Toowoomba mum Lee still remembers the harrowing journey to her six-year-old son’s ADHD diagnosis.
Her beautiful youngster was suffering increasingly emotional outbursts and inattentiveness at school, to the point teachers suggested seeking medical help.
WATCH THE VIDEO ABOVE: Queensland mum tells of son’s misdiagnosis.
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Lee said it was also a massive challenge to get him to go to sleep at night and it was just as hard to wake him in the mornings.
Twelve months of appointments with a range of health experts ensued, including child psychologists, optometrists, naturopaths, occupational therapists and even a dentist.
During this time a child psychologist made the diagnosis of attention deficit hyperactivity disorder (ADHD), the neurodevelopmental disorder believed to affect between 6 per cent and 10 per cent of all Australian children.
Lee and her husband were also given the option of prescription medication to treat their son’s ADHD, and its impact on his ability to control his behavioural impulses and to pay attention.
There were just two problems.
The diagnosis was entirely wrong, with Lee’s son among the one in four children being wrongly determined to have ADHD.
Even worse, the kind of drugs used for treatment for would be in effect “putting fuel on the fire” of the actual condition affecting him.
Looking back at the ordeal, Lee told 7NEWS.com.au “it blows my mind about the (lack of) education and how long it took” to find the true cause of her child’s problems.
Fortunately Lee’s mother’s intuition had kicked in, furthering her and her husband’s concerns about the psychologist’s ADHD assessment from the outset.
“There’s no part of us that feels that (ADHD) is present,” Lee told 7NEWS.com.au.
There were several reasons for their doubts — in particular her son’s severe sleeping issues.
Then there was also the fact the dentist Lee had taken her son to in their search for answers had noticed the youngster had enlarged adenoids, a patch of tissue that sits at the back of the nasal passage, and referred him to an ear, nose and throat (ENT) specialist.
She said she even brought this up at the psychologist appointment.
“I asked the psychologist if the sleep apnoea he’s experiencing can cross over or mimic the ADHD symptoms, and she said, ‘Not a chance’,” Lee said.
However, when they finally got through the waiting list, the ENT specialist diagnosed a sleep-disordered breathing.
Since undergoing corrective surgery to remove his adenoids, Lee’s son is now thriving and “does not present with a single symptom (of ADHD)”.
Losing sleep on ADHD errors
Lee’s son’s misdiagnosis drama is not unique.
In fact, there are claims one in four childhood ADHD cases is being misdiagnosed and incorrectly medicated, to the child’s detriment.
That is because of the “overlap of symptoms” between sleep disordered-breathing and ADHD, according to Dr David McIntosh.
McIntosh specialises in sleep-disordered breathing, a condition where a child has a blockage and is “not getting good quality breathing or good quality sleep”. The most common blockages are caused by enlarged tonsils or adenoids.
Disrupted sleep hinders a child’s development and can cause many of the symptoms traditionally linked to ADHD.
“These kids are struggling at school,” McIntosh said. “Or they have emotional regulation problems, behavioural problems, concentration or focus problems.
“Collectively that feeds into the speculation they have ADHD.”
In Australia, there are currently no requirements for medical professionals to perform a sleep assessment on a child before prescribing medication for an ADHD diagnosis.
Even more alarming is that many of the medications prescribed can impede sleep quality, and McIntosh explains this can cause further issues.
“If we already have an underlying sleep problem, we’re then putting fuel on the fire,” he said.
Sleep-disordered breathing impacts 10 per cent to 20 per cent of children. Yet only one in 10 is diagnosed with the condition.
McIntosh explains: “Sleep-disordered breathing is more common than asthma and diabetes combined, and yet most parents will never even have heard of the condition.”
‘He’s a completely different kid’
Only nine months since Lee’s son received his ADHD diagnosis and five months since having his adenoids removed, “his schoolwork has improved, his confidence has improved, he speaks to us about situations, he’s able to connect with people”, Lee happily revealed.
The correlation between corrective surgery for sleep-disordered breathing and a reduction of ADHD symptoms is not a new revelation.
In fact, a 2007 study on children aged five to 13 with baseline ADHD demonstrated that only one year post-surgery, half of the children no longer met the diagnostic criteria for ADHD.
However, in 2023, 16 years since this study, there is still a lack of education and awareness of this topic.
McIntosh stresses the importance of sleep for a child, and says that based on brain scans “we can show conclusively that their brain function and formation is different”.
“The parts of the brain that do things such as emotional regulation is not working properly, the parts of the brain that deal with anxiety are overstimulated, areas of language processing are not working properly, visual spatial processing is not working properly, auditory processing is not working properly. It really is a global problem when you start looking at the fine print of these kids.”
There are also concerns over moves to include ADHD in the National Disability Insurance Scheme without implementing checks for other conditions, such as sleep-disordered breathing.
“Anything that you can do to help and support kids through a true diagnosis of ADHD makes a huge difference to that child and the family … but you just want to make sure you’ve got the diagnosis right,” McIntosh said.
Despite the positive outcome, Lee still says it’s frustrating “to know that there’s such a cross-over (of symptoms) and that there’s not lots of conversation or education around it”.
She is urging other parents to “investigate and question” an ADHD diagnosis.
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