Hi,
Can anybody tell me the name of the test that identifies the chemical that causes ADHD? I asked my doctor and he says he has never heard of one.
Re: Information please
Marcy what Grover is saying a a round about way is there is no reliable or objective diagnostic tool for determining ADHD.
The MRI and PET scans that Grover’s post refers to were done on subjects that had been on stimualants like Adderall and Ritalin for a long time. The brain abnormalities found were not consistant with ADHD. They were consistant with the brains of hard core amphetamine users.
If a doctor were to order an MRI and see those areas of the brain that show atrophy it would not be interpreted as evidence of ADHD.
The DSM criteria for ADHD are really the diagnostic criteria for childhood. ICD-9 is a manual used for medical coders and billers for submitting bills to insurance companies.
Long story short there is NO test for ADHD. What exists is a shaky list of “symptoms” that was arrived upon by committees of the APA and other self interest groups.
If your kid is bouncing off the walls chances are it is not ADHD.
Re: Information please
Grover
ThanK you for those studies. I will look into them. That Amen book was also recommended to be by our doctor. Kelly, you should get some facts straight. You have just posted lies that everyone can see through. You back nothing up. I think I’ll have to go with the facts from the study I’m not impressed with the ramblings of a scientologist.
Conspiracy Theory
Whether scientologists or not, there will always be a ‘fringe’ of people who willingly buy into all the conspiracy theories. One of the most popular is that ‘pharmaceutical companies are only out for money’ and therefore can somehow persuade all of government to allow them to market medicines for ‘fake’ disorders! Boggles the mind how people can buy into that junk. Nobody is smart enough to concoct a conspiracy that large for starters LOL. So you will find a whole lot of people who equate ‘medicine’ with ‘evil’. It does take all kinds, and some of every kind is here on the Web if you look.
Re: Information please
Kelley’s facts are right on. I would like to know the name of the test that identifies the “chemical balance”
A chemical imbalance does not exist. That is why there is no test for it if there were it would rule out ADHD 99.999 pecent of the time.
Brain chemistry in delicate and complex. If someone’s brain chemistry were “off” they would have real symptoms.
Re: Information please
Prerequiste courses in college on psychology and behavior aren’t forcing anything or have a propaganda. Anything / any subject in science has this attitude…You don’t believe the textbook/current research is correct and you have a different way of thinking and a different hypothesis or theory… Prove it… Plain and simple.
Re: Information please
I have inattentive ADD. I told a friend that I was taking amphetamines and she thought I was kidding. It is very difficult to explain or under stand how a person with ADD can take them and have such a different effect. It is absolutly worth the side effects. Mine are not as bad as yours, knock on wood. to be able to study, pay bills, clean, simple tasks that once escaped me, is an amazing thing. I have no doubt they help children as well. I can take a week off of amphets if I want to stuble around in a daze. I choose not to. I would choose not to do that to my child if I had one. I have no withdrawal. Its not like a drug, it’s a medicine, and yes folks, ADHD is indeed a chemical imbalance. Why else would the meds work so well? If you don’t know what you are saying, go to a board with ignorant people. We got it down pat here. We know full well what we are doing and we know the facts and we recognize lies when we see ‘em.
Re: Information please
I dont know if it is a chemical imbalance or a deformation or a wiring issue. I know there is something wrong with my child and all of yours. From my experience with children that have ADD it is a problem with concentration, focus and/or thought process. With my 10 year old, all the information has been learned, but when it’s time to recall it, it’s as if his mind can’t find it. That is a problem with thought process in my opinion and organization. The disorganization not only effects how he handles his belongings and physical surroundings, but the information stored in his brain. If this condition that he has can be corrected soon without medication, then that is what we will do, but if he requires medication then that’s what we’ll do. It is already effecting his self esteem and his emotions. He used to be a very happy kid, now he cries daily. I have already seen what it can do to a child with my 17 year old who is learning disabled, ADD and gifted. He is ok now, but went through some very unhappy years, being bullied and also thinking that he was stupid. He is on wellbutrin for depression which has also helped with the ADD.
What I don’t understand is why some people who have no personal experience with ADD want to argue about it on a board that is here to help people who do have personal experiences with it. It is a very real thing and not only that, it is a heartbreaking thing to see a child go through.
Re: Information please
More lies. Tisk tisk. Wish you guys could come up with something reputable to post. Like this;
While examining the brains of hyperactive, inattentive boys with a new type of scanner, Harvard researchers found a reduced flow of blood into a specific area of the brain. Known as the putamen and located deep in the center of the brain, this area helps to control movement and attention.
When doctors gave the drug Ritalin to the six of 11 of these boys, blood flow into the putamen increased significantly. The same doses, however, decreased blood flow even further in five other boys.
“This study points to the putamen as an important region of the brain involved in ADHD (Attention Deficit /Hyperactivity Disorder),” says Martin Teicher, associate professor of psychiatry at Harvard Medical School. “Diminished blood flow may be a new way to objectively diagnose ADHD, rather than relying strictly on reports of behavior. The study also shows that Ritalin may not be effective for all children diagnosed with the disorder.”
Attention deficit/hyperactivity disorder ranks as one of the most common psychiatric problems among children in the United States. Estimates of how many school-age children have the disorder range from 2 million to almost 4 million, a reflection of the uncertainty of diagnosis. Most of these cases are boys 6-12 years old.
Just as the number of cases is imprecise, “so is the use of Ritalin,” Teicher concludes. “If a child behaves like we expect someone with ADHD to behave, we label the child with that disorder, then treat him or her with medication. That fails to distinguish between children who can’t sit still and those who can but don’t.”
Six of the boys in Teicher’s test fell into the first category. “Giving Ritalin to kids like these can be helpful,” he notes. “Those that benefit most from the drug have an impaired ability to control their activity. In the classroom, that can be disruptive, but on the playground they may be no more hyperactive than a normal kid.”
The finding adds to a growing body of evidence that ADHD has a biological basis; in other words, it’s not just willful, disobedient behavior. These children can be successfully treated with medication and behavior therapy, lifting a great emotional stone from the backs of harassed parents.
Re: Information please
I think that study is flawed for several reasons. First the sample group was too small. secondly the part of the basal ganglia where the putamen is located is damaged by amphetamine use so that is why it “lit” up when the Ritalin was introduced. It has become dependant on ritalin to stimulate it. The study was funded by the institute og mental health so I’m sure the will put their spin on it.
[size=18][/size]BUT! the main reason I don’t believe it is because the subjects were deemed ADHD which begs to question how could they stay still during an MRI and not have it degraded by motion artifact? What this study does not tell you about are the meds used to drug these kids in order to keep them still in the MRI machine. If no sedatives
were used how could the kids stay still that long?
[size=12][/size]I can only seriously come to a few possible conclusions. None of the kids were hyper-active. The kids were sedated thus the apearance of damage to the putamen. The test data is fraudulent.
I have researched the cause of obesity and there is research that suggests that fat people produce more of the hormone leptin because the brain isn’t recognizing signals from the vagus nerve. Fat people have jumped on the band wagon and are believing it. They are wrong to believe it because they are too weak willed to admit their own gluttony. It also create a market for another diet drug that won’t work. People have become gomandizing gluttons. 25 years ago there wre less than half the fat people than there are today.
Even publishing this research is reckless because it is so painfully inconclusive. For a scientist to suggest that this reseach prove anything only prove that that scientist is really a politician
Alvin Grimes Research Scientist
Re: Information please
METHYLPHENIDATE
Gross Effects
Wang et al. (1994)—using the PET in normal adults and a small 0.5 mg/kg IV—found decreased overall flow of blood by 23%-30% into all areas of the brain lasting until the end of the experiment at 30 minutes. The researchers warned that these effects “should be considered when prescribing this drug chronically” (p. 143).
Nasrallah et al. (1986) found a small but measurable degree of atrophy of the brain in more than half of 24 young adults with prior stimulant-treated hyperactivity during childhood. The authors suggest that “cortical atrophy” is a long-term adverse effect of [stimulant] treatment” (p. 245).
Several studies claim to demonstrate brain abnormalities associated with ADHD; they probably show the effects of Ritalin and often multiple other drugs.
I knew that study you sighted saying Ritalin increases blood flow in the putamen was bogus.
Alvin - Ball
So Alvin/Ball why don’t you answer the questions a few of the posters have asked you instead of regurgitating the same old tired anti-med posts.
[quote]
So, why don’t you take your beef to the Schools? The Pharm companies? The AMA? Congress. Wouldn’t they all be interested in your non-pharm studies? [unquote]
Re: Alvin - Ball
[quote=”Mayleng”]So Alvin/Ball why don’t you answer the questions a few of the posters have asked you instead of regurgitating the same old tired anti-med posts.
[quote]
So, why don’t you take your beef to the Schools? The Pharm companies? The AMA? Congress. Wouldn’t they all be interested in your non-pharm studies? [unquote][/quote]
I don’t know about Ball but I have written every senator about the drugging of our children. Many have written back and thanked me for my concern. Others are upset by the drugging of our children. As near as I can tel this is a bi-partisan issue.
I would love to see the kind of expose on the Pharm companies that was done on big tobacco.
I think factions in the AMA are seeing the light.
As far as schools go, in some schools 40% of kids are on psychotropic where as other schools discourage drugging.
Re: Information please
ADHD - Is Ritalin Kiddie Cocaine?
Ritalin - The Feminists’ Answer to Active Little Boys
By: Mary Mostert, Analyst, Original Source (www.originalsources.com)
September 2, 1999
A study published recently by the American Journal of Public Health which involved 30,000 children in two school districts in Virginia strongly suggestes that ADHD, the attention deficit hyperactivity disorder, “may be overdiagnosed, and the drug used to treat the condition may be overprescribed.”
Really now? Having raised a very active boy who quite definitely would be on Ritalin today if his teachers had their way, I still doubt the existence of the “disorder.” Today, nearly 6 percent of the school-age population in the United States has been diagnosed with ADHD, a condition “characterised by impulsive behaviour and difficulties in paying attention and keeping still.” Approximately 90 percent of patients with ADHD take the drug Ritalin.
Ritalin, or methylphenidate, is a mild central nervous system stimulant. It boosts the brain’s ability to control impulsive behaviour and helps children concentrate. Dr. Mary Ann Block the author of “No More Ritalin” refers to Ritalin as “kiddie cocaine” and contends it can cause dangerous behaviour. (see: http://www.blockcenter.com/main.htm) Among my grandchildren’s generation, Ritalin use, in my opinion, quite definitely IS being used as “kiddie cocaine” to “control” normal boy behavior.
Today, when a child is totally bored in school, or jumps from one subject to another, you can bet someone at that school is going to pressure the parents to put the kid of Ritalin. In fact, one of my grandaughters, far less active and less rambunctious than her uncle at the same age was teacher-diagnosed as needing Ritalin. Her mother’s answer was a firm “No!”
LeFever found the number of children medicated in school for ADHD was 17 percent for white boys, 9 percent for African-American boys, 7 percent for white girls and 3 percent for African-American girls.
Seventeen percent of Virginia’s white boys are abnormal and require what Dr. Block calls “… mind-altering drugs”? Block points out that Ritalin, is “almost identical to cocaine — goes to the same receptor site in the brain, causes the same high when taken in the same manner,” Block said. Of course, the doctors who prescribe Ritalin claim it is “safe when taken under close supervision and does not have long-term effects even if started at a very young age.”
Others see a totally different picture with the same “results.” What many teachers want to see in their students, and what Ritalin does may be the same thing. However, is what teachers want in the way of behaviour in their class necessarily a good thing for a bright, healthy, child with an inquiring mind? Is the problem in the classroom with the child not paying attention or the problem in the classroom a boring teacher?
For example, if your 10 year old son is considered ADHD in the classroom because he won’t or “can’t” concentrate, but comes home and plays for hours with his game-boy or Nintendo, the kid obviously CAN concentrate. In fact, most 10 year olds today can beat the socks off their grandparents at Nintendo because they are so GOOD at concentrating on the game.
Invariably when I get into a discussion with ADHD parents they tell me that their child usually “performs better in school” and “relates better with family and friends.” When I ask for specifics I find that the child is “better able” to do boring school work. This is a plus? Parents, some of the homework I’ve seen in recent years makes no sense. A child who can plow through it and end up believing it makes sense is the one with the problem, not the child who is bored with it.
In November 1998, Dr. Peter R. Breggin presented a scientific paper at the Plenary Session of the National Institute of Health Consensus Conference on ADHD and its Treatment. (see: http://www.breggin.com/ritalin.html) He dealt with the common dosage of Ritalin for young children saying, in part: “There is little doubt that stimulants can, for a time at least, subdue a child’s behaviour, making the child easier to manage and especially more willing to perform rote, boring tasks. But we need to look beneath the surface at the underlying effects and mechanisms of action.”
Dr. Breggin’s warnings need to be known to every parent who gives their child Ritalin:
1. Psychostimulants (such as Ritalin) can cause irreversible brain damage and dysfunction. This is known with high degree of scientific probability in regard to amphetamine and methamphetamine, and with a high suspicion in regard to methylphenidate.
2. Psychostimulants cause multiple adverse effects, including a variety of cardiac and central nervous system effects, such as COD, depression, and even mania. The CNS effects often confuse doctors, leading inappropriately to further psychiatric diagnosis and medication rather than to drug withdrawal.
3. Psychostimulants impair growth—including the brain.
4. Psychostimulants work by suppressing spontaneity and sociability, by enforcing obsessive-compulsive preservative behaviour, and by isolating the child from normal outside influences.
A chart that accompanied Breggin’s paper listed adverse drug reactions, some of which were considered “improvements in behaviour” by parents and teachers! He listed the following adverse drug reactions (ADRs): Social withdrawal and isolation; General dampening of social behaviour; Reduced social interactions, talking, or sociability; Decreased responsiveness to parents and other children; Increased solitary play; Diminished play.
Other adverse affects of Ritalin included: Obsessive-compulsive behaviour, Preservative behaviour; Cognitive preservation; Inflexibility of thinking; Over-focusing or excessive focusing; Compliance, especially in structured environments; Reduced curiosity; Somber; Subdued Apathetic; lethargic: “tired, withdrawn, listless, depressed, dopey, dazed, subdued and inactive” —passive and submissive behaviours.
Why are these adverse affects considered “improvements” in the child’s (usually a boy’s) behaviour? Why do we want the men of America to be less curious, lethargic, subdued, inactive, passive and submissive? Because we are living in a militantly feminist culture which condemns anything masculine - but especially active, curious, hard to brainwash or manage males, that’s why. Any bright, energetic, boy who challenges today’s politically correct feminist notions is very apt to find himself drugged into submission, especially if he’s living with a feminist single mother.
Often when there’s a father in the house, he will squash the drug approach to behavior which he probably well remembers doing himself at the same age. Someone should study the ritalin use of boys being raised by a single mother. I suspect they’d find a far higher use of mind altering drugs on boys being raised without their fathers.
The very characteristics that working parents and controlling teachers see as “problems” in growing boys are often the same as the characteristics of success - the ability to move quickly from one idea or problem to another, sociability, curiosity, friendliness - once the boy is grown. It sometimes takes patience and humour to see a sociable, curious, friendly, boy with many different interests and ideas through to adulthood, but the rewards are great.
Without those characteristics I don’t see how my son Guy, who today is an orthopedic surgeon, could ever have had the determination to get through 2 years as a full-time missionary, 4 years of college, 4 years of medical school, three years as a Navy doctor, (who served in Desert Storm) and four years as an orthopedic surgery resident. If I’d given him Ritalin, he would have simply remained a framing carpenter. Now, there’s nothing wrong with framing carpenters. He worked his way through college as a carpenter. But, there were other things he was curious about and wanted to learn and some teachers really got upset with that. They could not comprehend why Guy was reading in the encyclopedia about elephants when they had explicitly ordered him to look up owls. They never understood that he looked up owls, and found they ate mice and that got him curious about mice and what they eat so he looked up mice and then remembered that elephants were supposed to be afraid of mice so he was looking up elephants to see if that was really true. Some teachers just wanted him OUT of their class.
Today his “lack of concentration” on owls would be treated with a mind-altering drug. In fact, in the 1960s the common response was tranquilizers. I had a lot of people suggest I put him on tranquilizers. I have seen Ritalin control those impulses to jump from one subject to another in young boys I taught in Church and it’s so sad. The LaFever study will “prompt other communities to study their rates of Ritalin use in school-aged children” Xavier Castellanos of the National Institute of Mental Health observed. “Were the previous estimates of ADHD too low? Is ADHD being overdiagnosed or are doctors now doing a better job of diagnosing it? Certainly no one has found the prevalence of Ritalin use to be this high up until now.”
Before allowing your child to take a mind-altering drug, first ask yourself how many hours a day of active play is he participating in. Does he have the opportunity to run, jump, and play vigorously a couple of hours a day? Would his energy level be a problem if you were living in a log cabin and he was up milking a cow at 5 AM? If the you have to say “no” to these questions, HE’S not the one with the problem. You and the teacher are the problem. He needs to be given more challenges and more physical activity. It’s quite possible he is a smart kid and is simply totally bored.
I bought a trampoline for Guy and when he couldn’t sit still or was driving his sisters crazy I’d say, “Guy, go jump on the trampoline for 15 minutes.” He’d jump for longer than that and come in happy. Still, to the day of his graduation he hated high school and would avoid going whenever possible. The school kept trying to get Guy to act “normal.” He never did. He couldn’t slow down that much. After high school he worked for a year at a quarry breaking up rocks with a jackhammer, saved his money and went to Japan on a mission for his Church, came home and spent the next 15 years either in a classroom or in the army.
Had I given him Ritalin in elementary school to “slow him down” or make him more content with meaningless paperwork, he would never have made it as an orthopedic surgeon. However, he’s the kind of doctor everyone wants in the emergency room - alert, quick thinking, well prepared and energetic. Without a doubt had he been on Ritalin then, or now, he wouldn’t have those characteristics. Of course, all the ADHD symptoms didn’t go away. To this day the government’s mountains of paperwork bores him just like the English teacher’s boring lessons.
However, today if he wanted to he could hire one of his old English teachers to do all that stuff at close to minimum wage while he saves the lives of people broken and bleeding to death after a car accident.
To comment: [email protected]
PLEASE SUPPORT REAGAN.COM!
Re: Information please
[quote=”Black Sheep”]ADHD - Is Ritalin Kiddie Cocaine?
Ritalin - The Feminists’ Answer to Active Little Boys
By: Mary Mostert, Analyst, Original Source (www.originalsources.com)
September 2, 1999
A study published recently by the American Journal of Public Health which involved 30,000 children in two school districts in Virginia strongly suggestes that ADHD, the attention deficit hyperactivity disorder, “may be overdiagnosed, and the drug used to treat the condition may be overprescribed.”
Really now? Having raised a very active boy who quite definitely would be on Ritalin today if his teachers had their way, I still doubt the existence of the “disorder.” Today, nearly 6 percent of the school-age population in the United States has been diagnosed with ADHD, a condition “characterised by impulsive behaviour and difficulties in paying attention and keeping still.” Approximately 90 percent of patients with ADHD take the drug Ritalin.
Ritalin, or methylphenidate, is a mild central nervous system stimulant. It boosts the brain’s ability to control impulsive behaviour and helps children concentrate. Dr. Mary Ann Block the author of “No More Ritalin” refers to Ritalin as “kiddie cocaine” and contends it can cause dangerous behaviour. (see: http://www.blockcenter.com/main.htm) Among my grandchildren’s generation, Ritalin use, in my opinion, quite definitely IS being used as “kiddie cocaine” to “control” normal boy behavior.
Today, when a child is totally bored in school, or jumps from one subject to another, you can bet someone at that school is going to pressure the parents to put the kid of Ritalin. In fact, one of my grandaughters, far less active and less rambunctious than her uncle at the same age was teacher-diagnosed as needing Ritalin. Her mother’s answer was a firm “No!”
LeFever found the number of children medicated in school for ADHD was 17 percent for white boys, 9 percent for African-American boys, 7 percent for white girls and 3 percent for African-American girls.
Seventeen percent of Virginia’s white boys are abnormal and require what Dr. Block calls “… mind-altering drugs”? Block points out that Ritalin, is “almost identical to cocaine — goes to the same receptor site in the brain, causes the same high when taken in the same manner,” Block said. Of course, the doctors who prescribe Ritalin claim it is “safe when taken under close supervision and does not have long-term effects even if started at a very young age.”
Others see a totally different picture with the same “results.” What many teachers want to see in their students, and what Ritalin does may be the same thing. However, is what teachers want in the way of behaviour in their class necessarily a good thing for a bright, healthy, child with an inquiring mind? Is the problem in the classroom with the child not paying attention or the problem in the classroom a boring teacher?
For example, if your 10 year old son is considered ADHD in the classroom because he won’t or “can’t” concentrate, but comes home and plays for hours with his game-boy or Nintendo, the kid obviously CAN concentrate. In fact, most 10 year olds today can beat the socks off their grandparents at Nintendo because they are so GOOD at concentrating on the game.
Invariably when I get into a discussion with ADHD parents they tell me that their child usually “performs better in school” and “relates better with family and friends.” When I ask for specifics I find that the child is “better able” to do boring school work. This is a plus? Parents, some of the homework I’ve seen in recent years makes no sense. A child who can plow through it and end up believing it makes sense is the one with the problem, not the child who is bored with it.
In November 1998, Dr. Peter R. Breggin presented a scientific paper at the Plenary Session of the National Institute of Health Consensus Conference on ADHD and its Treatment. (see: http://www.breggin.com/ritalin.html) He dealt with the common dosage of Ritalin for young children saying, in part: “There is little doubt that stimulants can, for a time at least, subdue a child’s behaviour, making the child easier to manage and especially more willing to perform rote, boring tasks. But we need to look beneath the surface at the underlying effects and mechanisms of action.”
Dr. Breggin’s warnings need to be known to every parent who gives their child Ritalin:
1. Psychostimulants (such as Ritalin) can cause irreversible brain damage and dysfunction. This is known with high degree of scientific probability in regard to amphetamine and methamphetamine, and with a high suspicion in regard to methylphenidate.
2. Psychostimulants cause multiple adverse effects, including a variety of cardiac and central nervous system effects, such as COD, depression, and even mania. The CNS effects often confuse doctors, leading inappropriately to further psychiatric diagnosis and medication rather than to drug withdrawal.
3. Psychostimulants impair growth—including the brain.
4. Psychostimulants work by suppressing spontaneity and sociability, by enforcing obsessive-compulsive preservative behaviour, and by isolating the child from normal outside influences.
A chart that accompanied Breggin’s paper listed adverse drug reactions, some of which were considered “improvements in behaviour” by parents and teachers! He listed the following adverse drug reactions (ADRs): Social withdrawal and isolation; General dampening of social behaviour; Reduced social interactions, talking, or sociability; Decreased responsiveness to parents and other children; Increased solitary play; Diminished play.
Other adverse affects of Ritalin included: Obsessive-compulsive behaviour, Preservative behaviour; Cognitive preservation; Inflexibility of thinking; Over-focusing or excessive focusing; Compliance, especially in structured environments; Reduced curiosity; Somber; Subdued Apathetic; lethargic: “tired, withdrawn, listless, depressed, dopey, dazed, subdued and inactive” —passive and submissive behaviours.
Why are these adverse affects considered “improvements” in the child’s (usually a boy’s) behaviour? Why do we want the men of America to be less curious, lethargic, subdued, inactive, passive and submissive? Because we are living in a militantly feminist culture which condemns anything masculine - but especially active, curious, hard to brainwash or manage males, that’s why. Any bright, energetic, boy who challenges today’s politically correct feminist notions is very apt to find himself drugged into submission, especially if he’s living with a feminist single mother.
Often when there’s a father in the house, he will squash the drug approach to behavior which he probably well remembers doing himself at the same age. Someone should study the ritalin use of boys being raised by a single mother. I suspect they’d find a far higher use of mind altering drugs on boys being raised without their fathers.
The very characteristics that working parents and controlling teachers see as “problems” in growing boys are often the same as the characteristics of success - the ability to move quickly from one idea or problem to another, sociability, curiosity, friendliness - once the boy is grown. It sometimes takes patience and humour to see a sociable, curious, friendly, boy with many different interests and ideas through to adulthood, but the rewards are great.
Without those characteristics I don’t see how my son Guy, who today is an orthopedic surgeon, could ever have had the determination to get through 2 years as a full-time missionary, 4 years of college, 4 years of medical school, three years as a Navy doctor, (who served in Desert Storm) and four years as an orthopedic surgery resident. If I’d given him Ritalin, he would have simply remained a framing carpenter. Now, there’s nothing wrong with framing carpenters. He worked his way through college as a carpenter. But, there were other things he was curious about and wanted to learn and some teachers really got upset with that. They could not comprehend why Guy was reading in the encyclopedia about elephants when they had explicitly ordered him to look up owls. They never understood that he looked up owls, and found they ate mice and that got him curious about mice and what they eat so he looked up mice and then remembered that elephants were supposed to be afraid of mice so he was looking up elephants to see if that was really true. Some teachers just wanted him OUT of their class.
Today his “lack of concentration” on owls would be treated with a mind-altering drug. In fact, in the 1960s the common response was tranquilizers. I had a lot of people suggest I put him on tranquilizers. I have seen Ritalin control those impulses to jump from one subject to another in young boys I taught in Church and it’s so sad. The LaFever study will “prompt other communities to study their rates of Ritalin use in school-aged children” Xavier Castellanos of the National Institute of Mental Health observed. “Were the previous estimates of ADHD too low? Is ADHD being overdiagnosed or are doctors now doing a better job of diagnosing it? Certainly no one has found the prevalence of Ritalin use to be this high up until now.”
Before allowing your child to take a mind-altering drug, first ask yourself how many hours a day of active play is he participating in. Does he have the opportunity to run, jump, and play vigorously a couple of hours a day? Would his energy level be a problem if you were living in a log cabin and he was up milking a cow at 5 AM? If the you have to say “no” to these questions, HE’S not the one with the problem. You and the teacher are the problem. He needs to be given more challenges and more physical activity. It’s quite possible he is a smart kid and is simply totally bored.
I bought a trampoline for Guy and when he couldn’t sit still or was driving his sisters crazy I’d say, “Guy, go jump on the trampoline for 15 minutes.” He’d jump for longer than that and come in happy. Still, to the day of his graduation he hated high school and would avoid going whenever possible. The school kept trying to get Guy to act “normal.” He never did. He couldn’t slow down that much. After high school he worked for a year at a quarry breaking up rocks with a jackhammer, saved his money and went to Japan on a mission for his Church, came home and spent the next 15 years either in a classroom or in the army.
Had I given him Ritalin in elementary school to “slow him down” or make him more content with meaningless paperwork, he would never have made it as an orthopedic surgeon. However, he’s the kind of doctor everyone wants in the emergency room - alert, quick thinking, well prepared and energetic. Without a doubt had he been on Ritalin then, or now, he wouldn’t have those characteristics. Of course, all the ADHD symptoms didn’t go away. To this day the government’s mountains of paperwork bores him just like the English teacher’s boring lessons.
However, today if he wanted to he could hire one of his old English teachers to do all that stuff at close to minimum wage while he saves the lives of people broken and bleeding to death after a car accident.
To comment: [email protected]
PLEASE SUPPORT REAGAN.COM![/quote]
I AM OUTRAGED!!!! :x :x :x Then again, outrage is just jealousy disguised
Hi Marcy and welcome,
Not an easy question to answer. I hope you don’t expect the answer to be easy to read. ADHD is a neurological disorder and like many, can be diagnosed by careful observations of symptoms and attentional testing. There are things like brain spects and magnetic imaging, but they are very new and very expensive and insurances will not cover them. If you like to research, I recommend Daniel G Amen, Healing ADD. You will find these tests do indeed diagnose ADD with out fail. Proper diagnosis is crucial to get your child properly treated so you are wise to be concerned. There are many disorders that mimic ADHD so these must be ruled out first.
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.