Neal Boortz: "ADD does not exist!"

[Steve]

There are a fair few psychiatrists and educators etc who don't believe that ADD and ADHD are discrete biological diseases but merely a function of a somewhat arbirary definition and diagnoses. Certainly people are successfully treated using exactly the same methods as used on simply badly behaved kids.

It is rather odd how it seemed to crop up in the USA - a country with a culture of MTV and videogames, no exercise and a me-me-me philosophy. And then it spread to the most US influenced European countries first. And odd that so many people seem to have it at a time when juvenille behaviour is at it's worst. Convenient that it removes responsibility from a generation of parents who don't want any.

People who have kids diagnosed with ADD really want to believe it too so are highly insulted by any suggestion it's not biological.

If it isn't a real, discrete disease then it would have been invented anyway IMO.

I am not convinced by the evidence that it is a specific disease.

It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect .

I have read this post several times but I cannot seem to grasp your point. Care to summarize for me?

 

[athon]

There are a fair few psychiatrists and educators etc who don't believe that ADD and ADHD are discrete biological diseases but merely a function of a somewhat arbirary definition and diagnoses. Certainly people are successfully treated using exactly the same methods as used on simply badly behaved kids.

First of all, welcome to the forum. Always happy to have more people at this party.

The question here is 'can we distinguish between a learned behaviour pattern and a significant underlying biological influence?' The answer is yes, we can.

Of course we are all subject to underlying biological influences. All emotions, compulsions, tendencies etc. have some sort of a neurological and/or endocrinological influence. How we deal with these in terms of behaviour varies with the environment in which we learn. So I'm not surprised that learned behaviour and behaviour that is highly influenced by 'ASD' biology could both be remedied with identical methods, such as changing environments or by teaching coping skills.

It is rather odd how it seemed to crop up in the USA - a country with a culture of MTV and videogames, no exercise and a me-me-me philosophy. And then it spread to the most US influenced European countries first. And odd that so many people seem to have it at a time when juvenille behaviour is at it's worst. Convenient that it removes responsibility from a generation of parents who don't want any.

Hmm, a bit of the 'glory age' rose-coloured glasses approach, I'm afraid. Juvenile behaviour is not necessarily any worse than before. I agree that there are comparitively different problems now, and that some cycles of behaviour might have continued, but kids are no worse now than they were before. I challenge you to support your case to contrary.

We are now a society more aware. However, awareness has a cost; we have access to more information now than ever before, and that information may or may not be good. People lack the skills to be able to discern the relevance or the value of what they are being told. Therefore, what was once a 'bad child' now is seen as being an 'ASD' child. A hundred years ago, the understanding that biology influenced behaviour on a variety of levels was basic in the least.

The thing is, what do we do with the information? I agree that a lot of people use it as an excuse. These people do not understand the significance of biologically influenced behaviour, that as humans we have the option to adapt and take responsibility.

People who have kids diagnosed with ADD really want to believe it too so are highly insulted by any suggestion it's not biological.

If it isn't a real, discrete disease then it would have been invented anyway IMO.

I'm not sure I understand what you mean. Can you clarify?

I am not convinced by the evidence that it is a specific disease.

It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect .

Hmm, again I'm a little lost. Are you saying that a variation in biochemistry can't be considered a disease?

See my definition of disease in my above post. Indeed, the problem is not with this definition, but with how to define 'normal'. All things we see as 'diseases' are simply variances in function. What's one man's genetic disease is another man's genetic trait. Change the environment, and the disease becomes something of an advantage (see sickle cell anaemia vs. malaria). Bacteria can be seen in a similar fashion (salmonella is actually normal GI microflora in fish and foul).

Our issue lies with our understanding of what constitutes a disease. True, we can't see it in a simple 'black and white' picture. But dimissing it because it doesn't fit is even more foolish.

Athon

 

[Steve]

Athon,
You appear to have understood a lot of what I did not understand in Splossy's post Your responses have made Splossy's comments somewhat clearer to me - thanks. I would still be interested in a clarification from Splossy

 

[Eos of the Eons]

Okay,

We have ADHD/ADD associated with:
ASD
Tourette's Syndrome
FAS


And some people would deny that there is some underlying physical cause? These kids undeniably have different brains from the "norm".

Not all kids with any of the above diagnoses have ADD/ADHD, so it is then the parenting??

Not all kids with ADHD/ADD have any of the above diagnoses, so blame parenting? If it were just the parenting, then the drugs that actuallly help these kids would have no effect.

These are very complicated cases. Ritalin actually makes my son's other problems and his ADHD symptoms worse. He doesn't have just ADHD, he has Tourettes. You can't use the same interventions as you would for those with "just" ADHD/ADD. My son was not able to take anything to help with his ADHD symptoms. He does take an antipsychotic (very low dose, a low dose would not help with other disorders that are helped by antipsychotics) and an antidepressant. This is a normal course of action for those with Tourettes.

We learned parenting techniques to address his specific needs and worked with the schools for strategies to address what he needed to get the most out of a school setting. There was never anything chemically given to address my son's hyperness or tics. The meds may have helped him be that much less distractible (and evened out some moods) they certainly brought him "down to earth" so that he could focus more on what was being said to him. They just gave that "edge" needed to help the rest of interventions sink in and help him out. We still had a very hyper aggressive and prone to anger kid, but less so. It was like getting a fire under control so it could be directed.

Kids I've seen that get Ritalin aren't turned into zombies. One boy's mother wanted to take him off the meds on weekends and holidays, but the boy wanted to take them 100% of the time because he finally started to make some friends. Things didn't "bug" him so much. He could stand to read a book. He liked feeling in control.

I've yet to see a careless case where a child is zombified. If the kid is zombified, then maybe the dose needs to be looked at, or maybe the kid doesn't even have ADD. I'd like to see these zombified kids!!

I would like to ask those people out there that would blame parenting...what kind of parenting makes a kid get ADHD/ADD?? If it IS parenting, then why don't all the siblings then turn out the same?


Truth is, only 3 - 5 % of the population has ADD. We aren't seeing high numbers of misdiagnosed children carelessly chucked on medications. This is a myth.

ADHD was first described in 1902. Ritalin has been in use since 1955.

http://www.holysmoke.org/cos/ritalin.htm


There is a big stink NOW about this now rather old news? Why? Is it because so many kids are zombified? Is it because parents are just looking for a "quick fix"?? NO.

I would look at who's making these ridiculous claims and why. Humour me.

ADHD occurs in 3-5% of school age children. ADHD must begin before the age of seven and it can continue into adulthood. ADHD runs in families with about 25% of biological parents also having this medical condition.

http://www.aacap.org/publications/factsfam/noattent.htm

There is no epidemic, and this isn't a "new" diagnosis. Parenting can either help or exacerbate it. Parenting won't cause it. From the time my child was a toddler I tried various techniques to try to help him. It wasn't until he was "labelled" that I could access better services. These "labels" are a tool, not an excuse.

Help parents, don't don't dismiss or blame them. It takes a village.

research has shown some differences between the brain functioning of individuals with AD/HD and that of normal subjects. Individuals with brain injury to the frontal lobes of the brain may show attention problems similar to those of AD/HD adults.

A study done at NIMH showed that boys with AD/HD had a smaller prefrontal cortex, (part of the brain just behind the eyes and forehead) caudate nucleus and globus pallidus. The latter two structures are located deeper in the brain. Xavier Castellanos, M.D. compared the prefrontal cortex to the brain’s steering wheel with the caudate nucleus and the globus pallidus as the accelerator and the brakes. (2) These size differences are just averages. One cannot use a brain scan to diagnose AD/HD.

Other differences in brain activity and function have been found. It is believed that the transmission of dopamine and norepinephrine in the circuits between the frontal cortex and deeper brain structures play an important role in AD/HD.

http://www.baltimorepsych.com/Stimulants.htm

We're talking ADD, not Tourettes, so I'm trying to focus on that. The ignorance spills over to other disorders like Tourettes, ASD, and FAS where there is a hyper & distractible child though. Awareness for all these children would be a help.

For ADD though, I would encourage more awareness. It's the most talked about for some darn reason.

 

[Beth]

Hmm, again I'm a little lost. Are you saying that a variation in biochemistry can't be considered a disease?

What I took Splossy to mean by "It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect ." is that the change in neurochemistry might be considered an effect of what we call "depression" not a cause of it.

This is a legimate question in regards to the cause/treatment of mental illnesses. There does appear to be a tendancy to presume that if a consistent difference in found in brains of affected individuals that the difference is the cause of rather than the effect of the illness.

Personally I suspect that it might well be a result of a bad feedback cycle. Being depressed (having some imbalance of neurochemicals) leads to behaviors (ie.e sitting around moping, feeling bad about yourself, etc.)which lead to being more depressed (further imbalance in neurochemicals) which leads to further depressed behaviors, etc.

I don't know, I'm no expert, but it seems reasonable and plausible to me. If true, it would imply that either medication (changing the brain chemistry and thus affecting behavior) or behavor modification (changing behavior and thus modifing the brain chemistry) should work to improve the condition. This seems to be the case for at least some forms of depression.

Beth

 

[athon]

What I took Splossy to mean by "It's like depression. Nobody makes bad decisions or tries to hold together conflicting beliefs. They are not slothful or misanthropic - they are CHEMICALLY depressed. Hey, we can prove it because they have less serotonin. Well, prove it if we ignore any question of cause and effect ." is that the change in neurochemistry might be considered an effect of what we call "depression" not a cause of it.

Ok. I'll comment on this view of it, keeping in mind the fact that Splossy hasn't verified whether this was what was meant.

I agree that a correlation does not indicate cause and effect. However, in relation to studies in the field of neurochemistry, we can fairly safely conclude that a number of biochemicals have an influence on behaviour. Cortisol, for example, is released as an effect of stress. By artificially adding cortisol, the effects of a stressed situation can be replicated.

Depression is similar. Serotonin blockers (one of the neurotransmitters involved) can be administered to replicate depressive states. My knowledge in this area is limited (slept through a lot of my neurophys' lectures...hehe), so I'd have to look up exact examples.

This is a legimate question in regards to the cause/treatment of mental illnesses. There does appear to be a tendancy to presume that if a consistent difference in found in brains of affected individuals that the difference is the cause of rather than the effect of the illness.

It's often a safe assumption to make initially, but does need to be supported by additional evidence. The problem faced in pharmacological research is more to do with the knock on effects of these chemicals, rather than sorting whether they are directly responsible.

Personally I suspect that it might well be a result of a bad feedback cycle. Being depressed (having some imbalance of neurochemicals) leads to behaviors (ie.e sitting around moping, feeling bad about yourself, etc.)which lead to being more depressed (further imbalance in neurochemicals) which leads to further depressed behaviors, etc.

You base this on what, exactly? I have a vague sense that you are almost insinuating some sort of metaphysical origin to the original feeling. For example, in a given situation, your brain will respond to a stimulus or a range of stimuli through producing various neurotransmitters in localised areas. Severe clinical depression (which is what we are talking about, and is defined as recurrent bouts of depression that last for long periods of time, nominally about two weeks), is not 'normal' behaviour. It appears that people who suffer this have - for whatever reason - a bias in those chemicals normally responsible for such behaviour.

There's no great cause and effect confusion here.

I don't know, I'm no expert, but it seems reasonable and plausible to me. If true, it would imply that either medication (changing the brain chemistry and thus affecting behavior) or behavor modification (changing behavior and thus modifing the brain chemistry) should work to improve the condition. This seems to be the case for at least some forms of depression.

Beth

Thanks for the opinion. Having had a rather personal experience with clinical depression, my opinion is that modifying behaviour and environment is preferential to using drugs for long term benefit. However, I can also see the benefit to short term use of pharmaceuticals for some people.

Athon

 

[Beth]

I agree that a correlation does not indicate cause and effect. However, in relation to studies in the field of neurochemistry, we can fairly safely conclude that a number of biochemicals have an influence on behaviour.

I don't think there's any disagreement on that. Certain chemicals can certainly affect behavior.

You base this on what, exactly?

Personal experiences and things I've learned from diverse and mostly forgotten sources. I can never remember where I read some snippit or who wrote it. You may ignore my opinion if you like, it's not an area of expertise for me. This is just my current best assessment. It's also likely to change as I learn more.

I have a vague sense that you are almost insinuating some sort of metaphysical origin to the original feeling. For example, in a given situation, your brain will respond to a stimulus or a range of stimuli through producing various neurotransmitters in localised areas. Severe clinical depression (which is what we are talking about, and is defined as recurrent bouts of depression that last for long periods of time, nominally about two weeks), is not 'normal' behaviour. It appears that people who suffer this have - for whatever reason - a bias in those chemicals normally responsible for such behaviour. There's no great cause and effect confusion here.

No, nothing metaphysical being insinuated. And I don't know that I would term the cause and effect relationship confused, but I don't think it's as well understood as many people assume it to be. People have experiences and react to them. In addition they have certain genetic predispositions in the form of biases in brain chemicals as you put it. But people also make choices in how they respond to various situations and those choices can create environmental situations that can then either help them change their current situation or become more entrenched in it. I don't think this is an area of clear cause and effect channels, but rather a meshing of environmental and physical factors combined with personal choices.

Thanks for the opinion. Having had a rather personal experience with clinical depression, my opinion is that modifying behaviour and environment is preferential to using drugs for long term benefit. However, I can also see the benefit to short term use of pharmaceuticals for some people.

We are in complete agreement here!

Beth

 

[Z]

Well, all I can offer is anecdotal evidence - first hand.

I was - and still am - ADHD. I actually have real, documented problems staying focused for any length of time. I forget things on a regular basis, and bore easily.

Like right now - in order to post logically and sanely on JREF, I am using my browser (Opera), downloading videos, listening to music, playing Spider Solitaire, and enjoying a pipe. Oh, and drinking coffee, watching the kids, and digesting a yummy dinner of Rotini.

My third son - the six year old - has a form of ADD. The doctors have been extremely reluctant to pin a label on it, as his behavior is unusual, even for ADD children. Medication was not advised; instead, his diet is carefully monitored (he has specific and documented sensitivity to various food dyes), and his behavior is carefully controlled. He is homeschooled, in part because his abilities are so unbalanced; he's technically a first-grader, but doing third grade math and second grade language arts, while struggling with music.

My other children are all fairly normal, so far. Not one exhibits the same ADD-related behavior that he does.

He wasn't raised on television; we don't have cable, there are no broadcast channels here, and no satellite. He's limited to one or two movies per day, which he also rarely bothers with. We have no Playstation or Gamecubes, Gameboys, or other game systems. He does have a computer, on which is loaded educational software like Reader Rabbit, and a few games - Hot Wheels and Lego titles, mostly - which he also rarely plays.

I've heard people claim his behavior is the result of too much short-attention-span entertainment, like TV or games. They are much taken aback when I tell them these things do not exist in our home.

No, I'd have to stand by the theory that ADD is, in some cases, an actual genetic problem. No other hypothesis fits with the observable data in my son's case, nor in mine.

That being said, I do think that it's over-diagnosed and used way too often as an excuse for rotten behavior. My son doesn't get away with anything because of ADD. He's disciplined regularly for being too wild, for misbehaving, for not doing his work. Rarely a day goes by when he doesn't spend at least an hour, total, in time-out, isn't grounded from something, and hasn't been lectured at least three times.

On the plus side, his siblings are learning to behave by example. They don't want what he goes through! lol

 

[NeilC]

What I meant was:

1. Cause and effect are difficult to deal with in brain chemistry. What might appear to be the cause of a problem can be the symptom. Depression is a good example. People are told they have a chemical depression because they have low serotonin levels but in many cases that might be a symptom of their depression which is actually caused by their life.

2. Many medical folk argue that once you define an entity such as ADD you will start to find people with it. You are grouping symptoms and labelling them. It is possible that you are doing this somewhat arbitarily. It's like saying that a cold is defined not in terms of it's viral cause but it's symptoms - you will catch a lot of people with hayfever using that diagnostic process. Obviously it's a lot more complicated than that with ADD.

On the news today was a report from a world expert in Dyslexia who states that after decades of research he cannot even be confident that it actually exists as a discrete brain disorder. Check it out: http://news.bbc.co.uk/1/hi/education/4205932.stm - as you will see from dyslexia NGOs - there is a violent reaction to any such question being raised.

Similar things happened with schizophrenia - little was known of the actual cause and the term was really nothing more than a description of symptoms. This has been looked into and now lots of people who would previously have been told they are schizophrenic are not.

3. My point about parents was this - many of them want to believe there is a simple biological cause for their child's problems. So diagnoses are accepted readily and an army of people are formed all backing up the concept. This makes rational discussion on the subject difficult.

4. My point about how it arose in the USA was this: The USA is famous for it's overdose of media requiring little or attention. Their children spend a hell of a lot of time in front of MTV and vid games etc. These have been shown tpotentially lower people's ability to concentrate and cause behavioural problems, as have poor diet and lack of exercise - all these things are problems on the rise. Some researchers believe that THESE are the reasons for the symptoms.

I also find it odd how the disease seems to have exploded in the USA but is totally unknown in other countries. There are explanations for this but it makes me suspicious that the way of life and tendency to medicalise everything might be important in this issue.

Sorry it wasn't clear before. More sorry it if isn't now!

A couple of quotes from people involved in the US health system who make similar points, but probably better than I do:

"Tom DeWeese of the American Policy Center contends that Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) are "frauds. There is no scientific evidence whatsoever to prove either exists. Yet today," he notes, "almost seven million children have been diagnosed as having ADD or ADHD. And most have been placed on a behavior-altering drug called Ritalin, which is supposed to be the miracle answer to a nonexistent problem...... DeWeese emphasizes that "there has never been issued a single peer-reviewed scientific paper officially claiming to prove that ADD or ADHD exists"

"Interview with California neurologist Fred A. Baughman Jr:

Interviewer: You've spent 35 years in private practice as an adult and child neurologist, diagnosing real diseases. What spurred your interest in the ADHD diagnosis?

Baughman: Through the 1970s and 1980s the ADHD "epidemic" began to impact all of us, and the numbers of children being referred to me were increasing dramatically. I'd examine these kids to determine whether they did or did not have real diseases. After giving them thorough examinations, doing such tests as I deemed were necessary, I couldn't find anything wrong with them.

I was becoming more and more aware that something was afoot from the tone with which the diagnoses were being made in schools and by psychiatrists who were part of the school team. And never mind that I could find no scientific basis for the diagnosis. But here were pediatricians and school psychiatrists practicing mental health in ways that did not make sense. Principals and teachers would threaten that if I didn't diagnose ADHD they'd find someone who would. As a neurologist, I'm in the business of diagnosing real diseases, so this attitude on the part of people who should know better was very disturbing."



I am suggesting that the case for it's existence as a genuine disease is far from being proven. So I am currently skeptical about it.

 

[athon]

What I meant was:

1. Cause and effect are difficult to deal with in brain chemistry. What might appear to be the cause of a problem can be the symptom. Depression is a good example. People are told they have a chemical depression because they have low serotonin levels but in many cases that might be a symptom of their depression which is actually caused by their life.

Thanks for the clarification.

I think the problem lies in your definition of 'depression'. Depression, in common vernacular, is simply when we feel a sense of sadness resulting from a particular event that extends for a small period of time. Clinical depression is divided into three categories; mild, moderate and severe. Mild depression is what everybody gets from time to time, and is denoted by the fact that it rarely lasts longer than a day or two and is typically linked with a particular event or environment.

Moderate lasts up to a week and is typically recurrent. It may or may not be related to a particular event, but environment will often be the cause. Severe depression is persistent, lasts up to and beyond two weeks at a time and is not necessarily related to an event or circumstance.

While I understand your 'cause and effect' query, I might be able to help clarify it a bit. Behaviour within an environment can indeed often be the stimulus, especially in mild and moderate cases of depression. However, it is considered a normal response for people to lose this sense of depression once they are removed from the stimulus. The rate at which this is lost varies, but for some the continued depressed state impacts their normal functioning. The sensation itself is caused by the variance in biochemistry, which may have either been brought on by a behaviour or by an original increase in the neurochemicals to begin with. In addition, other blockers and neurotransmitters responsible for returning the body to a 'normal' state (homeostatic mechanisms) are often inadequate in people suffering from depression. Therefore, the problem is less the cause of the depression itself, and more the persistance of it.

2. Many medical folk argue that once you define an entity such as ADD you will start to find people with it. You are grouping symptoms and labelling them. It is possible that you are doing this somewhat arbitarily. It's like saying that a cold is defined not in terms of it's viral cause but it's symptoms - you will catch a lot of people with hayfever using that diagnostic process. Obviously it's a lot more complicated than that with ADD.

Be careful about the vague appeal to authority. If you specifically state 'people say' you might want to back it up with some sort of evidence.

ASD at this point has few non-behavioural markers, making it hard to test in a lab. This makes it extremely difficult to diagnose and does rely heavily on speculative observation of a subject. But look at it this way;

ASD is defined by a set of behaviours. I'm a teacher and have a great diversity of learning abilities and social behaviours in my class. I find it useful to be able to predict to a certain extent how my class will interact, what activities I should set for them and where I should aim the lesson. For instance, should I have a few large, focussed activities or many small, fast-paced ones? If I am aware of students who have ADD or Aspergers or mild Autism, to give them additional assistance it's like knowing if a child comes from another country and speaks little English, or if a child is gifted, or if a child has diabetes and needs to be monitored for BSL.

I guess it's a bit like saying 'this child is scratching; you say it's chicken pox, I say it's only hives'. Concerning some applications of ASD diagnosis, it doesn't matter: the child is evidentally itchy and needs assistance.

As for the root cause (and using again the above analogy), dismissing a disease simply because it's hard to distinguish borderlines of behaviour is like saying 'there's no such thing as chicken pox because it looks a lot like hives'.

On the news today was a report from a world expert in Dyslexia who states that after decades of research he cannot even be confident that it actually exists as a discrete brain disorder. Check it out: http://news.bbc.co.uk/1/hi/education/4205932.stm - as you will see from dyslexia NGOs - there is a violent reaction to any such question being raised.

Of course there'd be a reaction, because stupid people interpret such things as 'there's no obvious, single cause, therefore it doesn't exist'. Dyslexic behaviour is very real. Tying it to a discrete, single neurological variation might well be difficult to do. However dyslexic people have a variation in behaviour that is consistent between individuals. The application is that I, as a teacher, would like to be able to anticipate this behaviour and offer assistance.

Similar things happened with schizophrenia - little was known of the actual cause and the term was really nothing more than a description of symptoms. This has been looked into and now lots of people who would previously have been told they are schizophrenic are not.

What is your point exactly? That as diagnostic analysis becomes more refined, we can distinguish behaviours into categories with more precision? Of course. Or that as diagnostic analysis becomes more refined, we're going to find that some people just don't exhibit the behaviours that led to the original conclusion?

Autism used to be just that; a single disorder called autism denoted by extreme disfunctional behaviour. Now it has been extended into a family of similar behaviours called 'Autism Spectrum Disorder'. Thus categories change accoriding to our understanding. I'm sure most of my behaviours could be classified into conditions (or traits) which are in part learned and in part biological, which are similar to a number of people. But classifying these has little benefit for others to anticipate my behaviour; none of my 'conditions' are disorders or diseases, as they do not impede my normal functioning.

3. My point about parents was this - many of them want to believe there is a simple biological cause for their child's problems. So diagnoses are accepted readily and an army of people are formed all backing up the concept. This makes rational discussion on the subject difficult.

It does make it difficult to discuss, but this is a problem with education of people and not with the diagnostic field itself. I've got kids who often say 'it's not my fault, I've got ADD'. Again, this is a fault with understanding how to deal with the diagnosis and not with the diagnosis itself.

One day we might refine ASD diagnostics and find that a lot of children who are labelled ASD don't share a certain characteristic (e.g. a chemical basis), and that it is more of a learned behaviour. Their behaviour still exists, only now we have classified it better as technology advances.

4. My point about how it arose in the USA was this: The USA is famous for it's overdose of media requiring little or attention. Their children spend a hell of a lot of time in front of MTV and vid games etc. These have been shown tpotentially lower people's ability to concentrate and cause behavioural problems, as have poor diet and lack of exercise - all these things are problems on the rise. Some researchers believe that THESE are the reasons for the symptoms.

Indeed, a few researchers have argued alternative causes. And these should be taken seriously. But be mindful of what you're arguing there. I'm all for looking for root causes of ASD, and at no point did I say it had to be genetic. Environmental causes might be significant to the disorder. And there is evidence that additives in various foods alter developmental behaviour, not to mention the environment a child is raised it will of course do the same.

But again, how does this dismiss the existence of ASD?

I also find it odd how the disease seems to have exploded in the USA but is totally unknown in other countries. There are explanations for this but it makes me suspicious that the way of life and tendency to medicalise everything might be important in this issue.

Please, support this argument. I've lived and taught in both the UK and Australia, and the incidence of ASD has increased in both. This is nominally because of refined diagnostic methods and changes to classification schemes, and increased awareness in the public, so before children who exhibited a set of behaviours were simply 'bad'. Now, the subjective label has been exchanged for one that attempts to be objective. Yes, the child misbehaves, but why? And more importantly, how can this be addressed?

Sorry it wasn't clear before. More sorry it if isn't now!

Much. Thank you.

A couple of quotes from people involved in the US health system who make similar points, but probably better than I do:

Being skeptical is a good thing, but be mindful of how you're defining your terms so the issue doesn't get confused.

Athon

 

[Kiless]

Bugger. Athon beat me to the punch, but his response is better than what I was formulating anyway.

Certainly this statement:
"I also find it odd how the disease seems to have exploded in the USA but is totally unknown in other countries. There are explanations for this but it makes me suspicious that the way of life and tendency to medicalise everything might be important in this issue."
... has already been rebutted - you have a Canadian and two Australians (both teachers, one who has been working for some time in the UK) who have experienced this 'totally unknown' condition and have expressed such in this thread. Certainly, I've undergone PD and done a unit for my studies that focused on it as a part of basic teacher training.

 

[NeilC]

I must say I don't see how any of that assuages the concern that this might merely be an artificial construct created by a combination of over zealous psychologists immersed in their own culture, attention-damaging youth behaviour, some bad parenting, a desire to medicalise and remove personal responsibility plus some drugs company influence.

It might be a useful label to some but I see little real evidence that it has a single cause or even an exact and reliable symtomology. I can also see how such medicalisation could be a disasterous thing for many people.

You ask how does this negate the existence of ADHD. How can anyone negate the existence of an arbitary definition? The question is how useful and is that label and what does it actually mean.

If I am right, then saying someone "has" ADHD is somewhat lacking in meaning. You might also say that they have trouble concentrating, or are badly behaved or any number of other things.

I might label people who get angry a lot as having Anger Control Disorder (ACD). Some can be treated with tranquilisers. This supposedly proves there is a chemical reason for their behaviour. People with angry kids can now tell people their kids are not nasty but have ACD. They can't control it - it's a disease. And when we start applying this definition to the nation we find that we have been ignoring millions of other kids with this disease. They all need treatment. It rings bells with adults too - NOW they know why they kept hitting people when growing up.

Why not go the whole hog and create labels for all human behaviour? I might have a medical reason for my laziness and abrutness socially?

 

[athon]

I must say I don't see how any of that assuages the concern that this might merely be an artificial construct created by a combination of over zealous psychologists immersed in their own culture, attention-damaging youth behaviour, some bad parenting, a desire to medicalise and remove personal responsibility plus some drugs company influence.

You still don't understand the nature of what you're arguing, it seems.

What is the point of diagnosing a condition? If you have a range of symptoms that disrupt your normal functioning, you want the symptoms to abate, true? If you're sick, you want to know what is causing it in relation to a possible remedy or a treatment. That is no different here.

A range of behaviours are exhibited by a number of individuals that disrupts their normal functioning, and this set of behaviours are commonly seen together. We can classify them together under a term; thereby when somebody says 'they have X', the behaviours are described within.

You seem to be indicating that these behaviours are not necessarily influenced by an underlying set of physical differences, that they are simply learned behaviours a large percentage of us all exhibit from time to time, except sometimes a little more extreme. But in itself, that dismisses responsibility. It benefits us to know why these behaviours are being exhibited, why they vary, why are they sometimes more extreme, why does conventional behavioural management not work, and how we can deal with that.

Please, forget this idea that it is about diagnosing a person and then leaving it at that. It is not; it is about addressing underlying causes and diminishing the disfunctional behaviour through a range of different means.

In addition to this, we've already pointed out that behaviours classified by ASD are indeed influenced by circumstances outside of mere 'bad parenting' or social constructs.

It might be a useful label to some but I see little real evidence that it has a single cause or even an exact and reliable symtomology. I can also see how such medicalisation could be a disasterous thing for many people.

No offence, but how well read up on this issue are you?

Behaviour complicates diagnosis; the 'symptoms' don't equal the behaviour, but rather they are the underlying influences on the behaviour itself. Different people who have ASD behave differently with regards to the symptoms; ask Zaaydragon, I'm sure he can explain this better than me. So underlying 'symptoms' are difficult to describe, at least in a sense we are used to. Again it does not mean they don't exist.

Medication for any condition will vary in effect depending on numerous factors, and I doubt you would argue that something like cardiac disease or leukaemia or even HIV are not diseases. yet with each of these, some drug regiments are ineffective due to numerous factors.

And, of course, I've already admitted that ASD might actually have a whole lot of different causes, each creating similar symptoms. As technology advances, it will again be divided into different categories. For example, perhaps a common behaviour is found in people who all have an enzyme missing in thier nervous system. These might then be termed 'a-enzyme A ASD', to distinguish them from 'Learned Behaviour ASD'...

It's an example of how we endeavour to understand behviour, not sweep it under the carpet because it's 'just a variation on normal'.

You ask how does this negate the existence of ADHD. How can anyone negate the existence of an arbitary definition? The question is how useful and is that label and what does it actually mean.

Ok. Firstly, the definition is not arbitrary. It refers to a set of behaviours an individual exhibits under variable circumstances. The defining points between 'ASD' and 'non-ASD' have more to do with our human need for precise definition, not to do with biology. Nature has no written definitions.

I'll give you another example; where is the exact defining line between 'heart disease' and 'not heart disease'?

Secondly, I've already explained how I find the label useful as a teacher. Zaayrdragon could probably give you a better idea of how it is useful as a parent. And its diagnostic relevance I have also addressed. Reread my above posts.

If I am right, then saying someone "has" ADHD is somewhat lacking in meaning. You might also say that they have trouble concentrating, or are badly behaved or any number of other things.

Collectively, under certain circumstances, these behaviours can be classified under ASD. How is this complicated for you?

I might label people who get angry a lot as having Anger Control Disorder (ACD). Some can be treated with tranquilisers.

Indeed, you might. Is this ACD behaviour exhibited by a number of individuals under similar circumstances? Does it indicate a possible, underlying influence? Is this influence disrupting normal functioning? There are such conditions as this, you know, so I think you inadvertanlty added support to a contrary argument.

This supposedly proves there is a chemical reason for their behaviour. People with angry kids can now tell people their kids are not nasty but have ACD. They can't control it - it's a disease.

Here is the crux of your misunderstanding. 'Can't control it' is the construct, not the diagnosis.

Indeed, they probably do have a biased chemical influence that varies within the population. Knowing they find it harder than most will help devise techniques, alternative environments, strategies etc. that can help this child.

Or do you just say 'face it, you're an angry kid, suffer it...'?

And when we start applying this definition to the nation we find that we have been ignoring millions of other kids with this disease. They all need treatment. It rings bells with adults too - NOW they know why they kept hitting people when growing up.

Perhaps. We are all influenced by our biochemistry. For instance, I have a rather above average ability to sit for long periods of time, concentrating on the one thing. Anti-ADD, you could say. It's a condition I have, you could say. I can change this behaviour, and it can be effected by the environment. But it's influenced by my genetics as well.

It's not a disease because it does not effect my normal functioning to any great extent. So it's hardly going to be addressed as a medical issue.

Why not go the whole hog and create labels for all human behaviour?

We could. But how much of that would be useful?

I might have a medical reason for my laziness and abrutness socially?

No. You probably have an underlying chemical influence on that, modified by education and environment. If it is so severe that standard education (by parents, system or society) cannot remedy it, and it affects your day to day living, then perhaps it might attract medical interest and need to be addressed.

Athon

 

[Z]

Part of the other problem is that the labels 'ADD', 'ADHD', 'ASD', etc. cover a wide range of different problems, each with its own causes, symptoms, and potential treatments. It's a fallacy that the public expects there to be a single condition called, 'ADD'. There is no single condition; there are a host of similar conditions. Each case is different, and there's no shoehorning ADD kids into any specific mold, as there seems to be with some other conditions.

So Neal Boortz, I would guess, doesn't know anything about these disorders either. It's sad, but not overly surprising, that people react this way to ADD. It's also sad that so many people abuse the idea of ADD as well. This abuse is part of what drives folks like Neal Boortz to lash out as they do. I do it myself, and I have ADHD. But it still drives me nuts to see parents with wild kids, and their only response is, "Well, Johnnie has ADD. We can't control him."

In our house, we have five boys, ages 7, 6, 5, 3, and 2, and a baby girl, age 1. The six year old has an ADD variant, and the five year old has ASD. But on fairly regular occasion, we go out to eat. I'm not talking McDonald's or Wendy's, I'm talking sit-down and enjoy kind of dinners. Invariably, almost without exception, the wait staff or managers come to us after dinner is over, praising our kids. One waitress even returned the tip, saying that a) with this many kids, we needed the cash more than she did, and b) since they were so well-behaved, there wasn't really that much more for her to do.

We can take them shopping. We take them to movies. We take them to all manner of outings. And we never have the trouble with them that I see other parents having with their kids. That's not to say they're perfect; but the lot of them at dinner remain in their seats the entire meal, unless it's for a potty break; they don't throw food or spill drinks, they don't run around the restaurant, they don't whine at what they're served for dinner. They eat their veggies, they are polite, they chew with their mouths closed. Elbows on the table is currently a difficult issue - since I'm guilty of it myself - but it's one we're working on.

Neither of the two A_D kids are medicated, by the way.

Now, if my wife and I can keep six children in line, with two of them suffering from disorders, I see no reason - none at ALL - why parents with one or two kids can't manage. ADD and ASD have become catch-all excuses for lazy parents, and it sickens me - in part, for what they are doing to their children, and in part for what they are doing to the reputation of those who actually suffer these problems.

...

SOrry, I seem to be ranting.

 

[stamenflicker]

dogguy,

Unless you have something positive to contribute towards enabling our FAS, NAS, ADD, ADHD daughter to become a happy child and a contributing member of society I suggest you stop insulting us with your biased and unfounded opinions. Go have your "fun" at someone else's expense.

For the record, FAS is real disorder. But I'll gladly leave the topic. It beats trying to discuss something with folks who've only studied their side of it. Quoting the DSM or a psychologist's word on this issue is to me about as logical as a Christian quoting the bible to make his case to a non-believer.

If you want to make it personal (which you have), then I can take the academic issues elsewhere. Culture can chose to live its many social constructs, and we all do it to one degree or another and that's fine.

As to the academic case, the professional dialogue is out there and documented by people much smarter than me... hardly "unfounded" as you seem to think. I've posted a good starting off point for reading for those interested. To those who aren't, it's no big deal to me.

Best wishes for your daughter, sincerely.

Flick

 

[athon]

dogguy,

For the record, FAS is real disorder. But I'll gladly leave the topic. It beats trying to discuss something with folks who've only studied their side of it. Quoting the DSM or a psychologist's word on this issue is to me about as logical as a Christian quoting the bible to make his case to a non-believer.

Fancy strawman argument you have there, mate. Nice hat you've made and everything.

Christian argument is based on faith; scientific argument is based on the ability to alter what models exist in light of new evidence. If that makes no sense to you, then maybe there isn't much point in discussing it.

Where is your argument coming from, if I can ask? Based on what exactly?

People here have offered a well rounded argument from diverse fields and backgrounds. There is no single 'side' these arguments are coming from.

Athon

 

[stamenflicker]

Where is your argument coming from, if I can ask? Based on what exactly?

I've posted suggested readings. To claim that the opposing position is coming from science is a fallacy. That hardly seems like a strawman to me. But then again, I said I was leaving.... so *waves*

Flick

 

[Roadtoad]

I've only skimmed a lot of this, and I'll be re-reading all of it, not to mention checking links. But, thought I'd jump in with this.

As it happens, my youngest son is ADHD. Matt was always hyperactive, and it wasn't until he was in school that we found out about his attention deficit situation.

When things started becoming difficult, Peggy and I would go down to the school, many times demanding that they test Matt to find out if, in fact, he was ADHD. The school wanted to affix the label without the test, and we were adamantly against it. We fought them over their refusal to work with Matt, and demanded to know when Matt had homework, (he wouldn't tell us), and insisted that they tell us what was going on in his classroom. Frequently, whenever we could make the arrangements to do so, we would actually show up and sit in class with Matt, trying to find out what the hell was going on.

It was recommended that we put Matt on Ritalin. We told the school to go to hell. Some vitamins have actually helped Matt, but ultimately, it led us to homeschool our younger two sons. The organization which we worked through for that part of our sons' education then tested Matt (he was in the seventh grade by then), and, bullseye, it turned out he was, in fact, ADHD.

It has been a long fight to get Matt literate. The Rio Linda School District did not want to be bothered. We had to be. Matt now reads at a post-graduate level, and is in college, learning to become a chef. He gets help from the school when he needs it, but he's never, ever, been on medication.

If Boortz is referring to Ritalin, he might have a point. Unfortunately, I don't think that's what he's talking about. And, frankly, I'm not sure he knows what he's talking about.

 

[Kiless]

I've posted suggested readings. To claim that the opposing position is coming from science is a fallacy. That hardly seems like a strawman to me. But then again, I said I was leaving.... so *waves*

Flick

No.

You mentioned off-hand a few authors.

You failed to answer my questions.

Let me know if you still call yourself a skeptic. Because you have no legitimate arguement whatsoever.

There is another label for you that comes to mind - one, that I personally believe, is more shameful than anything used on a ADHD kid. Because this one came by your choices.

 

[EagleEye]

Neal was right... but not in the way you think...

All of you are in here debating whether it's a real CONDITION or not... but you have to realize that while the behaviors and condition are real, the DISORDER is NOT.

It's not a disorder... it's merely a different way of thinking...

It's not something to be fixed... it's something to be handled and dealt with.

It's not something we need to be doping up our kids over... it's something we need to teach them how to deal with, and teach parents and teachers how to deal with.... because they're approaching it all wrong.

It's more about realizing that these kids are square pegs that are trying to be forced in to a round hole, and to make that happen, the corners are being cut off... sacrificing a special part of the square peg that makes it what it is...

It's an attempt to force these poor kids in to a mold they simply don't fit in to. The problem is not the child, it's the curiculum. The problem is not the child, it's the insistance that they THINK LIKE EVERYONE ELSE that is the problem. It's the attempt to force them in to a structure that contradicts how their minds work...

I learned this the hard way, being an ADD kid on ritalin, and ultimately getting OFF the ritalin (do you KNOW what it's like to have your brain shut down?) and learning how to structure my own environment to suit my way of thinking...

Ritalin ignores and pushes the problem aside... my method addresses it and teaches how to live WITH it and even use it as an advantage.

So no, "Attention Deficit Disorder" doesn't exist. Because it's not a disorder.

Oh yeah, and about the symptoms?

Read this: http://keirsey.com/addhoax.html

It lists the criteria by which ADD is diagnosed... as far as I know, it's the only "disorder" in the DSM IV where the symptoms of the disorder are also the cause of the disorder... which is absurd on the face of it, but studiously ignored by the psychiatry and drug industries... because apart from depression, ADD is the biggest money maker in the world for them...