So I watched Frontline
and they did a story that really seems, to me, to be of critical importance.
What constitutes ADD or ADHD? Are psychologist and doctors over-diagnosing people? Have we become a society who are to quick to put kids on medication rather than helping them deal with their problems in a more natural and healthy way? Could the drug companies be behind it all?
Honestly, I don’t have kids. I’m interested in hearing from people who do and anyone who’s close to the issue. When I watched the story last night I was left with a lot of confusion because I wasn’t sure how I felt about it.
There’s something inherently wrong, I can’t help but to think, or dangerous in giving kids perscription drugs like this. Making them think there’s something wrong with them. In a lot of these cases couldn’t the child just be going through a faze.
Should we perhaps quit reaching for the medicine bottle and reach for the switch a little more often.
I suppose it’s up to the individual parents. I have no background in psychology or medicine, so I can’t make any authoritative statement. I believe ADD /ADHD (whatever its called these days) is overdiagnosed. Not that it doesn’t exist, mind you.
I think we’re teaching our children to be on prescription medication effectively since birth for things which don’t necessarily require it, and that this is a Bad Thing.
But, that’s more gut instinct than anything else. YMMV
Seems from your questions that you haven’t read the material that you linked to. It’s pretty good, so it would be a good place to start. I am a psychologist who sees many children with and without ADHD in clinical practice. I am also involved in longitudinal research on this topic, and published a study in 2001 demonstrating a link between problems of inattention and tobacco use in adolescent boys.
I am not convinced that a rash of overdiagnosis and overmedication is occurring, although it is possible. It would be easy to misdiagnose ADHD. I do believe that too often medications are used without also employing behavioral therapy. My preference would be a trial of behavioral therapy (including parent management) before trying stimulant meds in all but the most severe instances.
I thought that both the thread that Reeder linked to, and the PBS material were helpful, but neither highlighted the social difficulties that these children experience. Their behavior tends to be noxious to their peers. They often butt in on conversations and activities, are loud, say annoying things and make annoying noises, cannot wait for their turn in games, and have marked difficulty reading social cues and considering other’s viewpoints.
As for your assertion that perhaps a switch would be beneficial, this is not supported by the research. Further, do you think that you are the first one to consider corporal punishment for disobedient children? I can tell you anecdotally that in the majority of cases I see, the rod has not been spared, yet the problems persist. Again, read the material you linked to, and then tell me how corporal punishment might help.
** Beelzebubba**, I would quibble with your suggestion that a child with ADHD might be on medication from birth (although there are some who begin medication at very young ages). I would more strongly argue that, with a child with significant problems of ADHD, the last thing you would be worried about would be their taking away the wrong message about medications. My mileage does vary.
In my very un-educated opinion, I think it might be an interesting task to try to restructure our society so that it is not so impossible for someone with ADD to function productively. If sitting in lecture for an hour is an impossibility, then why not try other methods of schooling, for example.
The problem is that ADHD is both overdiagnosed and underdiagnosed: there are some psychologists, doctors and educators who think Ritalin is the silver bullet for every possible behavior problem, and others who refuse to believe that the disorder exists at all and think the kid who’s suicidally depressed at her own inability to get her schoolwork done is just a lazy whiner, dammit.
I’m pretty sure I have some form of ADD, but when I told my parents, they ignored me and said I was fine. These are the people who would rush me to a psychologist if an adult suggested one, but they ignored me whenever I said there was something wrong. Even the psychologists laughed at me when I told them I thought I had ADD. Nobody took me seriously until I went to the counseling center in college. I was never diagnosed with anything, but at least I wasn’t suspicious that they were telling my parents everything and minimizing my concerns. I don’t think I need any medication at the moment, but I’m just annoyed that nobody takes me seriously. I guess it’s because I’m young and they think I’m just looking for attention or something.
However, I do feel like kids are being overmedicated. Instead of working out their problems, doctors just automatically prescribe stuff. I think medication is necessary in some situations, but it should be a last resort when nothing else is working.
Speaking of ADD, here I am posting instead of writing papers and studying for finals. Bah…
6 million American children have been diagnosed with ADHD. That’s an awful lot.
Something between 7% to 10% of elementary age children are diagnosed with this (about the same number as who are left handed). It seems to me that if up to 10% of children have this neurobehavioral pattern, it’s not a disease, rather a characteristic.
90% of the world’s Ritalin is taken by American children. Does that suggest that something is going on here?
Ritalin is a Schedule II drug, just like cocaine, morphine, opium, methadone, and methamphetamines. Is a form of speed!
I’ve no doubt that Ritalin (and other such drugs work). They make children easier to deal with.
Humble apologies. The above quoted figure is not correct. The corrected stastics are that the US and Canada account for a startling 95of worldwide Ritalin consumption.
You seem to understand that Ritalin (methylphenidate) is a stimulant. Yet you imply that it would work on children in general (apparently suggesting that it is given to children regardless of their ADHD status) to make them easier to deal with. How would children be easier to deal with on speed?
I’m going to avoid the whole labelling debate. Heck some kids are overlabelled and some are underlabelled. Label it as a disease or as a “neurobehavioral pattern” … whatever.
The point is that this … “processing style” if you will … when present to a significant degree, is handicapping these children from functioning well within the world in which they must function. And appropriate, prudent use of medication allows them to function without handicap.
I have poor vision. Sure I can always sit in the front row of the movies or the lecture hall, and that may work for some situations, but why shouldn’t I have my presciption glasses and wear them?
Psychostimulants (Ritalin and Dexamphetamine), when given to both normal adults and children, in small doses, have the same effect as they do on ADHD people. They improve attention and decrease motor activity. It is all to do with the dosage.
I don’t have a link, but can give you a hard copy reference if you like
However, MRIs (I believe) have demonstrated different chemical activity in the brains of ADHD people that is affected differently by the administration of those stimulants.
When I was first told my son had ADHD, I thought it was a bunch of baloney. I thought it was a case of his teachers trying to rationalize his disinterest in school - “We’re not boring, he’s got something wrong with him…”
Time passed…and it turns out my son DOES have the inattentive kind of ADHD. He is a scary smart kind of guy, and struggled in all his classes in high school. His doctor explained his brain does not produce enough Dopamine, and that if we paid $1,000 to have a brain scan done, we’d see abnormal activity in certain portions of his brain. Adderall stimulates the production of Dopamine in the brain. We started him on Adderall. AS SOON as he started taking Adderall he started getting As in all his classes, and was able to participate in class discussions. It was like flicking a switch. The results were incredibly positive and immediate.
So, there are cases where the diagnosis is correct, and the perscribed medication is right on the mark. I was a huge sceptic. I was wrong.
I don’t think there are any changes on MRI, but I think some things can be seen on PET scan. It isn’t really of any clinical utility, though–if you meet the criteria, you have ADHD, regardless of what your PET scan shows. (We don’t use PET scans clinically anyway, at least not in any field I can think of.)
This is my favorite analogy as well. Can you imagine the squawking that must have gone on when the first kids got glasses? “He’s not going to wear those things all the time, is he?” “He can see the board just fine; he’s just lazy.” “Those things will ruin his eyes!” “If he’d try harder, he could see better.”
I knew it wasn’t a C.A.T. scan but couldn’t remember which procedure it was.
I realize that the scan does not serve a diagnosyic function, however, the fact that we can see different activity in the brains of ADHD-diagnosed patients argues against the “there is nothing really different, you just want to dope up the kids” argument.
Your idea (emphasizing behavioural therapy) makes alot of sense in light of the symptoms you indicated in the second paragraph. Social graces are learned, and the behaviours you described above really just consist of “being a jerk”. Maybe if we tried harder to train children into not being jerks and teaching them qualities like empathy, courtesy and delay of gratification, we’d see fewer instances of “out-of-control” kids.
I’d love to see the support for that. Please just reply with the authors, year and source (journal or book name); I can probably find it. Yes, stimulants (including nicotine and caffeine) have similar effects on all people.* However, I bristle at the suggestion that it is given to all children to calm them down. One might take from your post that they have a sedative effect ("…decrease motor activity…") What they actually appear to do is reduce impulsive behavior. Part of the problem with children with ADHD is that they have a reduced capacity to filter out extraneous internal and external stimuli, including impulses to get up and run out of the room, run over and jump on the back of a peer, grab the dice and roll them immediately. Stimulants appear to improve the ability to disregard these impulses. Now, with children who don’t suffer from such deficits (i.e. they do not act on the impulse to yell out, they remain in their seat, they note the lawnmower outside without becoming distracted from the lesson), how would a stimulant make them easier to control? What about children who show undesirable behavior due to anxiety or conduct disorder? How will the stimulant make them easier to control?
*In fact, I hypothesized that the stimulant effect of nicotine might explain the increased nicotine use among the boys with inattention in our sample.