Posted on 08/04/2006 12:18:12 PM PDT by Teflonic
Aug. 3, 2006 -- In contrast to claims that children are being overmedicated for attention-deficit/hyperactivity disorder (ADHD), a team of researchers at Washington University School of Medicine in St. Louis has found that a high percentage of kids with ADHD are not receiving treatment. In fact, almost half of the children who might benefit from ADHD drugs were not getting them.
"What we found was somewhat surprising," says Richard D. Todd, M.D., Ph.D., the Blanche F. Ittleson Professor of Psychiatry and professor of genetics. "Only about 58 percent of boys and about 45 percent of girls who had a diagnosis of full-scale ADHD got any medication at all."
Much has been written about the increasing number of children taking drugs for ADHD. One study found that the percentage of elementary school children taking medication for ADHD more than tripled, rising from 0.6 percent in 1975 to 3 percent by 1987. Another study reported that the number of adolescents taking ADHD drugs increased 2.5 fold between 1990 and 1995. And many reports have noted a rapid increase in the U.S. manufacture of the stimulant drug methylphenidate — usually sold under the brand names Ritalin or Concerta.
The researchers studied 1,610 twins between the ages of 7 and 17. Of those, 359 met full criteria for ADHD: 302 boys and 57 girls. The total number of boys in the sample was 1,006, and 604 girls were included.
"From a clinical point of view, this study affirms that for whatever reason, many children who could benefit from treatment are not receiving it," says first author Wendy Reich, Ph.D., research professor of psychiatry in the William Greenleaf Eliot Division of Child Psychiatry.
It's possible those children aren't being identified at schools or pediatrician's offices or that their parents are choosing not to put their children on stimulant medication, according to Reich.
"It may be that mental health professionals need to do a better job of explaining the risks and benefits of treatment," Todd says. "The vast majority of parents whose children were involved in this study reported that their kids improved with medication, and when used properly these drugs have been shown to be very safe."
Todd, who also is the chief of child psychiatry, says among the 1,251 kids in the study who did not have ADHD, some did take stimulant medications, but it was a very small percentage, only 3.6 percent of the boys and 2.6 percent of the girls.
He says, however, that in many cases, there's an understandable reason those children have sought treatment. The study found that most of the children without ADHD who took medication did have some symptoms of ADHD — some hyperactivity or problems with inattention — but not enough symptoms to meet formal diagnostic criteria as defined by the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-IV). The study also found that most of the kids who took medication without an ADHD diagnosis had a twin who did have the disorder.
"These children have what we might call subsyndromal, or mild, forms of ADHD, and they seemed to come from families where other children had full-blown ADHD," Todd explains. "We didn't find that children got these drugs because they had other problems, such as conduct disorder or a learning disability."
Reich says the eventual goal of studying twins is to learn what elements of ADHD are passed down in families. She says some aspects of the disorder are certainly genetic. Others may be related to environmental factors, and studying twins allows the researchers to tease out those influences. Todd says the hope is to identify genes that contribute to the disorder, or rather, the disorders.
"It's becoming clearer that ADHD is not a single problem but a group of disorders that have different causes but similar clinical expressions," he explains. "There also can be lots of reasons why you become diabetic or hypertensive. The end result is high blood sugar or elevated blood pressure, but how that happens can differ greatly from individual to individual. It's the same thing for ADHD."
Todd believes that as genes are identified, it may become possible to intervene in new ways — with psychotherapies, environmental interventions or medications that affect biological pathways that haven't yet been identified. But he says a potential stumbling block in the future, as now, will involve getting children into treatment.
"That's especially true for girls because for whatever reason, less than half of the girls who had ADHD in this sample ever received treatment," Todd says. "As genes are discovered and treatments developed, they won't be able to solve problems unless they are used."
I'd say over half the children with ADHD, do not have ADHD.
Discipline and challenge keeps the ADAHD diagnosis away. Schools and parent need to keep kids busy and challenged...
About 10 years ago, I knew several couples, who each had 10-11 year old boys.
Every one of those boys were on Ritalin.
One of the guys I work with was told his kid had to medicated to stay in school. They chose to home school him. He finished high school early and is now in college. Without drugs.
"They will never rest until ALL children are medicated into compliance. There was no such thing as ADHD 20 years ago and we all grew up just fine."
The researchers have no clue. They should try a couple of things.
1. Take all of the art down in the classrooms. Just put it up for parent/teacher conference. Getting rid of this one distraction alone will cure 90% of ADD kids.
2. Television. 500 channels and nothing on. Once my niece stopped channel surfing and went to one or two channels she liked her distractions went away.
3. Stop the ADD medication. My kid takes it because he is too distracted in school. He didn't take it this summer for camp and he was fine.
It is about focus and until schools understand that it is tough for a kid to focus on schoolwork while 100 other things are going on around him, this problem won't go away.
The person with ADHD may not be suitable for working in a white collar factory but their ability to jump from task-to-task is a real plus when trying to get a small business off the ground.
I'm not sure there was "no such thing" as ADHD 20 years ago. It just didn't matter as much. There were ample good jobs in manufacturing and agriculture and other manual trades which required only a marginal high school education, or even less. Kids (especially boys, who are the bulk of diagnosed ADHD cases) who couldn't concentrate on "book learning" simply stopped pursuing it by their late teens, and went into a steady job which neatly dovetailed with the classic ADHD ability to hyperfocus on repetitive physical tasks. But the world has gotten a lot more sophisticated, and unless we want to give up computers, the Internet, high tech medicine, etc., we need a much larger percentage of the population to achieve substantial levels of academic learning.
However, the assertion that something on the order of 20% of US children need to be on medication for ADHD is ludicrous. If there are really that many children who have the symptoms of ADHD, then the schools need to change their programs to better suit ADHD kids (this would tend to mean a return to "rote memorization" and "drills" and similar politically incorrect educational methods, which seemed to work fine for non-ADHD kids too, back in the "good old days").
There was no such thing as ADHD 20 years ago and we all grew up just fine.
But there was such a thing called "disciplining your children". Not so today...
Dittos to what you both said! We had recess in the morning, at lunchtime and in the afternoon, so we could run off any extra energy we had. That took care of any ADHD we might have had! Most days, our teacher would play games with us -- outside -- and we would go outside even in winter! The teachers and the principal also had the "board of education" to keep us in line. Oh, and we all ate peanut butter and jelly sandwiches for lunch and no one ever had a peanut allergy.
Well, since ADHD does not exist and was invented from whole cloth entirely to enrich the therapist class, who cares?
If your child comes to the attention of the authorities as one who might have ADHD and you decline to treat him, you could find the child being treated by the authorities, or that you would face a charge of child abuse.
Yet another reason to take your children out of government schools.
As a result, boys, who are by nature more difficult to control, become impossible to control in a classroom setting. They KNOW the teacher can't touch them, even to pull them off another student. So, they become uncontrollable. They're designated with a learning disability and drugged to near unconsciousness. When dealing with boys, once the options of touching them or making them do pushups and situps is removed, you will not control them without drugging them. This is aggravated by the fact that boys are playing against a stacked deck, and they know it. If the boy is successful, it's considered proof that the test is biased, and it is normed (the girls test is made easier until the results are equal). When the girls achieve equal results with the new "normed" tests, it's proof of "girls can do anything boys can do.
As far as having learning problems, BS. These kids can memorize dozens of football plays and execute them. They can do it in the middle of the third quarter after taking thirty hits, and playing offense, defense and special teams. They can memorize thirty dungeon levels in Quake or Doom type games. Although the Pokemon fad is over, did you ever check the complexity of those games? Boys mastered them, though, with no classes and nobody trying to force them into it.
"It just didn't matter as much. There were ample good jobs in manufacturing and agriculture and other manual trades which required only a marginal high school education, or even less."
Agreed. We need a strong system of apprenticeships in labor-intensive jobs for these kids. Switzerland has this system and it works great.
But we don't want a system for this created by gov't, either, it should be created by private industry. Problem is, unless it's something that the kids get school credit for the school administrators will scream because they lose money if those kids are pulled out of school early.
By 14 they both had been trained to control themselves and their attention span without need for drugs. They both can and do succeed well now in a classroom situation.
It took my time and effort and was a pain in the... well you get the picture, but they were my children and I wanted to give them a chance for success before I let anybody drug them to make it easier for some teacher who has to keep control of 30 kids. Of the 2, the one who has finished high school is now at Juilliard, something he would never have been able to accomplish had he been left in school on drugs.
Thats the cure for this mostly, non disease
My grandson (7) has been diagnosed with ADHD. In lieu of medication my son and dil have decided to pursue whether food preservatives and processed foods are the culprit.
After two weeks on natural foods the ADHD symptoms have abated. Now they are introducing foods one at a time to find what foods are the cause of the ADHD.
And 99% of kids being treated for ADHD probably don't really have it.
yup, let's just medicate/treat us all against every possible ill...;)
after all, just a couple of weeks ago we discovered the "Intermittent Explosive Disorder" and I believe I may have suffered from that once or twice in my years...:o
where is this BS coming from? why are people so blind and stupid that they can't see that this is all hogwash? discipline your kids. they'll learn eventually.
And kids used to go out and play and run.
Might have something to do with it as well....
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