I am in the ADD is wayyyy overdiagnosed camp. I am not anti- medication for the children who are carefully diagnosed with Attention Deficit Disorder. But, I believe that medication is only appropriate only AFTER the parents and the child have gone through an extensive evaluation and interview process. This business of filling out a behavior checklist and then getting a prescription with little to no medication follow-up is just unethical. Also, it makes me cringe when I hear about little ones, PRESCHOOLERS for crying out loud, being diagnosed as hyperactive or having a short attention span and being put on medication. Hellooo, just how boring and calm and attentive are you supposed to be at the age of...THREE! All right. I'll get off my soapbox now. I could stand on it for quite a while on this topic. Sorry.

Oh. And I forgot to rant about the race and gender issues associated with the diagnosis. I can't state this as a statistical fact, but, in my clinical experience far too many young black boys are diagnosed with the disorder and drugged into a stupor as a result. It really (hacks) me off, when I see the parents of a normal, bright, inquisitive, active, healthy little boy all the age of 7 being told to rush to a pediatrician or child psychiatrist for medication. It makes me crazy. Okay. I'm done now.

This topic his home for me. My birthson has been diagnosed ADHD and takes Adderall, among other drugs. It makes him not want to eat at all, and there are other side effects, which are all hard to see.

I fall more in the camp of "this is a personality trait, not a disease." But then again, I don't live with it every day.

Some people believe you can control ADHD with diet. I don't know how effective that is.

Thanks for a balanced discussion on AD/HD, a topic dear to my heart. I disagree that it is a personality trait. And I equally disagree that it is a disease; I see it as a neurobiolgical condition that is easily and usually successfully treated by a combination of medication, educational support and behavior management.

I also do agree that it is often overdiagnosed and over-treated with meds. But I also feel STRONGLY that it is underdiagnosed, misdiagnosed and under treated.

Studies show that NOT treating this condition often leads to more serious problems in the future.

I work with adults with AD/HD and families trying to help their children. Understandably, most parents are very unsure about using medications as part of their child's treatment, and that is a wise reaction. One should be very certain of the diagnosis, try other things first (behavioral management, etc) before jumping into meds. However...in the great majority of cases, those strategies just don't do enough to help the child manage his/her hyperactivity, distractibility, etc.

When ADD symptoms go unchecked, we see children- and adults- who struggle academically, socially and psychologicaly. Thus, it is more often than not that we see co-morbidities arise, typically depression, anxiety and even substance abuse and conduct disorders.

In fact, over 70% of prison inmates have undiagnosed/untreated AD/HD.

So though it seems like the whole world has ADD and is on meds, studies also show that many of these children who need to be on medication, are not.

Here's an article I wrote about the concerns parents have about using medications for their ADD child:

http://www.addconsults.com/articles/full.php3?id=1454

Ok, off my soap box!

Terry Matlen, ACSW
Director, ADD Consults

www.addconsults.com
www.myADDstore.com
- past board member, www.add.org -

Gosh - I got a lot of comments in a very short time!
Personally, I'm in between the over-prescribed and the neuro-biological camp. I think the kids who truly have this disorder probably do need medication, and I also think that medicating them early is not a bad thing.
Here's my reasoning. I see no reason to wait until a child is failing school, unable to read, hating school, in trouble all the time, etc. to investigate and help deal with the root of the problem, which is what seems to be the typical progress of diagnosis. I have been a teacher and a school librarian for many years and I've seen first-hand what it's like for kids who don't like school: they don't succeed and are doomed to have a poor school career, typically drop out and have difficult times later in life. I don't want that for my children...so for Little J we are beginning to explore his issues NOW (at almost age 4 - and if you've been reading my blog at all you'll know that he has significant behavior problems that are different from most little boys his age. I am not talking ordinary active little boy stuff - my older son is one of those and I know what that's like - I'm talking problems doing simple things like putting on shoes to go to school because on the way to get his shoes he sees a toy on the floor, picture on the wall, here's a funny noise...and completely forgets what he was going to do).
But, that said, I'm not saying we are looking to medicate him...yet. But if, after a lot of behavioral analysis, family counseling, etc., it's determined that medication may help then HECK YEAH I'll give him the pills.

Dr. G said:

I can't state this as a statistical fact, but, in my clinical experience far too many young black boys are diagnosed with the disorder and drugged into a stupor as a result.

It is a statistical fact. See http://jad.sagepub.com/cgi/content/short/9/2/392
for a summary of prevalence of ADHD prevalence and race.

Adrienne, I'm in complete agreement.
BTW, I'm new here and know I'll lose my way. Is there a way to get an autoresponder when comments or posts are made?

Thanks,
Terry

www.addconsults.com
www.myADDstore.com

Yeah, "personality trait" was a bad way to put it. What I was trying to say was, a condition or way of being that some people face. Maybe that's similar to a neurobiological condition.

This topic hits home with me too. When my son was just over two years old, I was getting comments that he wouldn't make it in school without Riddlin. Oh yeah, this was at church! I was so upset. I didn't know alot about ADHD and thought that there was too much over-medication. Then I became a special education teacher - and did my world and viewpoint change! I could tell the children who hadn't taken their meds immediately. I'm not saying that when they take medication they sit like little angels - but they are able to learn and do their assignments and focus on the teacher - instead of 50 other distractions in the room. Personally, my son had a very difficult year in Pre-K last year. He is very intelligent and he knew the majority of the things that the teacher was teaching. That's why we reasoned he was off doing somersaults on the other side of the room instead of participating in circle time. He also had/has very extreme temper tantrums. We were confused about his problems - were they because he was adopted? or institutionalized for 15 months? or lack of good bonding at an early age? or our parenting? I did a lot of research into ADHD especially after seeing my students (who were in 8th grade) failing school and getting into a lot of trouble. I knew I didn't want that for my son and if it meant putting him on medication, I would do that. I could see his potential, but it seemed like no one else did. In my research I learned that ADHD IS a MEDICAL DISORDER, just like any other condition. In order to be treated, there is medication involved. People with ADHD have a chemical imbalance and the medication brings their brain function to a 'normal' level. If your child had a heart condition and required medication, noone would question whether or not you would give it to him. Just because ADHD didn't have a name 30 years ago doesn't mean that it didn't exist then. I read a great book that talked in plain english called "ADD/ADHD Behavior Change Resource Kit" by Grad L. Flick, PHD. It explains ADHD and what causes it, but the best part of the book is that it gives a lot of strategies to use with children along with lists, charts, monitoring checklists. It's really good and I would reccommend it for parents who have children with ADHD. One of the main things that it talks about is that medicine alone is not enough. Parents need to work on strategies to help their children cope with their distraction and to learn strategies to help them in all aspects of their life as they grow into adults. But if my son was not on any medication, it would be useless to try to teach him any strategies. He was too unfocused and distracted by everything. He tried to do the right thing, but he is very impulsive and would jump into the fire every time.
Now, for the good news, at the beginning of this school year (Kindergarten), Zac was placed in an early intervention class. I agreed to it, but was upset about it, because I knew Zachary was very smart. It was his behaviors that were keeping him from showing his intelligence. After being on medication since Nov, he has made a complete turn around! He is getting all good behavior marks on his daily sheet. He just went 2 months in a row with a good report every day - We really celebrated! His academics is doing excellent - his teacher has removed him from the EIP class because he doesn't need it anymore, in fact he is excelling.
One more thing - sorry for going so long. But there are so many misconceptions - I had them too! But Zac is not a little zombie. By no means! He is still very active, energetic and just as funny as he was before he went on medication. The only different is he is now able to focus on his teacher in school, do one thing at a time and finish it, he is less impulsive and thinks a little before he does or says the first thing that comes to his mind. I feel bad for my students whose parents won't put them on medication because they don't want them to 'become a zombie' but they will continue to let them fail in school and get in trouble constantly. The students I see will most likely drop out or get kicked out of school. Which would you prefer for your child?

Dear ADHD specialist,
ADHD is real- and there is now a test to prove it. This test is avaliable to any practitioner. To read more- follow the links below.
I would like to bring to your attention a new concept in ADD testing. An objective physiological measure of ADHD has been elusive. However, research by Jason Alster MSc has shown that when an ADD person tries to sit still , do a boring task, or concentrate- they actually enter stress as measured by electro dermal activity. This marker is positive in the majority of ADD clients tested. Then GSR biofeedback may be used to improve the stress result. A protocol using this valid objective physiological marker has just been published in a video- Guide for GSR Biofeedback Techniques For The Natural ADHD Practitioner.
Jason Mark Alster MSc


http://jasonalster.googlepages.com/home
http://www.amazon.com/gp/product/9659025114/
http://www.amazon.com/gp/product/9659025130/
http://www.amazon.com/gp/product/9659025149/
http://www.theadhdspecialist.com/gsraudio.html (pod-cast)
http://www.theadhdspecialist.com/gsraudio2.html
http://www.thesourceisrael.com/issue34/article.shtml?intimate
http://www.lessontutor