Overreacting to attention deficit disorder.

• Author: Vatz, Richard E.

A PHYSICIAN who has failed to pass board certification examination in his medical specialty nearly a dozen times claims that his disability of attention deficit disorder (ADD) qualifies him under the Americans with Disabilities Act (ADA) to be given unlimited time to take the timed test. A law student who twice has failed his bar examination successfully sues to be given twice the normally allotted time to take the test due to his alleged ADD and dyslexia.

Anecdotal evidence mounts of attempts to bring such emotional/psychiatric claims under the Americans with Disabilities Act. They currently account for 11% of all such actions. To qualify under the act as "an individual with a [mental] disability," one must show that he or she "has a physical or mental impairment that substantially limits one or more ... major life activities; has a record of such an impairment; or is regarded as having such an impairment." The questions this law raises are obvious. If a medical student requires extra time to pass an examination on cardiac arrhythmias, for instance, who will give him or her extra time in a real life cardiac crisis after he or she has become a physician?

Attention Deficit Disorder has been known by a large number of names, but usually implies some type of overactivity and/or inattention. Because ADD is defined so vaguely, it is tailor-made for bogus claims of psychiatric disability. As the American Psychiatric Association's latest diagnostic manual concedes, there are "no laboratory tests that have been established as diagnostic" for "Attention-Deficit/Hyperactivity Disorder [ADHD]." In fact, the manual's criteria for ADHD include only vague and nonmedical measures such as "is often forgetful in daily activities" and "often talks excessively." Historically applied just to children, vast numbers could qualify under these measures and even more can be added in the manual's "ADHD Not Otherwise Specified" category, which, the APA's Research Department admits, allows psychiatrists to diagnose the condition more freely when a child's behavior does not fit the diagnostic criteria.

Lest there still be some restrictiveness perceived, potential ADHD sufferers may be diagnosed by a variety of nonphysicians (such as psychologists and social workers) for third-party reimbursement in all major proposed national health care plans. Meanwhile, the ADA does not indicate any specific requirement for physicians to make diagnoses.

With such nonspecific criteria for hyperactivity, it is not surprising that estimates of its incidence typically range from one to five percent of the population, with some researchers claiming that 33% of all boys are afflicted. A brochure distributed by...