Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed disorder among U.S. children, affecting 5.4 million American kids ages 4 to 17. Young people who suffer from ADHD struggle with basic cognitive processes—working memory, sustaining attention, controlling emotion, solving problems, organizing and self-monitoring. The symptoms make doing well in school and maintaining friendships especially difficult and frustrating.
But a spate of otherwise healthy teens are faking signs of ADHD.
Take the case of Steven, a teen who felt stressed out and exhausted by the academic pressure at his elite boarding school. Desperate to get ahead, Steven (not his real name) decided that an ADHD diagnosis would give him special privileges and a competitive advantage over his peers. He feigned symptoms of the condition, and deliberately started failing tests. As he confessed to the Daily Beast, written evaluations from teachers and parents helped him convince doctors that he actually had ADHD.
Steven was put on stimulant medication, and allowed to take school tests untimed. He was also given extra time to complete his SATs. After being accepted to a top college in Upstate New York, Steven no longer felt the need to keep up the charade. He stopped taking medication and no longer claimed to have ADHD.
Dr. George DuPaul is an education professor at Lehigh University who researches interventions for K-12 and college students with ADHD. He told TakePart that teens who feigned ADHD were tempted by numerous incentives, including “educational accommodations such as extra time on tests or being allowed to take different forms of tests (like oral exams), as well as being given extra time on high stakes standardized exams such as SATs or GREs. There may also be incentive to obtain prescriptions for central nervous system stimulant medications used to treat ADHD (like Ritalin, Concerta, and Adderall).”
After acing tests and outscoring their peers on the SATs, kids like Steven apply to top colleges without even having to mention the ADHD label since disclosure could result in unfair discrimination by admissions counselors. They reap all the benefits of undeserved accommodations without incurring any costs.
When asked whether faking ADHD is a common phenomenon, Dr. DuPaul replied: “Anecdotal information suggests there are some students attempting to feign ADHD, but there is no data to confirm how successful they are in doing this, nor any data on the prevalence of this practice.”
GAMING THE SYSTEM
Just how easy is it for students to dupe their doctors and convince psychologists that they have ADHD? To find out, TakePart contacted psychology professor Dr. David Berry at the University of Kentucky who studies the detection of feigned cognitive and neuropsychological deficits.
As it turns out, successfully faking ADHD symptoms is a surprisingly easy scam. “Several published reports indicate that relatively unsophisticated college students are able to respond to questionnaires, rating scales, and performance tests in a way consistent with the presence of ADHD,” he explained. “This, combined with interview and history data consistent with ADHD symptoms, could facilitate their being diagnosed with the disorder.”
The problem, he said, is that few testing instruments commonly used to diagnose ADHD have any built in scales for detecting fakers. So Berry and his colleagues wondered whether Symptom Validity Tests (SVTs), normally used to detect inadequate effort during head injury evaluations, could also be used to detect feigned ADHD symptoms.
They recently conducted a study which found that SVTs could in fact be useful in determining whether people are feigning ADHD. Berry concluded that “clinicians evaluating college students seeking a diagnosis of ADHD should probably administer at least two SVTs in order to detect faked ADHD.”
Even though the possibility of faking ADHD exists, Berry is careful to note that the public shouldn’t assume the disorder isn’t real. In his words: “I do want to emphasize that I do not believe that most people with ADHD are faking the disorder. There clearly are a significant number of children and adolescents who suffer from ADHD and who benefit from medication and classroom accommodations. However, someone who first presents for diagnosis of the disorder in college may require more thorough scrutiny than those who have a long and documented history consistent with ADHD.”