Misdiagnosis Of ADHD And Role Of The School Nurse

MISDIAGNOSIS OF ADHD AND ROLE OF A SCHOOL NURSE
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Abstract
ADHD or Attention Deficit Hyperactivity Disorder is currently one of the most challenging neurobehavioral disorders in children. The effects of this condition are widespread and tend to spill over to family members as well as the community. As per the current statistics, the number of children who are diagnosed with ADHD is quite high. By taking the phrase ‘children are the future’ literally, it is indeed essential for schools as well as health centers to take measures to not only create awareness of the condition but also help prevent the misdiagnosis of the same. Within the school’s jurisdiction, school nurses are the chief or primary providers of health care in schools and therefore, they play a significant role in the diagnosis of conditions that students might be in danger of succumbing to. One of those conditions is ADHD which, apparently, is among the conditions which are highly misdiagnosed. Misdiagnosis has its effects, and they vary from simple and easily manageable issues to extremely severe and dangerous. Therefore, it is essential that school nurses get the diagnosis of a disease or condition right, lest they offer recommendations which are suitable for a particular condition.
The role of school nurses in the prevention of misdiagnosis of ADHD could be obvious to some people. However, others, including some school nurses, believe that they should be spared blame if at any time they are guilty of misdiagnosis. First of all, nurses can help in the identification of early signs and symptoms of ADHD. Their training, as well as education, should help them to make informed conclusions. Secondly, they can gauge the performance of any therapeutic measures that have been employed. School nurses can also help to create awareness about ADHD around the school. They can also sensitize parents about the condition and make them understand the measures to take if they suspect their child is a victim of the condition. Upon detection of suspicious signs and symptoms, school nurses can also recommend further study on a student. Early signs are never conclusive, and therefore, instead of jumping to an early conclusion, they can advise parents on their next step. School nurses can also recommend referrals for students for the confirmed cases. As a school nurse, it is expected that one will have connections or information regarding the best treatment facilities which they can offer parents. Finally, school nurses can also influence policy making in schools and therefore, making the environment conducive for students to learn without parents worrying about the safety of their children. A school nurse’ say matters, especially on matters related to health and therefore, they can use their knowledge to influence a school’s direction health-wise.
However, some other factors might also make school nurses’ role in the prevention of misdiagnosis of ADHD seem impossible or far from their job description. One such factor includes their lack of mental education and training in the detection or diagnosis of ADHD. This indeed makes them spectators in the quest to prevent misdiagnosis of this condition. Another factor includes the lack of school-based health centers in many institutions. The above factor is also tied to the lack of useful information as well as the reduction of learning capacity. School nurses are also in need of information to help them offer their services better. The lack of these centers makes it impossible for them to make any significant steps in preventing misdiagnosis of ADHD. Lack of evidence-based practice guidelines, research studies as well as data to help nurses make conclusive as well as an informed diagnosis is also a major factor. As discussed later, these factors might hinder school nurses from effectively doing their job. However, while it is true that school nurses might be shorthanded, it is also true that they are the people closest to the students. Therefore, as it will be depicted in greater detail, they are indeed integral in the push to preventing misdiagnosis of ADHD.
Introduction
Approximately 11% of children 4-17 years of age (6.4 million) have ever been diagnosed with ADHD as of 2011 CITATION USD17 \l 1033 (U.S Department of Health and Human Services, Center for Disease Control and Prevention, 2017). Such startling statistics need prompt measures to diagnose and treat ADHD to warrant children a better future. Early diagnosis can be done in schools where teachers and parents can identify symptoms or signs of ADHD in children. Critical to a school is a nurse, whose role in providing quality health care to children cannot be overlooked. However, 30 percent of schools only have part-time nurses, and only half of all schools have registered school nurses who raise concerns over their importance in managing common disorders such as ADHD CITATION Nat15 \l 1033 (National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention; Division of Adolescent and School Health, 2015).Parents, teachers and school nurses play a very critical role in diagnosing and treating ADHD in children. Nurses have a very particular niche in the diagnosis and treatment of ADHD in children since he/she is the primary healthcare professional in a school setup. Managing the condition is a collective responsibility that requires various key people in the life of a child. Psychologists and therapists can be brought on board to help manage the conditions for children who have been diagnosed with the condition. However, nurses are at the heart of the issue, and their contribution towards impacting positive change in the school setup and helping children with ADHD is imperative. One of the places where ADHD is recognized is in school through teaching or playing activities. And one of the best places to manage ADHD is in school by applying relevant therapeutic medication on children with ADHD. School nurses come in handy here by offering their professional advice and treatment procedures that can help the child manage the condition. School nurses also help the school community understand children living with the disorder. School nurses play a pivotal role in managing the condition and suggesting ways help kids get accommodated within the school system. Those with active medication they have to take rely on the school nurse for the proper administration of the drugs they ought to take. While nurses play a significant role in providing for proper healthcare for children with ADHD, their role is often underemphasized. The role of school nurses in diagnosis, management, and treatment of children with ADHD is discussed in detail. Thus, school nurses should have an integral role in the prevention and misdiagnosis of ADHD.
Role Played by School Nurses in Prevention and Misdiagnosis of ADHD
Through helping identify early signs and symptoms of ADHD. School nurses are trained professionals who can distinguish symptoms of ADHD and any other disorder. They interrogate the children and their caregivers at home to ascertain or confirm his/her assumptions. Further evaluation and analysis of the child’s behavior are carried out by the nurses before he/she recommends that the children should receive specialized medical attention. As school nurses interact with the students, they observe them and can spot children who suffer from the disorder. Since in a school teachers are readily available, they can consult with the teachers and create a profile of the identified children who are further examined to confirm if they hail from ADHD. Information from teachers and students can help nurses profile a possible case of ADHD. Upon confirmation that there is an enough evidence for further examination of a possible ADHD case, the school nurse can refer the student to psychologists who recommends the best treatment for the child. The presence of a school nurse is, therefore, not limited to treatment and prevention of diseases; it goes into identifying children with ADHD and helping them live normal lives even after diagnosis.
School nurses help create awareness of ADHD within and without the school. Some teachers and students might not understand the underlying condition of their students and colleagues respectively, and thus school nurses can help educate the school community on ADHD. Health fairs, notices, healthcare club, memos, etc. can be indispensable tools at the disposal of school nurses to inform the school community of the existence of ADHD. Customized information meant for each target group is carefully drafted and disseminated to respective groups who are educated on ADHD conditions. Through creating awareness, the school community can understand ADHD and help those students who suffer from the condition. Informing the school community also helps reduce the stigma of the condition and cases of bullying for the children diagnosed with the condition. School nurses are indispensable in this area since they help come up with relevant factual information and activities that educate the school communities about ADHD. Some of the key things to include in the ADHD Awareness program include how to manage the condition and the role of every person within the school in helping children live normal lives even after a positive diagnosis of ADHD. The school community is an important environment in helping children with ADHD and thus the community ought to be informed about it. The school community is a therapeutic environment I well utilized to identify and treat children with ADHD. Thus, school nurses must be actively involved in educating school communities and the public of how to diagnose and treat ADHD.
School nurses help to administer drugs to children with ADHD. Through proper administration, nurses can evaluate the condition’s response to the drugs and recommend a further diagnosis of the condition to confirm if it is existent or a wrong diagnosis. When some children are diagnosed with the conditions, they are enrolled in medication program to help them manage the condition. The treatment mechanisms differ while some require a combined strategy to bear positive results CITATION Sor17 \l 1033 (Soreff, 2017). Each of the treatment methods can be effected through the school nurses. If a child is required to take medicine at the certain time, the school nurses can help them by ensuring they take their medicine at scheduled time. Stimulant medicines which are used for the treatment of ADHD can be addictive and might require the presence of a professional to ensure the children do not abuse the medicine. Behavioral therapies are also important for children with ADHD and thus require a professional to help tailor them to the needs of each child. Through talking to other child caregivers, school nurses ensure all children with ADHD are treated. For behavioral therapy treatment, they can recommend slight adjustments to accommodate the child within and without the school setup, but if they are ineffective, further evaluation can be considered. Parents and teachers are educated on how to provide the best environment for the children. Thus, nurses play a very critical role in ensuring parents, teachers and students team together to create a conducive environment managing ADHD. They go ahead to helping teachers and parents to adjust their teaching and parenting mechanisms, respectively to accommodate children with ADHD. Thus, school nurses oversee proper administration of medication to children with ADHD and help teachers and parents to play their role in treating the children.
The efficacy of each ADHD treatment mechanism ought to be evaluated by a professional over time. Through the evaluation of the medication method, nurses, as trained professionals, can profile a patient and reevaluate their diagnosis if they have sufficient information that it might have been the wrongful diagnosis. Checkups and follow up information on the response of drugs to a particular individual can prompt a school nurse to reevaluate the basis of diagnosis and recommend further evaluation CITATION Rey15 \l 1033 (Reynolds & Maughan, 2015). A school nurse is indispensable in gauging the efficacy of each treatment procedure. School nurses are healthcare providers, the closest to a school and thus remain to be the most important professionals who can evaluate the efficacy of the medication methods adopted for each case of ADHD. School nurses suggest various ways improve each strategy employed to manage the condition for each child. Through and evaluative process designed by professionals included but not limited to the school nurse, children with the condition can be helped to overcome the disorder. As the child grows, the school nurse can observe his/her behavior and recommend a change to behavior therapy to suppress the ADHD. Recommendations for the change of therapy of the child is to ensure the child’s growth is progressive and relevant to his/her medication. A school nurse is instrumental in evaluating the medication approach taken and ways to determine its efficacy and suggest ways to improve it and drop ineffective strategies. A school nurse also understands the history of the child with ADHD better. A school nurse is also able to recommend alternative drugs in case the side effects of some drug are adverse or do not produce expected results. Thus, the presence of a school nurse in managing ADHD in children, especially regarding evaluating the efficacy of treatment method is critical in the diagnosis and treatment of ADHD children.
Can recommend referrals for ADHD students depending on the data he/she has profiled about a student’s behavior.If there is a confirmed case, then nurse becomes instrumental in referring the patient to other professionals for further evaluation and a second opinion. After close examination by the school nurse, he/she can recommend further evaluation of the student’s condition. The evaluation has to be done by psychologists and therapists to give a second opinion of the condition of the child. The facilities found in a school health care facility are not sufficient to provide treatment and care of advanced cases of ADHD, and thus school nurses can refer their patients to other healthcare facilities with more specialized health care. Such referrals must be done by professionals in the healthcare industry with a detailed profile of the patient to the specialist. The specialists conduct his/her evaluation of the patient before delivering his/her opinion. The specialist can recommend the best treatment method or drugs if need be. Nurses can bring on board another professional to help study the behavior of some students before earmarking them for further analysis. Referral cases can be done to deliberate on the efficacy of treatment methods administered to various patients. Patients can be requested to invoke experts who can help their children to live normal lives. Thus, school nurses help manage ADHD through referring patients to specialists who can suggest best approaches for each patient to manage their condition.
Observation of children in school can help recognize symptoms of ADHD. Without the presence of a trained professional, many students would remain undiagnosed since teachers do not have sufficient skills to positively identify ADHD among their students. In a school setup, the social circles of children and their behavior can be a clear indicator of children suffering from ADHD. As students interact with their colleagues and teachers, a trained professional can spot a child who has behavioral traits of an ADHD.A school nurse can recommend further evaluation of student’s behavior to ascertain if he/she is suffering from ADHD. Cross-examining the student and teachers can help the nurse to recommend further evaluation of the child. Some students might be suffering from other disorders and can lead to misdiagnosis, and thus a trained professional inclusion is imperative. To avoid misdiagnosis, a school nurse can refer the student to professionals who recommend the best ways to treat and manage the condition. Thus, school nurses play an important role in identifying of ADHD children who need specialized care. An untrained professional would possibly misdiagnose the child and subject him/her to unnecessary treatment and management of the condition that would be unnecessary. Therefore, to prevent misdiagnosis of ADHD in school, a school nurse role cannot be overlooked as they help evaluate and affirm any ADHD cases from a professional standpoint through a careful evaluation of a student behavior.
School nurses also can play an important role in policy making to favor ADHD students in a school. Wrongful diagnosis sometimes is a result of poor policies governing the school that bestows power on untrained people to diagnose ADHD. Policies can be tweaked to help the nurses in...