approach, it makes no sense or diagnosis. From my experience, I think it is of little use to use the hyperactive label.
The child behaves like this because he has hyperactivity. And he has hyperactivity because he behaves like this. Who put the egg before?
Are there scientific diagnostic tests with verifiable data or is a large part of the diagnosis due to the personal criteria of adult observers?
I am a strong advocate of the second approach. Hyperactivity is not something that is in the brain waiting to be discovered by a "magical" diagnostic technique. So there is no test that detects what does not exist. Almost all diagnostic tests are observation methods that collect indicators of how the child behaves in different contexts (such as Conners school and family scales).
So, does the diagnosis depend on the observer and the child's behaviors that adults describe and define?
That's. Behaviors are described, but almost exclusively the child's behaviors. There is very little of how adults behave with these children in those contexts. And for me it is essential to evaluate the educational tools of the adult world.
Tomorrow we will publish the second part to this interview with psychologist Antonio Ortuño, which will explain more details about the method of diagnosis of TDHA and the non-pharmacological treatments with which he cares for children and their families.
