Sep 20 2007

ADHD – behind the hype and myth are research and treatment

Posted by Lisa in Uncategorized

It’s ADHD Awareness Day again! Read and be more aware! (and if you have the time volunteer in your schools! I do – medieval, medieval, medieval!!) Myth: Attention-Deficit Hyperactivity Disorder isn’t a real medical disorder.

ADHD has been recognized as a legitimate medical diagnosis by major medical, psychological, and educational organizations; these include the National Institutes of Health, the U.S. Department of Education, and the American Psychiatric Society, which recognizes it as a medical disorder in its Diagnostic and Statistical Manual of Mental Disorders. It is biologically based, and research shows that it’s a result of an imbalance of chemical messengers, or neurotransmitters, within the brain.

The primary symptoms are inattention and impulsiveness, sometimes also combined with hyperactivity. Those with this diagnosis often have difficulty with many core aspects of daily life, including time management and organizational skills. My Emma is combined-type, that is she displays all of the aforementioned primary symptoms (in spades!). Like many other parents of ADHD children I know, after her diagnosis and education on the nature of the disorder I noticed the signs that allowed me to trace it to her paternal line – I know parents whose own ADHD was diagnosed only after their children and were relieved to learn the information that put their own experiences to date into clear perspective.

Myth: ADHD is a new diagnosis.

The symptoms that describe the disorder were published in the respected medical journal Lancet in 1902, first described by George Fredrick Still. Although the technical moniker has changed over the years, the disorder described has not.

Myth: The use of Ritalin is a fairly recent development.

Ritalin has been in use for over 45 years and Dexedrine was used for ten years before that. Something new, however, is delivery – in addition to tablets, there is long-active time-release, and even the same stimulant in a patch (marketed as Daytrana, which Emma is on now and which I am grateful for as the delivery method both circumvents her rocket-speed metabolism and leaves her system slowly enough that the stomach issues that led to poor appetite and mood swings are almost non existant). There are many other stimulant medications on the market, now, increasing the ability of pediatricians to best treat the individual needs of individual patients.

Myth: Children with ADHD eventually outgrow their condition.

On the contrary – more than 70 percent of the individuals who have ADHD in childhood continue to have it in adolescence and up to 50 percent will continue to have it in adulthood. Given the severity of Emma’s displayed symptoms I am fairly certain that she will continue to have struggles with the disorder into adulthood and may need to treat it with medication, in addition to other treatments, even then. Early diagnosis has been key for her in our striving to give her the best tools possible to succeed – estimates suggest that 6% of the adult population has ADHD and the majority of those adults remain undiagnosed (only one in four of those diagnosed seek treatment). Without help, adults with ADHD are highly vulnerable to depression; anxiety; substance abuse; career, legal and financial problems; and trouble in personal relationships — children left undiagnosed or diagnosed very late struggle with self-esteem issues, difficulties in social interaction (which can inlclude run-ins with authority in and out of the school setting), and overall poor educational foundations. Only through early diagnosis have we been able to work with both pediatrician and school system as well as we have to ensure Emma has what she needs both educationally and chemically to put her in the best position possible for learning and advancement.

Myth: ADHD affects only boys.

Girls are just as likely to have ADHD as are boys, and the gender of the child makes no difference in the symptoms caused by the disorder – because this is a persisting myth, however, boys are still more likely to be diagnosed than girls. Emma, obviously, is a girl with the disorder.

Myth: ADHD is the result of bad parenting.

This one always gets my riled, especially when I read it in conjunction with opinions of physicians in other countries to attempt to claim this it’s merely an American invention. Parenting these children is difficult, plenty difficult enough without the sort of stigma this myth bolsters. A child with ADHD has been taught that blurting things out in class, getting out of their seat, paying no attention to adults teaching, and letting their impulses for self-entertainment rule their behavior are wrong – the child cannot control these impulses and the issue is rooted in brain chemistry, not discipline. Overly strict parenting, like punishing a child for things s/he can’t control, can actually serve to make ADHD symptoms worse. Professional interventions: drug therapy, psychotherapy, and behavior modification therapy (in varying combinations) are often required. While I tend to lean toward strictness, we are aware of the time of day, timing of medication, and even what she’s eaten and the amount of sleep gotten – we, therefore, respond to Emma’s behavior accordingly.

Myth: People who have ADHD are stupid or lazy – they never amount to anything.

Recent studies show that people with ADHD are of above-average intelligence and certainly aren’t lazy. Many well-known, high-achieving individuals from the past are thought to have had the disorder, including Mozart, Benjamin Franklin, Abraham Lincoln, George Bernard Shaw, and Salvador Dali. There are high-achieving individuals with the disorder in business today (to consider merely one career area) including top executives David Neeleman, founder of JetBlue Airways, and Paul Orfalea, founder of Kinko’s. The high incidence of co-morbid learning disorders can compound the appearance of a student lacking in intelligence, and getting extra help for Emma’s LDs has been a particular focus for us from 1st-grade to present (4th grade).

Consider checking out these Expert Podcasts about ADHD.

(posted one day late, as for some reason I could post on the old version of my blog last night but not this)

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