ADHD, trauma and neglect: How do we prevent children who are in the child protection system being misdiagnosed with ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a very prevalent and common neurobehavioural disorder in children and adults. It is considered to be a developmental disorder and is recognised when children display inappropriate levels of hyperactivity, impulsivity, and inattention (American Psychiatric Association, 2013). It is now the leading diagnosed health condition for children in western countries and is now reported to have a worldwide prevalence of anywhere between 1% to 18% (Polanczyk, de Lima, Horta, Biederman and Rohde, 2007; Spitzer, Schrager, Imagawa and Vanderbilt, 2016). Whilst rates in Ireland tend to be lower, there is a feeling from some that numbers are on the increase (irishexaminer.com, 2013). For the purposes of this article, it is important to note that the rates of diagnosis for children within the child protection system are up to three times higher than that of the general population (Klein, Damiani‐Taraba, Koster, Campbell, and Scholz, 2015; McMillen et al., 2005; Sonuga-Barke, Daley, Thompson, Laver-Bradbury and Weeks 2015). As of yet, no study has been able to definitively establish why this is so. However, a number of theories have been put forward by researchers and clinicians (Howe, 2010; Panzer and Viljoen, 2003; Tarver, Daley and Sayal, 2014; Thapar, Langley, Asherson and Gill, 2007), which include ideas that the behaviours perceived by professionals to be ADHD could be something else entirely.