Overdiagnosis and medication for attention-deficit hyperactivity disorder in children with cleft: diagnostic examination and follow-up.
OBJECTIVE
To examine the diagnosis of attention-deficit hyperactivity disorder (ADHD) in children with cleft to determine whether language-learning characteristics are taken into account when making this diagnosis.


METHODS
Prospective examination of 177 consecutive patients. Objective behavioral ratings, cognitive assessments, and attention/impulsivity testing of 32 of the 177 children with nonsyndromic cleft lip and palate (CLP) who had previously been diagnosed as ADHD and were receiving medication were performed. the prospective 6- to 9-month follow-up examination was examined to determine the accuracy of prior and posttest diagnoses.


METHODS
University hospital-based cleft palate clinic.


METHODS
Pretest/posttest design to determine accuracy of DSM-IV psychiatric diagnosis.


CONCLUSIONS
The results show that the proportion of children originally diagnosed with ADHD (18%) was significantly higher than posttest diagnosis of ADHD (6% p <.001). Also, the frequency of pretest diagnosis of learning disorder (LD; 31%) was significantly different from posttest diagnosis (66% p <.01). The overdiagnosis of ADHD and underdiagnosis of LD in this sample of children with nonsyndromic unilateral cleft lip and palate appears to be due to lack of language-learning assessment.
Richman
Lynn C
LC
Department of Pediatrics, University of Iowa, Iowa City 52242-1083, USA. lynn-richman@uiowa.edu
Ryan
Susan
S
Wilgenbusch
Tammy
T
Millard
Tom
T
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000209:etiology; D002648:Child; D002971:Cleft Lip / Q000150:complications; D002972:Cleft Palate / Q000150:complications*; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006801:Humans; D007806:Language Disorders / Q000175:diagnosis* / Q000209:etiology; D007859:Learning Disabilities / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D011446:Prospective Studies; D011594:Psychometrics