A Closer Look At ADHD

Dr. Wendy Ghiora – Posting #79 – January 15, 2011

Three-quarters of ADHD Diagnoses are Wrong
Before you immediately accept a diagnosis of ADHD given your child, consider this. ABC News Online (Australia) reports that diagnoses labeling children as AD/HD are wrong up to 75% of the time. This discrepancy was discovered after careful examination of labeled students by a team specializing in ADHD. New studies published in the Journal of Health Economics suggest that nearly 1 million children are mistakenly diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). Todd Elder, Michigan State University Economist, would be in support of these findings. He suggests that about 900,000 children diagnosed with ADHD in the United States may not have the disorder at all. Often the suggestion of ADHD comes first from a school or daycare provider, and their completely subjective feedback can be instrumental in whether a pediatrician ultimately makes the diagnosis of ADHD and subsequently prescribes stimulant medication. ADHD is being treated as a “disease.”

Is ADHD Really a Disease “On The Rise?”
The article states, although 5% to 10% of American children are diagnosed with ADHD, other countries are not as quick to do so. For example, in England, well under one percent of children carry the diagnosis. In countries like France and Italy, many if not most doctors do not believe the condition exists. Are American children more hyperactive and distracted than those in other countries or is there something else going on?

Children are active, imaginative, and sometimes hyper individuals by nature. They are supposed to move around continuously, jump on things, often not listen to what they are told to do, and go off in their own world and daydream a little. If they weren’t doing those things then they wouldn’t be acting like normal kids. So why then, are children who are acting in normal child-like fashion, being quickly diagnosed as having ADHD? Why are doctors telling parents that to fight childhood obesity we need to keep our kids steadily active, and then almost in the same breath telling parents that something is wrong with their child if they happen to be overly active? What makes society want to put a label on children who are simply just being kids?

Follow The Money
The production of the stimulant medications Adderall and Dexedrine (commonly prescribed drugs for ADHD), has increased by 4,516% between 1993 and 2003. At the same time, the production of Ritalin has also increased by 375%. Drug companies spend 20 to 30 thousand dollars per American physician on things like junkets, free meals, trips, trainings, free samples, and cash rewards to high-prescribers. It is almost impossible to find a researcher who would advocate the use of stimulants for ADHD that is not on the drug company’s payroll.

In Understanding ADHD and the Creative Child, Colette Bouchez reports that ADHD students and gifted, creative children frequently share some traits. People who don’t understand intelligence and giftedness and creativity think that if you’re smart you ought to know how to behave, and if you don’t behave you’re not smart – or you have something wrong with you – but “that couldn’t be further from the truth,” says Minnesota child psychologist Deborah Ruff, PhD, National Gifted Children’s Coordinator for American Mensa and author of the book, Losing Our Minds: Gifted Children Left Behind. In addition, it is understandable that a gifted or intelligent child would be the one to finish the assignment early and then get in trouble out of boredom. Children probably are over diagnosed. If we look at the diagnosis cycle, we find that parents commonly get their first recommendation from their child’s teacher. The parent then takes the child to the family practitioner or their pediatrician where diagnosis is made in short order – twenty minutes of interview time. Pediatricians and family practitioners are typically not specialists in ADHD, but they wield the authority to prescribe medication. As for ADHD being a real “disease,” according to Dr. Ron Receveur, ADHD expert, ADHD remains merely a clinical diagnosis, meaning that there is no scientific test for ADHD only an interpretation of symptoms.

What’s A Parent To Do?
Parents should be slow to make a decisionon whether to medicate their child. Until recently, the most important question concerning Ritalin or amphetamine administration has not been asked. Do these drugs make a difference in the long-term outcome? A comprehensive examination of this subject carried out at the Montreal Children's Hospital discovered a startling fact. At the end of five years, hyperactive children who received Ritalin did not differ significantly from children who had not received. Although it appeared that hyperactive kids treated with Ritalin were initially more manageable, the degree of improvement and emotional adjustment was essentially identical at the end of five years to that seen in a group of kids who had received no medication at all.

There are side effects to the ADHD medications. If you’re still undecided about medicating your child, here are the side effects of the most commonly used medications (as listed in the Physician’s Desk Reference):

Common Side Effects
•Addiction
•Nervousness including agitation, anxiety and irritability
•Trouble sleeping (insomnia)
•Decreased appetite
•Headache
•Stomach ache
•Nausea
•Dizziness
•Heart palpitations

Other Serious Side Effects Include
-Slowing of growth (height and weight) in children
-Slowing of growth of body organs (including the brain)
-Seizures, mainly in patients with a history of seizures
-Eyesight changes or blurred vision

How Can I Help My Child Focus Better in School?
If you have an active child that has a challenge keeping focused during school, here are some suggestions that have proven to be of help. Research suggests that a good breakfast helps a child do better in school. For example, a 1998 study published in the Archives of Pediatrics & Adolescent Medicine, showed that children who ate breakfast regularly had higher reading and math scores, lower levels of depression, anxiety, and hyperactivity, better school attendance, improved attention spans, and fewer behavior problems.

For children with ADHD, the menu matters, too. In a 1983 study published in the Journal of Psychiatric Research, researchers at George Washington University tested three breakfast types (high-carbohydrate, high-protein, and no breakfast at all) on 39 children with ADHD and 44 kids without the condition. For the hyperactive children, performance on several tests, including a test for attention, was significantly worse with the high-carbohydrate breakfast, as compared with the scores of the children who ate the high-protein breakfast.

As a former school principal, I can testify that eating a breakfast high in protein resulted in a major improvement in children who previously had problems focusing during class time. I tested this and had great results. Believe me, I know, as a working parent, it’s much easier to let your kids just grab a bowl of cereal. However, giving them anything they like that has protein, such as eggs, bacon, peanut butter, string cheese, etc. will help them immensely. Why risk harmful side effects, especially when the effectiveness of the drugs are suspect? Spending the extra time to give your child a nutritious breakfast can help prepare them mentally and physically for a successful day at school.

“A child in the crowd calls out that the Emperor is wearing nothing at all and the cry is taken up by others. “