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The Cost of Undiagnosed ADHD in Children

I’m not sure who first said “ignorance is bliss,” but I’m fairly sure they weren’t talking about mental health conditions.

Not knowing you have a mental health condition doesn’t protect you from that condition’s symptoms. It just makes you less able to cope with them.

This point sometimes gets lost in all the handwringing about overdiagnosis: what about kids with ADHD who don’t get diagnosed and have to suffer the consequences?

SchoolA new study highlights exactly what some of those consequences might be. In the study, researchers followed 2,945 children in Japan for several years, evaluating them for symptoms of ADHD.

At age 12, 91 of the children had showed an ongoing pattern of ADHD symptoms. However, 76 of those, or 84 percent, had not been diagnosed.

The children who hadn’t been diagnosed fared worse on a variety of measures. They had lower self-esteem, higher rates of depression, and more problems with their peers. They also had more emotional symptoms and conduct problems.

For those who grew up with undiagnosed ADHD, these findings probably aren’t surprising. We know that not being able to do things other people take for granted and not knowing why sure can mess with your self-esteem, and it’s unlikely to help as far as depression goes either.

Kids with ADHD often impulsively do things that rub their peers the wrong way, or inattentively miss social cues. So the issues with peer relationships aren’t a surprise either.

Getting a childhood diagnosis won’t solve these problems of course, but it will give some insight and new possibilities for symptom management. The importance of insight itself shouldn’t be underestimated. When we’re talking about things like self-esteem, simply knowing the underlying reason behind ADHD symptoms does make a difference.

The researchers say their study highlights “the importance of paying more attention to the possible underdiagnosis of ADHD in children.”

Underdiagnosis? That’s funny, all I hear about is overdiagnosis.

It’s worth pointing out that overdiagnosis and underdiagnosis can both happen simultaneously. If understanding of ADHD is limited and the diagnosis protocols used in practice have shortcomings, it’s possible that some kids without ADHD will be given erroneous diagnoses while others who actually have ADHD will be overlooked.

In any case, though, we shouldn’t let worries about overdiagnosis get in the way of helping kids who really do have ADHD. This study suggests that many of those kids aren’t being identified, and that it has real consequences for them.

Image: Flickr/Best Buddies Delaware

The Cost of Undiagnosed ADHD in Children

Neil Petersen

Neil Petersen writes regularly on education, learning disabilities and technology. He received his B.A. in 2014 and was diagnosed with ADHD at the beginning of his college studies. Neil also works for a music education non-profit and hopes to help create an education system that can better serve students with ADHD.

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APA Reference
Petersen, N. (2019). The Cost of Undiagnosed ADHD in Children. Psych Central. Retrieved on December 6, 2019, from


Last updated: 2 Apr 2019
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