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ADHD
IN THE NEWS
Headlines about ADHD, Learning Disability and Mental Disorders
Study on ADD and TV
The recent study published on watching television between the ages of one and
three and the possible link to ADD/ADHD did not take many considerations into
account. The author of the study even admits that he cannot conclude that
television watching and ADD/ADHD are linked.
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Article
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The following article is an excerpt from ADDA website. For additional information, please visit their site at www.add.org
MYTHS ABOUT ADD/ADHD
by
Becky Booth, Wilma Fellman, LPC, Judy Greenbaum, Ph.D., Terry Matlen, ACSW,
Geraldine Markel, Ph.D., Howard Morris, Arthur L. Robin, Ph.D., Angela Tzelepis,
Ph.D.
The following myths - and factual responses - have been collected from
rebuttals to recent media articles about ADD/ADHD. The rebuttals were written by
MAAAN (Metro Area Adult ADHD Network, based in the Detroit area).
Myth #1: ADHD is a "phantom disorder".
FACT: The existence of a neurobiological disorder is not
an issue to be decided by the media through public debate, but rather as a
matter of scientific research. Scientific studies spanning 95 years summarized
in the professional writings of Dr. Russell Barkley, Dr. Sam Goldstein, and
others have consistently identified a group of individuals who have trouble with
concentration, impulse control, and in some cases, hyperactivity. Although the
name given to this group of individuals, our understanding of them, and the
estimated prevalence of this group has changed a number of times over the past
six decades, the symptoms have consistently been found to cluster together.
Currently called Attention Deficit Hyperactivity Disorder, this syndrome has
been recognized as a disability by the courts, the United States Department of
Education, the Office for Civil Rights, the United States Congress, the National
Institutes of Health, and all major professional medical, psychiatric,
psychological, and educational associations.
Myth #2: Ritalin is like cocaine, and the failure to give youngsters
drug holidays from Ritalin causes them to develop psychosis.
FACT: Methylphenidate (Ritalin) is a medically prescribed
stimulant medication that is chemically different from cocaine. The therapeutic
use of methylphenidate does NOT CAUSE addiction or dependence, and does not lead
to psychosis. Some children have such severe ADD symptoms that it can be
dangerous for them to have a medication holiday, for example a child who is so
hyper and impulsive he'll run into traffic withoug stopping to look first.
Hallucinations are an extremely rare side-effect of methylphenidate, and their
occurrence has nothing to do with the presence or absence of medication
holidays. Individuals with ADHD who are properly treated with stimulant
medication such as Ritalin have a lower risk of developing problems with alcohol
and other drugs than the general population. More importantly, fifty years of
research has repeatedly shown that children, adolescents, and adults with ADHD
safely benefit from treatment with methylphenidate.
Myth #3: No study has ever demonstrated that taking stimulant
medications can cause any lasting behavioral or educational benefit to ADHD
children.
FACT: Research has repeatedly shown that children,
adolescents, and adults with ADHD benefit from therapeutic treatment with
stimulant medications, which has been used safely and studied for more than 50
years. For example, The New York Times reviewed a recent study from Sweden
showing positive long- term effects of stimulant medication therapy on children
with ADHD. Readers interested in more studies on the effectiveness of medication
with ADHD should consult the professional writings of Dr. Russell Barkley, Drs.
Gabrielle Weiss and Lily Hechtman, and Dr. Joseph Biederman.
Myth #4: ADHD kids are learning to make excuses, rather than take
responsibility for their actions.
FACT: Therapists, educators, and physicians routinely
teach children that ADHD is a challenge, not an excuse. Medication corrects
their underlying chemical imbalance, giving them a fair chance of facing the
challenges of growing up to become productive citizens. Accommodations for the
disabled, as mandated by federal and state laws, are not ways of excusing them
from meeting society's responsibilities, but rather make it possible for them to
compete on a leveled playing field.
Myth #5: ADHD is basically due to bad parenting and lack of discipline,
and all that ADHD children really need is old-fashioned discipline, not any of
these phony therapies.
FACT: There are still some parent-bashers around who
believe the century-old anachronism that child misbehavior is always a moral
problem of the "bad child." Under this model, the treatment has been
to "beat the Devil out of the child." Fortunately, most of us are more
enlightened today. A body of family interaction research conducted by Dr.
Russell Barkley and others has unequivocally demonstrated that simply providing
more discipline without any other interventions worsens rather than improves the
behavior of children with ADHD. One can't make a paraplegic walk by applying
discipline. Similarly, one can't make a child with a biologically-based lack of
self-control act better by simply applying discipline alone.
Myth #6: Ritalin is unsafe, causing serious weight loss, mood swings,
Tourette's syndrome, and sudden, unexplained deaths.
FACT: Research has repeatedly shown that children,
adolescents, and adults with ADHD benefit from treatment with Ritalin (also
known as methylphenidate), which has been safely used for approximately 50
years. There are NO published cases of deaths from overdoses of Ritalin; if you
take too much Ritalin, you will feel terrible and act strange for a few hours,
but you will not die. This cannot be said about many other medications. The
unexplained deaths cited in some articles are from a combination of Ritalin and
other drugs, not from Ritalin alone. Further investigation of those cases has
revealed that most of the children had unusual medical problems which
contributed to their deaths. It is true that many children experience appetite
loss, and some moodiness or "rebound effect" when Ritalin wears off. A
very small number of children may show some temporary tics, but these do not
become permanent. Ritalin does not permanently alter growth, and usually does
not result in weight loss. Ritalin does not cause Tourette's syndrome, rather
many youngsters with Tourette's also have ADHD. In some cases, Ritalin even
leads to an improvement of the of tics in children who have ADHD and Tourette's.
Myth #7: Teachers around the country routinely push pills on any
students who are even a little inattentive or overactive.
FACT: Teachers are well-meaning individuals who have the
best interests of their students in mind. When they see students who are
struggling to pay attention and concentrate, it is their responsibility to bring
this to parents' attention, so parents can take appropriate action. The majority
of teachers do not simply push pills- they provide information so that parents
can seek out appropriate diagnostic help. We do agree with the position that
teachers should not diagnose ADHD. However, being on the front lines with
children, they collect information, raise the suspicion of ADHD, and bring the
information to the attention of parents, who then need to have a full evaluation
conducted outside the school. The symptoms of ADHD must be present in school and
at home before a diagnosis is made; teachers do not have access to sufficient
information about the child's functioning to make a diagnosis of ADHD or for
that matter to make any kind of medical diagnosis.
Myth #8: Efforts by teachers to help children who have attentional
problems can make more of a difference than medications such as Ritalin.
FACT: It would be nice if this were true, but recent
scientific evidence from the multi-modal treatment trials sponsored by the
National Institute of Mental Health suggests it is a myth. In these studies,
stimulant medication alone was compared to stimulant medication plus a
multi-modal psychological and educational treatment, as treatments for children
with ADHD. The scientists found that the multi-modal treatment plus the
medication was not much better than the medication alone. Teachers and
therapists need to continue to do everything they can to help individuals with
ADHD, but we need to realize that if we don't also alter the biological factors
that affect ADHD, we won't see much change.
Myth #9: CH.A.D.D. is supported by drug companies, and along with
many professionals, are simply in this field to make a quick buck on ADHD.
FACT: Thousands of parents and professionals volunteer countless
hours daily to over 600 chapters of CH.A.D.D. around the U.S. and Canada on
behalf of individuals with ADHD. CH.A.D.D. is very open about disclosing any
contributions from drug companies. These contributions only support the
organization's national conference, which consists of a series of educational
presentations, 95% of which are on topics other than medications. None of the
local chapters receive any of this money. It is a disgrace to impugn the honesty
and efforts of all of these dedicated volunteers. CH.A.D.D. supports all known
effective treatments for ADHD, including medication, and takes positions against
unproven and costly remedies.
Myth #10: It is not possible to accurately diagnose ADD or ADHD in
children or adults.
FACT: Although scientists have not yet developed a single medical
test for diagnosing ADHD, clear-cut clinical diagnostic criteria have been
developed, researched, and refined over several decades. The current generally
accepted diagnostic criteria for ADHD are listed in the Diagnostic and
Statistical Manual of Mental Disorders (DSM-IV) published by the American
Psychiatric Association (1995). Using these criteria and multiple methods to
collect comprehensive information from multiple informants, ADHD can be reliably
diagnosed in children and adults.
Myth #11: Children outgrow ADD or ADHD.
FACT: ADHD is not found just in children. We have learned from a
number of excellent follow-up studies conducted over the past few decades that
ADHD often lasts a lifetime. Over 70% of children diagnosed as having ADHD will
continue to manifest the full clinical syndrome in adolescence, and 15-50% will
continue to manifest the full clinical syndrome in adulthood. If untreated,
individuals with ADHD may develop a variety of secondary problems as they move
through life, including depression, anxiety, substance abuse, academic failure,
vocational problems, marital discord, and emotional distress. If properly
treated, most individuals with ADHD live productive lives and cope reasonably
well with their symptoms.
Myth #12: Methylphenidate prescriptions in the U.S. have increased 600%.
FACT: The production quotas for methylphenidate increased 6-fold;
however that DEA production quota is a gross estimate based on a number of
factors, including FDA estimates of need, drug inventories at hand, EXPORTS, and
industry sales expectations. One cannot conclude that a 6-fold increase in
production quotas translates to a 6-fold increase in the use of methylphenidate
among U.S. children any more than one should conclude that Americans eat 6 times
more bread because U.S. wheat production increased 6-fold even though much of
the grain is stored for future use and export to countries that have no wheat
production. Further, of the approximately 3.5 million children who meet the
criteria for ADHD, only about 50% of them are diagnosed and have stimulant
medication included in their treatment plan. The estimated number of children
taking methylphenidate for ADD suggested in some media stories fails to note
that methylphenidate is also prescribed for adults who have ADHD, people with
narcolepsy, and geriatric patients who receive considerable benefit from it for
certain conditions associated with old age such as memory functioning. (see
Pediatrics, December 1996, Vol. 98, No. 6)