Battling ADHD disinformation

Posted: Oct 08, 2002 12:00 AM
Conservatives are sure it is a sign of parental laziness. Liberals are sure it is big business, in the form of drug companies, conspiring to ensnare large numbers of American children. Observers of no particular outlook are nonetheless likely to believe that ADHD is either a fraud or an invention. They are apt to believe this for several reasons: 1) because the media have consistently misrepresented the facts about the disorder, and 2) because so many trends of the past several decades make it seem implausible that ADHD just burst onto the scene. Why, reasonable people may ask, did this disorder suddenly explode just when parents were becoming less involved with their kids' lives, and when discipline and good order were abandoned by the schools? Isn't this "disease" just an excuse for medicating high spirits and boyish antics out of existence? Christina Hoff-Sommers, author of "The War Against Boys" initially thought so. But, a careful scholar, she looked into the matter and discovered that clear evidence from neurology and psychiatry show that the disorder is real, and that, untreated, quite serious. Nor is it new. It has been identified for decades and successfully treated with medications for more than 40 years. Anyone who has seen a parent unable to discipline a mouthy child in public is right to conclude that parental authority ain't what it used to be -- but wrong to suppose that ADHD is a myth. Admittedly, mental health experts don't help matters by changing the names of disorders. ADHD used to be called "hyperactivity" (and bipolar disorder used to be manic-depression, etc.). The name Attention Deficit Hyperactivity Disorder virtually invites ridicule. But hundreds of studies and years of clinical experience leave no room for doubt that the disease is real and measurable. The American Medical Association, the National Institutes of Mental Health, The American Academy of Pediatrics, the U.S. Surgeon General, the National Mental Health Association, the American Academy of Child and Adolescent Psychiatry, the American Psychological Association, and many other professional and scientific groups recognize ADHD's validity. Children with the disorder have significantly diminished capacity to regulate their conduct, control their impulses and concentrate on a single task. Many are socially inept because they lack the ability to understand subtle social cues. They may or may not be hyperactive (if not, they are called ADD), but in many cases they have associated problems -- typically language disorders and depression. The syndrome has a strong genetic component, and twin studies have shown that home environment makes no separate contribution to the incidence of the illness (though, obviously, the environment can aggravate or ameliorate the underlying disorder). Among the myths circulated by the press is the notion that medicating children with ADHD leads to drug abuse in adolescence. In fact, as a consortium of leading doctors and academics recently emphasized, the opposite is the case. Untreated, ADHD sufferers are more likely than the general public to abuse illegal drugs. Those who receive treatment are less likely to do so. Untreated, 50 percent to 70 percent of those with ADHD have few or no friends, 70 percent to 80 percent underperform at work, and 40 percent to 50 percent engage in antisocial activities. They are also significantly more likely than the average person to get pregnant while a teen-ager, drive dangerously and have multiple car accidents, drop out of school, and experience depression. (For more on media misrepresentations, see Medication, in concert with other therapies like behavior modification, can produce dramatic results. Though the drugs do not work for everyone, they do work -- at least to some extent -- for the vast majority. Social skills groups, which target the ADHD child's difficulties with peers and family members, have also produced encouraging outcomes. The idea of ADHD as a myth fits our suspicions about contemporary America -- excuse seeking, short-cut finding and irresponsibility. But on closer examination, it turns out that the myth is a myth.