Diagnosing the Authors of Trouble Making Posts

Rebelmom, I still think that we are dealing with multiple aliases. So, in other words I think that it is primarily the same author. I think the board changes have forced this person to change his writing style a little so that it is harder to tell who he is. I don’t think there are that many folks out to “hang” parents that have chosen medication. But, I do think that there is an innate tendency for some people to be very impressionable when given information by a religious or otherwise well-respected individual. Look at all the nuts that want to kill people based on skin color or religious preference! Someone tells them that all folks of a particular type are a certain way and they believe it. I’m incredibly scientific-minded to the extreme that I question everyone and everything so it is hard for me to comprehend this but I know it’s true and there isn’t a blessed thing that I can do if someone chooses to not like me or my choices. You know what? I don’t care one bit because I am confident in my choices for my family and kids!!! You, by the way, are someone who I would look to for advice and I’d weigh your information very heavily! Don’t concern yourself with these misguided authors. They know nothing about you or your child.

TerryB (my account hasn’t been activated yet so I used a different Username)

Hi Rebelmom, I also wonder what motivates these negative posters. I was recently on readingrockets.com the sister to this board, and someone posted another anti-med message (which i don’t have a problem with, they are entitled to their own opinions), the problem I have is he/she used “bgb” name, and the real “bgb” had to post another message saying it was not her post. Before that board can even get off the ground he/she is starting there already. That new board does not require registering.
I am still waiting for my account to be activated here too.

I think these people just like getting the attention, they are not here to help because they don’t give alternatives but are just critical and the sad thing is they scare the people who are new to ADD and meds, like Nervous Mom. Now her son will not benefit from meds because she is scared.

Mayleng

Hi, I just went to readingrockets and it seems they have moved some old posts from here to there, and some of the imposter posts were moved too. So the negative posters have not disrupted that board as I mentioned in my previous message. They have locked that post so they don’t confuse people (like me).

I don’t know how much more upgrading this site will get, but there is very simple technology that can recognize a compueters IP address. Then, no matter what name they choose, their posts will be rejected. Even the opportunity to register will be rejected. By the TREMENDOUS leaps this site has made recently, I’d be surprised if this wasn’t in the works.

I feel bad for anyone new to ADD getting a reply from this loser first thing. But Most parents would recognize this guy for what he is. The few parents who might be swayed by such twisted logic and lies were bound to be tripped up sooner or later. They’ll be back looking for help, once they realize how wrong and harmful being so closed minded is and how much it can hurt a child to deny them medical treatment.

I agree, I too am certain its just Ball(-less). All by his lonesome, sad, angry self. I’ve been all over the highway and there’s hardly any people out there with this point of view, muchless all on one site. I mean, there are parents afraid of medicating and who chose not to, but they aren’t stupid idiots. They just made a different desicion than I and thats fine. Been there, done that, too. May go back! I’m not beating up parents who don’t medicate. But, I’ll gladly kick the butt of the self righteous, narrowminded, extremists. At any end of the spectrum, they hurt the children, not the parents, not the pharmacy companies, not the doctors, just the little ones.

The funniest thing about the confrontational replies I was getting is that I don’t use stims on my son. I use the new Strat, nonaddictive, nonnarcotic, very uncontroversial med. Amphets really are bad for some kids, this was clear by my son’s reaction, but they help many more than they harm. The other half of my son’s therapy is exercise and diet. But I’ll go to the mat for anyone’s form of therapy as long as it is safe and helping and well monitored. It’s the only the meek parents, easily swayed by opinionated bullies, or the uncaring parents who think they are helping their kids by doing nothing that I take issue with. Any one else trying anything is a superior parent in my eyes.

I agree with you, Millermom. The only people they are hurting are the little ones that need help. Yes, the irony is if we had a choice we probably would not take the meds route too. Like I said before in other posts, if they had something useful to contribute on how to help besides beating the same anti-meds drum, we would all benefit.

I hope all goes well with the Strat, and your son gets over this bump. I am praying for you. You do know alot is riding on your experience with Strat, don’t you. When it goes well for your son, we have hopes for our children too.

I hope they update their systems here before people stop coming here.
Leah Fl and I were just “chatting” about it on the Schwab board.

Ahhhh, technology!

Linda, I updated my strat bump at the other site. Some others replied saying that all kids can get spacey when school is ending, ADHD or not. I still see some Strat effects, but the inconsistancy made me worry. I just think the stress of losing his rituals is overpowering the Strat. He was very good in class, I stayed a little this AM. The fact is, I don’t care how he is at home, but for school and sports, self esteem is everything. He metabolized Wellbutrin with every upping of the dose, in about 4-5 weeks, each time. I think if this med was easy to metabolize, he would have done it by now. I think thats one of the many pluses of Strat, it’s hard for the liver to figure out. The kids who were in the trials, most of them stayed on Strat and I haven’t read of any problems where it stopped working after this long. So I’m hopeful.

Wanted Linda to see above reply.

Why is it that the pro-druggers can be insulting but when the anti-druggers defend themselves and their postitions they get censored banned?

Rebel Mom is an admitted cocaine user. I think it is reckless to let her have free reign espousing her views about the drugging of children on a public forum unchecked.

When ever a valid point is made about the drugging of children from those of us who believe Methyphenidate to be a dangerous and largely ineffective drug those posts disapear but when parents start doling out dangerous medical advice it is left standing with no caveat.

It makes me wonder if the owners of this site are not major stock holder of Novartis.

Our record indicates that “Kevin” is indeed a person (from a group of people) that had been banned before from the old boards. Anh “he” deserves to be banned forever from this site. He and his people had violated our rules by the use of insulting language, impersonations, and spammings. These people had tried to access our site even from outsite the US.

If they come back here with the same agenda, as seen recently, it won’t be long before their IPs are banned and announced to the public.

This site is for people to come to seek help, not to sell their religious beliefs or ideologies. You don’t have to agree with everything posted here, but please always keep the conversation friendly. If you don’t have anything helpful to offer, just don’t post anything.

Moderator.

Thanks for your reply. I will go to ADHD.com to checkout your post there. I had to go for my son’s IEP meeting this morning so I didn’t get a chance to check out your posts here.

Keeping my fingers crossed for you.

Mayleng/Linda

Well, that I’m not ashamed of my past (18 years ago!!!) is hardly a reason to ban me. That you would hold that against a person only validates whatwe already think of you. I don’t use stims, nor do my children. I think if you can avoid them, you should, they should be a last resort. My past was a big part of the reason I refused meds for a while for my son. Then when he did try meds, I was elated that they ended up being contra indicated. I was praying for a non narc med for years. I’m not against antimedders, just people who weren’t raised with manners and good character and don’t know how to make their point purely with information instead of insults. You just don’t get it. Your posts only prove out point over and aover and over again. You don’t have to have an MBA to know how to reach people and understand them.

The fact is, if you had to break the board up into two sides, for or against amphets, I’d be hanging out with my boy Kev and my home girl Ann W, lonely as that would be. I’d love to see the world change and our kids accepted, educated. The few kids left that still couldn’t fit in should find a non addictive med. I’m glad these new non amphet, nonaddictive meds are being developed. My past is part of who I am today. Your insults only remind me of how much better than you I am. They only make me the winner and you the loser. If you can’t accept that I danced to the wrong music for a few months, you must have a lot of people you cannot accept.
And my heart aches for the world you live in.

To the true fans of LDonline. What should be realized is, that when these types of people have an opportunity to voice their opinions in person, they will sit quietly in the corner, not daring to make any trouble. Thats why we never meet them, you’ll only find them hiding behind their computers.
The core difference between us and them is that anyone of us would gladly stand alone against a room full of them and challenge them until we lost our voices, while they held onto their little mouses for dear life!

Hear Hear Rebelmom. I keep wondering why Ann W. keeps bringing up the cocaine issue. It is like she thinks that should define who you are today. The fact that she keeps using the cocaine thing is like she is using this as an excuse to be antimeds. Like you said a mistake in the past does not make you a lesser person and if she would bother to read the posts, she would realise that your son is not on Stimulants, although there is nothing wrong with being on stimulant meds if your kids need them.

I wonder if she has ADHD kids, and if she has tried every way possible to make life bearable for them.

I just came back from an IEP meeting, and the principal acknowledge that not only does my son (ADD/IN) have it more difficult in school but outside of school as well, at home he has to work that much harder to catch up with his peers, socially and emotionally it is more difficult for him to make friends. He said Life is so much harder for my child. Surprising to hear it coming from a Principal. Life would be even more difficult for my child if he didn’t have his meds to help him. It took me 4 years to finally come to the decision to medicate. I am still trying to find other ways to help him. We signed him up for Tae Kwon Do, Piano to help with the attention/focus issue and to give him the exercise he needs and also to build up on his self-esteem. I have given him fish oil, etc trying diets. We have signed him up for tutoring over the summer to bring him up to grade level and so he won’t struggle so much at school. I am hoping to try him on Strattera (and Ann W. if you do your research - THIS IS NOT A STIMULANT) in August.

So Ann please don’t come and try to make us, caring and knowledgeable parents, feel like we are forcing drugs on our kids. You don’t have any idea the emotional stress we are under and the heart break we feel for our kids.

Walk a mile in our shoes before you get on your soap box and judge us. Like I always say, it is easier to judge then to give constructive advice and help. Instead of telling us not to medicate our children, tell us what we can do instead to help them.

This board is to help parents with kids that had LDs, not for people to insult and judge us.

Linda,
I really hope Strattera works for him, it sounds like he really deserves a break. I know you have read a lot about it, it really is nice med. Our boys soumd alike. My son has to try extra hard just to be on an level playing field with the average kid, both phys and academs. I do a lot of extra school work with him, buying my own work books, another Homeschooling mom said it sounded as if I was both homeschooling him and sending him to school. I guess I kind of am. If I could afford a tutor I’d do that too. But Right now the cost of boxing wrestling swimming lessons, some league sport everyseason is costing. My husband feels at his age, and under his circumstances what he’s learning now, is more important than getting A’s. Seeing how theraputic it is, I had to agree! I cannot ignor how much he enjoys it and how much like “one of the gang” it makes him. It’s not just the sports or diet or meds, it’s mostly him and I tell him that everyday. If he didn’t try so hard at everything, he’d be in a very sad place right now. I hope that I’m laying the ground work for a day (soon) when he can function without meds. Thats why it’s so important that we not count on meds alone.

Why do we both keep trying to reason with these people? Thats not what they are here for. They aren’t even reading our posts and they no nothing about the meds. Thats obvious by their ignorant comments and lack of facts. I’ll run into you later, I’m sure.

Chow.

You are going to let a child box who has a brain impairment. Do you think that is wise?

If “Kevin” doesn’t work why not try “Ann W” or “Ed Dedrick”. Ball your not fooling anyone.

So Ed, now you have a problem with giving children exercise and something to help them build their self-esteem. It’s a chemical imbalance not brain damage, you know! So your idea is no meds, no exercise, and probably no diet just let the kids suffer, right?

Linda,

Perhaps you’d like to share with the class the name of test is given to determine a chemical imbalance that causes ADHD.

Is this some sort of blood test?

Then maybe you could tell us what chemicals are involved in this imbalance.

Then perhaps you could tell us what the correct balance is.

Let me jump in for you hear Linda, I know you are busy and might not be back right away. Mr Dedike Here clearly needs and explaination of things .

ADHD or ADD is characterized by a majority of the following symptoms being present in either category (inattention or hyperactivity). These symptoms need to manifest themselves in a manner and degree which is inconsistent with the child’s current developmental level. That is, the child’s behavior is significantly more inattentive or hyperactive than that of his or her peers of a similar age.

Symptoms of Inattention:
often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
often has difficulty sustaining attention in tasks or play activities
often does not seem to listen when spoken to directly
often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not
due to oppositional behavior or failure to understand instructions)
often has difficulty organizing tasks and activities
often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or
homework)
often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
is often easily distracted by extraneous stimuli
is often forgetful in daily activities
Symptoms of Hyperactivity:
often fidgets with hands or feet or squirms in seat
often leaves seat in classroom or in other situations in which remaining seated is expected
often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be
limited to subjective feelings of restlessness)
often has difficulty playing or engaging in leisure activities quietly
is often “on the go” or often acts as if “driven by a motor”
often talks excessively

Symptoms of Impulsivity:
often blurts out answers before questions have been completed
often has difficulty awaiting turn
often interrupts or intrudes on others (e.g., butts into conversations or games)
Symptoms must have persisted for at least 6 months. Some of these symptoms need to have been present as a child, at 7 years old or younger. The symptoms also must exist in at least two separate settings (for example, at school and at home). The symptoms should be creating significant impairment in social, academic or occupational functioning or relationships.

The three types of ADHD:
Attention-Deficit/Hyperactivity Disorder, combined Type: if both of the criterion for Inattention AND Hyperactivity are met for the past 6 months.
Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if criterion for Inattention is met, but criterion for Hyperactivity is not met for the past 6 months.
Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if criterion for Hyperactivity is met, but criterion for Inattention is not met for the past 6 months.
In order for a child to be diagnosed with ADHD, at least 6 symptoms in one of the above categories must have been present for the last 6 months in a greater degree than other children of the same age.

Criteria summarized from: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Assoc.

There is no unanimous agreement on what causes ADHD. The current research points to a biochemical basis for the disorder. It is believed that deficiencies or an imbalance in the “chemical messengers” in the brain, the neurotransmitters, prevent it from working properly, thus causing the symptoms of ADHD. This imbalance in primarily found in the parts of the brain responsible for self-monitoring, the frontal lobes and their deep connections, the basal ganglia circuits.

Several studies have been performed between 1984 and 1999 using both PET (Positron Emission Tomography), SPECT (Single Photon Emission Computed Tomography), and MRI (Magnetic Resonance Imaging) scans to compare the brain activity and blood flow in those diagnosed with ADHD and non-ADHD children and adults. These studies seem to indicate an underactivity or underarousal in the brains of those with ADHD. This was determined by the lower absorption of glucose in the brains of adults with ADHD compared with their non-ADHD counterparts.

Bad parenting skills are NOT a cause of ADHD. Parents are potentially responsible, though, as ADHD is believed to be hereditary. Which means either you or your spouse, or both, or another close relative, probably have the disorder. Bad parenting skills however can make the ADHD symptoms more severe through increasing resentment, hostility, and poor self-esteem.

Just because ADHD has a biological basis does not mean that your child is powerless to change his/her behavior. But it does mean that children with ADHD will have to work much harder to pay attention, obey parents, complete chores, and finish schoolwork.

Thanks Rebelmom, for replying on our behalf, I was TOO BUSY trying to help another mom on another board with information about STRATTERA (non-stimulant meds) because her son was on Concerta and she had recently changed to Strattera and was having alot of side effects. I pointed her to our favorite site of course and referred her to your many posts. So I don’t have time to waste on replying to non-helpful posts of Mr Ed’s, especially when there are so many parents out there that need help and some support emotionally.

Unless Mr. Ed has a better solution to helping the kids. Well, DO YOU.
Stop making a mockery of other people’s pain, and give us some good suggestions to help these kids. I am still waiting for your helpful suggestions here.

Well, good morning there Linda,
Looks like we are on the same schedule, eh? Glad you don’t mind me juming in there, I can be so impulsive. It’s the (exdrugabusing) Rebel in me. I posted what I thought you would write, and I’m glad you approve. I too was on other sites last night. I don’t Know why I keep coming here except I’m already on the highway and it only takes a minute to pop in and discredit the narrowminded, it’s hard to resist. I’m trying to be patient with this guest thing. The better boards don’t have it. They need to do a few more changes and I know it takes time.

I LOVED the thing about the boxing, this guy is running out of material! He won’t be writing any books at least. I hope he doesn’t have kids…Oh, My. I pray!

Hi Rebelmom, Good morning to you too. Jump in anytime on my behalf, I think you can tell that we both think alike and have the same dedication to getting correct information out to help others, not to judge them.

Like you, I go to all my favorite sites first and pop by here to “see” all friends but posts like the antimeds garbage gets me going.

I will no doubt “bump” into you at the other sites.

Take Care.

He used to spell it “Dedicke,” but now it is “Dedike.” Interesting, isn’t it, especially when he took care to explain in one post that it was his true name and not a pseudonym.

Andrea
(Who wishes the moderator would get the registration problems fixed)

I agree Andrea. He can’t even get his name right - he is also “EdD”, so I will just call him “Mr. Ed” of course.

Yes, I wish they would get the registration thing going as well.

[quote:e1a1b45744=”andrea(still unactivated)”]He used to spell it “Dedicke,” but now it is “Dedike.” Interesting, isn’t it, especially when he took care to explain in one post that it was his true name and not a pseudonym.

Andrea
(Who wishes the moderator would get the registration problems fixed)[/quote]

Oh, gosh! I missed that. Too funny. You just made my day.

[quote] Oh, gosh! I missed that. Too funny. You just made my day.[/quote]

Duh! This post was made by me. Forgot to log in….where is that coffee mug…

Your account seems to work now. Please check your private email for your temporary password.

We hope this works for you.

Regards,

LDOnLine

You should all register, then he/she/it can’t use your handle. It’s active now. I registered in two minutes.

Yeah!!! I can log in now and use my real login name since I couldn’t use it before.

Linda/Mayleng

[quote:0e3cc9f701=”rebelmom”]Let me jump in for you hear Linda, I know you are busy and might not be back right away. Mr Dedike Here clearly needs and explaination of things .

ADHD or ADD is characterized by a majority of the following symptoms being present in either category (inattention or hyperactivity). These symptoms need to manifest themselves in a manner and degree which is inconsistent with the child’s current developmental level. That is, the child’s behavior is significantly more inattentive or hyperactive than that of his or her peers of a similar age.

Symptoms of Inattention:
often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities
often has difficulty sustaining attention in tasks or play activities
often does not seem to listen when spoken to directly
often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not
due to oppositional behavior or failure to understand instructions)
often has difficulty organizing tasks and activities
often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or
homework)
often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
is often easily distracted by extraneous stimuli
is often forgetful in daily activities
Symptoms of Hyperactivity:
often fidgets with hands or feet or squirms in seat
often leaves seat in classroom or in other situations in which remaining seated is expected
often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be
limited to subjective feelings of restlessness)
often has difficulty playing or engaging in leisure activities quietly
is often “on the go” or often acts as if “driven by a motor”
often talks excessively

Symptoms of Impulsivity:
often blurts out answers before questions have been completed
often has difficulty awaiting turn
often interrupts or intrudes on others (e.g., butts into conversations or games)
Symptoms must have persisted for at least 6 months. Some of these symptoms need to have been present as a child, at 7 years old or younger. The symptoms also must exist in at least two separate settings (for example, at school and at home). The symptoms should be creating significant impairment in social, academic or occupational functioning or relationships.

The three types of ADHD:
Attention-Deficit/Hyperactivity Disorder, combined Type: if both of the criterion for Inattention AND Hyperactivity are met for the past 6 months.
Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if criterion for Inattention is met, but criterion for Hyperactivity is not met for the past 6 months.
Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if criterion for Hyperactivity is met, but criterion for Inattention is not met for the past 6 months.
In order for a child to be diagnosed with ADHD, at least 6 symptoms in one of the above categories must have been present for the last 6 months in a greater degree than other children of the same age.

Criteria summarized from: American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders, fourth edition. Washington, DC: American Psychiatric Assoc.

There is no unanimous agreement on what causes ADHD. The current research points to a biochemical basis for the disorder. It is believed that deficiencies or an imbalance in the “chemical messengers” in the brain, the neurotransmitters, prevent it from working properly, thus causing the symptoms of ADHD. This imbalance in primarily found in the parts of the brain responsible for self-monitoring, the frontal lobes and their deep connections, the basal ganglia circuits.

Several studies have been performed between 1984 and 1999 using both PET (Positron Emission Tomography), SPECT (Single Photon Emission Computed Tomography), and MRI (Magnetic Resonance Imaging) scans to compare the brain activity and blood flow in those diagnosed with ADHD and non-ADHD children and adults. These studies seem to indicate an underactivity or underarousal in the brains of those with ADHD. This was determined by the lower absorption of glucose in the brains of adults with ADHD compared with their non-ADHD counterparts.

Bad parenting skills are NOT a cause of ADHD. Parents are potentially responsible, though, as ADHD is believed to be hereditary. Which means either you or your spouse, or both, or another close relative, probably have the disorder. Bad parenting skills however can make the ADHD symptoms more severe through increasing resentment, hostility, and poor self-esteem.

Just because ADHD has a biological basis does not mean that your child is powerless to change his/her behavior. But it does mean that children with ADHD will have to work much harder to pay attention, obey parents, complete chores, and finish schoolwork.[/quote]

ADHD has a biological basis? I don’t think so. Tell us what that “biological basis” is.

The criteria you site describes the symptoms of childhood and the symptoms of bad parenting and the systems of emotional disturbancecs in children.

The PET scan studies you referto were done on kids who had been on Ritalin for many years and yes their brains were malfunctioning. That study is meaningless because it was not done on kids who were identified as ADHD but not on Ritalin.

The very anomolies that that PET scan study reveals are the same brain anomolies cause by stimulants including cocaine and Ritalin.

I also wonder because ritalin and cocaine so adversely effect the frontal lobes of the brain that perhaps people who use those substances are incapable of making the mental leap it requires to understand the concept of cause and effect.

[quote:a5b2c6a8c4=”Mr Ed”]
The PET scan studies you referto were done on kids who had been on Ritalin for many years and yes their brains were malfunctioning. That study is meaningless because it was not done on kids who were identified as ADHD but not on Ritalin.

The very anomolies that that PET scan study reveals are the same brain anomolies cause by stimulants including cocaine and Ritalin.

I also wonder because ritalin and cocaine so adversely effect the [/quote]

Mr. Ed is not correct when he says that the testing was not done on children who were identified as having ADHD but were not medicated. Scans were in fact done on children who were medicated and children who were not medicated. For an interesting prior discussion of this, go to the Teaching a Child with LD board and look at the thread on ADHD and brain size.

Andrea

Why thank you Mr. Ed,
I always welcome the opportunity to state the truth. We were all just commenting on the excellent opportunity you have given us here at LDonline to spread the gosple, so to speak. I’ve even included the references since you seem to have such a great interest in the subject.
Love the name change, by the way. Very apropos, if you know what I mean. Thanks again for these excuses you have given meto get the truth out there.

Biological Bases of Attention Deficit Hyperactivity Disorder: Neuroanatomy, Genetics, and Pathophysiology
James Swanson, Ph.D., and F. Xavier Castellanos, M.D.
In a multistage process for validation of a psychiatric disorder (Jensen, Martin, Cantwell, 1997), two preliminary steps have been taken for attention deficit hyperactivity disorder (ADHD): (1) a partial consensus has been reached in the two primary diagnostic manuals, DSM-IV and ICD-9, about an ADHD phenotype that can be reliably assessed (Swanson, Sergeant, Taylor, et al., 1998) and (2) in followup studies of children with the disorder from several different geographical locations, adverse adolescent outcome in social adjustment and educational attainment has been documented (e.g., Mannuzza, Klein, Bessler, et al., 1993; Satterfield, Swanson, Schell, et al., 1994; Taylor, Chadwick, Heptinstall, et al., 1996). In this process, a critical next step is the delineation of biological bases of ADHD by laboratory tests. We will review recent pivotal studies from neuroanatomy and molecular biology that address this issue.

Recent investigations of a refined phenotype defined by the ICD-10/DSM-IV consensus criteria (ADHD-combined type without serious comorbidities present in childhood) (ADHD/hyperkinetic disorder [HKD]) have produced some converging evidence about biological bases of this disorder. Multiple causes have been assumed (see Conners, 1998, this volume), and both neurological damage and genetic variation have been proposed as likely biological etiologies. We will discuss research exemplifying both proposals.

Recent Research on Neuroanatomical Abnormalities

One of the most important current developments has been the convergence of findings from magnetic resonance imaging studies of brain anatomy (aMRI). We will present a meta-analysis of studies from several independent laboratories that have reported ADHD/HKD abnormalities in two specific but still coarsely defined brain regions of the frontal lobes and basal ganglia. For example, Filipek and colleagues (1997) reported that a group of children with ADHD/HKD had brain volumes about 10 percent smaller than normal in anterior superior regions (posterior prefrontal, motor association, and midanterior cingulate) and anterior inferior regions (anterior basal ganglia), and Castellanos and colleagues (1996) reported that right anterior frontal, caudate, and globus pallidus regions were about 10 percent smaller in an ADHD/HKD group than in a control group.

The convergence of findings within and across investigators has not emerged for functional imaging studies using positron emission tomography (PET) (Ernst, Zametkin, 1995) as it has for aMRI studies. We will discuss possible reasons for this, as well as a variety of findings from studies based on other methods of functional imaging, such as single photon emission tomography (SPECT), EEG event-related potentials (ERP), and functional magnetic resonance imaging (fMRI).

The reported aMRI findings may be localized in theoretical frameworks of neural networks, such as the parallel segregated circuits described by Alexander and colleagues (1986) and the neuroanatomical networks of attention described by Posner and Raichle (1996). We will discuss attempts to use these theories to organize the empirical findings from brain imaging studies of ADHD/HKD, and we will review some of the proposals that have been offered to account for executive function deficits of ADHD/HKD children documented by neuropsychological tests (see Tannock, 1998, in this volume).

Recent Molecular Genetic Investigations

Many family (e.g., Faraone, Biederman, Chen, et al., 1992), twin (e.g., Gjone, Stevenson, Sundet, 1996), and adoption (e.g., Deutsch, Matthysse, Swanson, et al., 1990) studies have documented a strong genetic basis for ADHD/HKD, but these studies do not identify specific genes linked to the disorder. Molecular genetic studies are necessary to identify allelic variations of specific genes that are functionally associated with ADHD/HKD. Dopamine genes have been the initial candidates for application of advances in molecular biology, based on the site of action of the stimulant drugs (Wender, 1971; Volkow, Ding, Fowler, et al., 1995), the primary pharmacological treatment for ADHD/HKD (see Greenhill, 1998, in this volume).

Two candidate dopamine genes have been investigated and reported to be associated with ADHD/HKD: the dopamine transporter (DAT1) gene (Cook, Stein, Krasowski, et al., 1995; Gill, Daly, Heron, et al., 1997) and the dopamine receptor D4 (DRD4) gene (LaHoste, Swanson, Wigal, et al., 1996; Swanson, Sunohara, Kennedy, et al., 1998). The associated polymorphisms of these genes are defined by variable numbers of tandem repeats (VNTR), which for the DAT1 gene is a 40-bp repeat sequence on chromosome 5p15.3 and for the DRD4 gene is a 48-bp repeat sequence on chromosome 11p15.5. Speculative hypotheses have been based on the notions that specific alleles of these dopamine genes may alter dopamine transmission in the neural networks implicated in ADHD/HKD (e.g., that the 10-repeat allele of the DAT1 gene may be associated with hyperactive re-uptake of dopamine or that the 7-repeat allele of the DRD4 gene may be associated with a subsensitive postsynaptic receptor). However, the literature on this topic is sparse, and not all studies agree about the association of ADHD/HKD with DAT1 (Sunohara, Kennedy, 1998) or DRD4 (Castellanos, Lau, Tayebi, et al., in press). This is an emerging area of research; so we will discuss its status at the time of the conference.

Investigations of Nongenetic Etiologies

Specific genetic models have incorporated a high phenocopy rate to account for a sporadic as well as a genetic form of the disorder (Faraone, Biederman, Chen, et al., 1992; Deutsch, Matthysse, Swanson, et al., 1990). In addition to rare genetic mutations, sporadic cases may be due to nongenetic etiologies such as acquired brain damage. For decades, theories of minimal brain damage and minimal brain dysfunction (MBD) have been proposed and rejected (e.g., Wender, 1971; Brown, Chadwick, Shaffer, et al., 1981) because of the lack of empirical evidence of suspected brain damage in children manifesting behavioral soft signs and the lack of specificity of the behavioral consequences of traumatic brain injury. However, recent theories based on animal models and brain damage have revived this approach. For example, Lou (1996) proposed that during fetal development, bouts of hypoxia and hypotension could selectively damage neurons located in some of the critical regions of the anatomical networks implicated in ADHD/HKD (i.e., the striatum). Fetal exposure to alcohol, lead, nicotine, and other substances may produce similar neurotoxic effects. Also, severe traumatic brain injury may produce selective interneuron damage in the frontal lobes, which Max and colleagues (1998) suggest may produce new-onset symptoms of inattention and impulsivity, though often not hyperactivity (Brown, Chadwick, Shaffer, et al., 1981). We will discuss these new developments in the context of the historical questions about documentation of specific neuroanatomical abnormalities (which may be addressed with modern imaging methods) and selective expression of ADHD/HKD symptoms (which may be addressed by prospective followup investigations).

Neurobiological Bases for Pharmacological Treatment

The abnormalities in neuroanatomical networks associated with ADHD/HKD (smaller frontal and basal ganglia regions) and the biochemical pathways (specific alleles of dopamine genes) suggest a possible theoretical basis (e.g., a dopamine deficit) for the standard pharmacological treatments of ADHD/HKD with dopamine agonist drugs (see Greenhill, 1998, in this volume). Primary treatment with the stimulant medication methylphenidate has stood the test of time and the scrutiny of controlled research (Wilens, Biederman, 1992; Swanson, McBurnett, Wigal, et al., 1993). Recent investigations (Volkow, Ding, Fowler, et al., 1995) have identified the site of action of methylphenidate, which blocks the dopamine transporter. This increases the temporal and spatial presence of synaptic dopamine when it is released in the basal ganglia (e.g., putamen, caudate, and ventrostriatum) and cortex (e.g., temporal, insula, and cingulate gyri) for approximately the post-peak length of action following oral administration (2 to 3 hours). We will discuss site-of-action hypotheses that have been proposed to account for effects of clinical doses of stimulant medication. For example, Castellanos (1997) proposed that presynaptic effects may predominate in D2-rich subcortical regions where presynaptic receptors are abundant, producing decreased synaptic dopamine, and postsynaptic effects may predominate in D4-rich cortical regions, which lack presynaptic receptors, producing increased synaptic dopamine. Also, Seeman and Madras (in press) have proposed that clinically relevant doses of stimulants may increase extracellular background levels of dopamine more than action-potential released dopamine, which may account for why these dopamine agonist drugs result in a reduction in psychomotor activity.

Other etiologies of ADHD/HKD have been proposed (e.g., adverse reactions to foods or food additives, cortical underarousal, muscular tension), and on the basis of these proposals, specific nonpharmacological treatments have been suggested (e.g., special diets, EEG biofeedback, EMG relaxation training). These proposals and treatments have testimonial support, but empirical support from controlled studies is lacking. Since these areas will be covered by Arnold (1998, this volume), they will not be discussed here.

Summary

Recent investigations provide converging evidence that a refined phenotype of ADHD/HKD is characterized by reduced size in specific neuroanatomical regions of the frontal lobes and basal ganglia. These specific deficits suggest abnormalities in neural networks that affect input-output processing and attention (alerting and executive function). These neural networks are modulated by catecholamines, which are affected by stimulant drugs. The site of action of methylphenidate (the primary stimulant now used to treat ADHD/HKD) suggests that dopamine is the principal neurotransmitter involved, although norepinephrine has also been implicated. Recent molecular genetic studies have documented significant association of a refined phenotype of ADHD/HKD with polymorphisms in dopamine genes, which may alter the functions of the implicated neural networks. Recent investigations of brain development and brain injury also suggest that damage to these specific neural networks may produce symptoms of ADHD/HKD. Overall, the recent investigations in these areas have provided considerable evidence of multiple biological bases of ADHD/HKD.

References

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Castellanos FX. Toward a pathophysiology of attention-deficit/hyperactivity disorder. Clin Pediatr 1997;36:381-93.

Castellanos FX, Giedd JN, March Wl, Hamburger SD, Vaituzis AC, Dickstein DP, et al. Quantitative brain magnetic resonance imaging in attention-deficit hyperactivity disorder. Arch Gen Psychiatry 1996;53:607-16.

Castellanos FX, Lau E, Tayebi N, Lee P, Long BE, Giedd JN, et al. Lack of an association between a dopamine-4 receptor polymorphism and attention-deficit/hyperactivity disorder: genetic and brain morphometric analyses. Mol Psychiatry. In press.

Cook EH, Stein MA, Krasowski MD, Cox NJ, Olkon DM, Kieffer JE, et al. Association of attention deficit disorder and the dopamine transporter gene. Am J Hum Genet 1995;56:993-8.

Deutsch CK, Matthysse S, Swanson JM, Farkas LG. Genetic latent structure analysis of dysmorphology in attention deficit disorder. J Am Acad Child Adolesc Psychiatry 1990;29:189-94.

Ernst M, Zametkin A. The interface of genetics, neuroimaging, and neurochemistry in attention-deficit hyperactivity disorder. In: Bloom F, Kupfer D, editors. Psychopharmacology: the fourth generation of progress. New York: Raven Press; 1995. p. 1643-52.

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Filipek PA, Semrud-Clikeman M, Steingard RJ, Renshaw PF, Kennedy DN, Biederman J. Volumetric MRI analysis comparing subjects having attention-deficit hyperactivity disorder with normal controls. Neurology 1997;48:589-601.

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Max JE, Arndt S, Castillo C, Bokura H, Robin DA, Lindgren SD, et al. Attention-deficit hyperactivity symptomatology after traumatic brain injury: a prospective study. J Am Acad Child Adolesc Psychiatry 1998;37:841-7.

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Bye-Bye Ed,
Next?

Thanks for handling this board so professionally! I love the new features, but the new abilities are best! Bravo on the banning!

Good one Rebelmom. How in the world are you able to dig up all this research so fast? I am impress. I am sure Mr. Ed will come back with more rubbish, of course.

Great board moderators. Thanks members for the quick accurate retorts in response to misinformation. There is nothing more impressive than an impulsive, educated individual that tells it like it is. Thanks for activating my account. Terry

Bump

Bump

Thanks for sharing the studies. I still am very uncomfortable with the disrespectful remarks. This should not be a competition to prove who is right. I though the term “spread the gospel” was particularly telling.

I feel it is only fair to point out that the above posting does not address the question of whether or not the children in the survey have been medicated prior to the research being done, so the question raised regarding the nature of the sample studied (though I also thought it was raised in a less than respectful manner) was not answered.

I also think it is important to keep in mind that, regardless of the causes of ADHD (and the article does agree that there are multiple causes or “etiologies”), there is still no convincing evidence that long term outcomes are positively affected. Hence, the conflict. Is it worth the risk of side effects and the smaller risk of long-term damage to obtain the benefit of reduced impulsivity and increased attention to assigned tasks in the short run? I believe this is the question that remains unanswered by this kind of exchange, and really it can only be answered by each individual person. I find this kind of an article interesting from a scientific perspective, but it doesn’t really address the question of whether or not to use medication at all. I am not convinced that proof of biological differences between “ADHD” kids and “normal” kids implies that they are ill or that medication will help. Only long-term outcome studies will really help, and so far, they have been pretty much equivocal - it doesn’t seem to matter much if you medicate or not, these kids turn out pretty much the same way. J.S. Swanson himself concluded this way back in 1993.

I’d really like to turn down the heat of the ideological debate here. It is almost not worth my time to have to read through all the junk posts to get to the meat of the matter. I thought this was a forum about parenting, not about drugs. Medicating or not is only a small part of the issue of raising our kids. Too bad we are wasting so much time trying to be “right”. Maybe we can just let people think what they want about this, and not try to convince everyone, while still feeling comfortable sharing our personal views.

–- Steve

Wow. This is an old thread….why was it bumped?

[quote=”bgb”]Wow. This is an old thread….why was it bumped?[/quote]

Barb,

It seems Odgen Roe (ball?), is finding all the old posts because nobody is interested in “playing” with him anymore, so he digs up old posts to start the nonsense again. I say just ignore him.

We are not interested in this board any longer and many have left. I only dropped by to see if anything has changed, and it hasn’t. Don’t waste your time here anymore.

MayL.

[quote=”disgusted”][quote=”bgb”]Wow. This is an old thread….why was it bumped?[/quote]

Barb,

It seems Odgen Roe (ball?), is finding all the old posts because nobody is interested in “playing” with him anymore, so he digs up old posts to start the nonsense again. I say just ignore him.

We are not interested in this board any longer and many have left. I only dropped by to see if anything has changed, and it hasn’t. Don’t waste your time here anymore.

MayL.[/quote]

More phoney outrage.