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Attention Deficit Hyperactivity Disorder

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Psychology XXX

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March 8, 00

Attention Deficit Hyperactivity Disorder

Treatment and Concerns

Attention Deficit Hyperactivity Disorder (ADHD) seems to be the affliction of this generation of children in the United States. It seems more prevalent every year. However, diagnosis criteria for ADHD is so subjective, what qualifies, who qualifies? There is no specific clinical cause for ADHD but it obviously exists. So many questions remain to be answered about ADHD. Are more children really being diagnosed with ADHD annually and is it really on the rise as it appears? Are too many children being wrongly diagnosed with ADHD as an easy way out because of other behavioral problems? And when ADHD is properly diagnosed are we overmedicating our children to make it easier for parents and teachers to cope? How often are other afflictions ignored in favor of ADHD because it's such a popular disorder in today's society? And probably most important of all, how adversely effected is a child's chances at a normal productive life because of ADHD. I believe given the current understanding of ADHD and available treatments, the medical community is doing a pretty good job as a whole diagnosing and treating ADHD while also attempting to break new ground and do even better.

First, on a personal note, my son was diagnosed with ADHD in 15, at the age of five. Therefore, ADHD is very dear to my heart. A typical problem for children with ADHD is just trying to make wise decisions. He acts on impulse without thinking of the consequences and of course quite often gets into trouble because of the resulting bad decisions. An ADHD child typically gets into trouble more than the average child does because of this failure to stop and think and foresee the outcome of his choices. Conversely, when he is blamed for something he knows that is not his fault he becomes frustrated and often gives up and quits trying to do the right thing altogether. Which of course multiplies the problem and causes others. We as adults must understand this detrimental impact in handling our children. There are so many ways to redirect that attention to try to help our children avoid those pitfalls. "…understanding parents and teachers who provide successful experiences and encouragement and avoid excessive criticism, bolstering self-confidence and leading to a healthy social and emotional development." (Millichap 000)

Second, are too many children being diagnosed with ADHD? Are we over-treating out of convenience? The earliest studies conducted in the 60's and 70's before specific testing criteria was established placed the percentage of children diagnosed with ADHD at 5%-10%. In numerous current studies with more reliable testing media the amount of children diagnosed with ADHD in the United States varies by study between 4% and 1%. Therefore the amount of children afflicted with ADHD is virtually unchanged in the last thirty years. So apparently ADHD is not on the rise as expected, just more people are becoming aware of it and it's becoming more acceptable.

Third, in a study by the Mayo Clinic, which has almost exclusive access and control of the medical records and treatments for the children of Rochester Minnesota, over-treatment did not appear to be a significant problem either. Specifically their study was to determine if too many children were treated with stimulants to help control their ADHD. Their study showed that 7% of the children in their study diagnosed with ADHD were currently being treated with stimulants. Only 6.1% of those treated were judged by the study to be over-treated and that actually a higher percentage (not given) were actually under treated.

Fourth, like all medical fields, there is slow gradual progress in the diagnosis and treatment of ADHD. Dr. Jeffrey Bradstreet, a Psychiatrist from Melbourne Florida, is pioneering a promising new treatment utilizing neuro-feedback in the treatment of ADHD and other brain disorders. Dr. Bradstreet just received approval from the Osceola County School Board to initiate his program where he maps an individual's brain by electroencephalogram (EEG) and then utilizes the results to help individuals help themselves to better utilize their brain functions more effectively. The EEG results are used to determine where sensors will be attached, to earlobes, or even hair to transmit thoughts through a transducer. The patient then must complete "tasks" by thought utilizing the appropriate brainwaves depending on the individual goal or disorder of that subject. It is a procedure than can help anyone, not just people with brain disorders. Dr. Bradstreet's own son who is Autistic, with the help of this treatment, has been able to stay current and progress at a normal rate in school. This new treatment can be used for ADHD, downs syndrome patients and even stroke victims. Jeanette Eddy, Osceola County Schools District Counselor and Stetson University Professor, volunteered as a test subject to prove the treatment is not only safe for the children in her school district, but that individuals with otherwise "normal" brain function could also benefit from this treatment. Ms. Eddy (personal communication, March 0, 00) "I'm excited that we have technology out there that is completely safe and can help anyone, not just individuals with psychological problems, but anyone to increase brain function." This is an exciting advancement in the treatment of ADHD and shows tremendous promise in the treatment of ADHD and other afflictions.

However, ADHD, diagnosis and treatment are so subjective that for now, establishing baselines for both and the efficacy of stimulant medication is impossible. For instance, in another study evidence shows a continuous increase in the use of both stimulant medications and selective serotonin reuptake inhibitors (SSRI's). Therefore over-treatment is supported by this study (Rushton and Whitmire 001). However they admit that inadequate information about the simultaneous combination of both medications exists and further studies are needed. This supports the underlying problem. Advocates of over treatment and under treatment can simply point to the study that supports their individual opinions and the debate will rage on.

In conclusion, I think we have merely scratched the surface in the treatment of ADHD. There will continue to be doctors who over prescribe, under prescribe or ones who are truly leaders in their field and will gradually break new ground or find new treatments like Dr. Bradstreet. We will always have people with psychological disorders. Like any number of medical problems, we can only use our God given intelligence to seek out cures and treatments and ultimately causes in the hopes of a better tomorrow for all. Considering the complexity of the human brain and our understanding of it, I feel tremendous progress has been made in the treatment of ADHD. For my son's sake, I hope the future is indeed bright with promise.

References

Barbaresi, W., Kautusic, S. & Pandratz V. (00), How common is attention-deficit/hyperactivity disorder? Incidenece in a population-based birth cohort in Rochester, Minn., Arch Pediatr Adolesc Med/Vol.156, 17-4.

Barkley, R., (10). Attention deficit hyperactivity disorder. A handbook for diagnosis and treatment. New York.

Greenhill, L. (00). Early Diagnosis and Treatment of ADHD Key to Success. Safety and efficacy of commonly-used treatment needs more study in very young patients. [Electronic Version]. American Medical Association.

McMahon, H.G., Paisley, P. (001). School counseling for the 1st Century Challenges and Opportunities. American School Counseling Association. 5 () 106-115.

Millichap, J.G. (000). Attention Deficit Hyperactivity and Learning Disorders. [Electronic Version]. American Medical Association. Arch Pediatr Adolesc Med/Vol. 154, 5-5.

Rushton, J., Whitmore, J. (001). Pediatric stimulant and selective serotonin reuptake inhibitor prescription trends 1 to 18. Arch Pediatr Adolesc Med/Vol. 155, 560-565.

Schwiebert, V., Sealander, K., & Dennison, J. (00). Journal of Counseling Development. Strategies for Counselors Working With High School Students with Attention Deficit/Hyperactivity Disorder. 80 (1) -10.

Wender, E. (00). Attention-Deficit/Hyperactivity Disorder Is It Common? Is It Overtreated? [Electronic Version]. American Medical Association. Arch Pediatr Adolesc Med/Vol. 156, 0-10.

Wolraich, M. (001). Increased Psychotropic Medication Use. Are We Improving Mental health Care of Drugging Our Kids? [Electronic Version]. American Medical Association. Arch Pediatr Adolesc Med/Vol. 155, 545.

Wozniak, J. (00). Pediatric Bipolar Disorder often Lost Among Comorbid Conditions. Porper diagnosis allows for effective intervention. [Electronic Version]. American Medial Association.

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