Masaki--I agree, the central problem is distinguishing between true cases of ADHD and anxiety manifestations or acting out behaviors related to family dysfunction or other issues....of course, I work in an abuse/neglect context where essential family problems, some quite serious, certainly feed into behavioral/emotional problems in the children.

I see far too many children simply hastily diagnosed as having ADHD because they are too much "trouble" for parents or foster parents, etc. Some of the service agencies that provide these "diagnoses" do not do a truly careful and ethical job, do not take into account confounding variables and possibilities, and do not do not make much effort to r/o other conditions.

I see tons of kids stuffed with all kinds of meds, yet receiving no therapy, and/or where the underlying family issues are not being addressed. Then, when the kid gets worse, he's simply stuffed with more meds. Although the court is supposed to review/approve of all requests for meds, most of those get rubber stamped.

Quite outside of CPS, I personally think that the number of peds patients on psychotropic meds of various kinds is alarmingly high. It troubles me deeply. I think we are also sending a message to children to "solve" it with meds--which, in the drug-rich culture they dwell in, is probably not a good idea. Of course, there are many cases where medication is necessary and fully appropriate. It's the overuse I react to.