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ADHD Myths
(From
www.addconsults.com distributed
with kind permission)
In Australia, many of these facts are the same as our own, the same
concerns arise from misinformation that people in Australia read
from the USA. It seemed pertinent to publish this as well. In the USA
there is a group of religious zealots, many with academic
qualifications, that have been feeding the wrong information to the
media and the public, that has been making it's way into our press
achieving negative results & putting children's lives at risk through
improper treatment management by parents because of the fear factor
employed by the media.
The following myths - and factual responses - have been collected
from rebuttals to recent media articles about ADD/ADHD. The rebuttals
were written by MAAAN (Metro Area Adult ADHD Network, based in the
Detroit area).
Myth #1:
ADHD is a "phantom disorder".
FACT:
The
existence of a neurobiological disorder is not an issue to be decided
by the media through public debate, but rather as a matter of
scientific research. Scientific studies spanning 95 years summarized
in the professional writings of Dr. Russell Barkley, Dr. Sam
Goldstein, and others have consistently identified a group of
individuals who have trouble with concentration, impulse control, and
in some cases, hyperactivity. Although the name given to this group of
individuals, our understanding of them, and the estimated prevalence
of this group has changed a number of times over the past six decades,
the symptoms have consistently been found to cluster together.
Currently called Attention Deficit Hyperactivity Disorder, this
syndrome has been recognized as a disability by the courts, the United
States Department of Education, the Office for Civil Rights, the
United States Congress, the National Institutes of Health, and all
major professional medical, psychiatric, psychological, and
educational associations.
Myth #2:
Ritalin is like cocaine, and the failure to give youngsters
drug holidays from Ritalin causes them to develop psychosis.
FACT:
Methylphenidate (Ritalin) is a medically prescribed stimulant
medication that is chemically different from cocaine. The therapeutic
use of methylphenidate does NOT CAUSE addiction or dependence, and
does not lead to psychosis. Some children have such severe ADD
symptoms that it can be dangerous for them to have a medication
holiday, for example a child who is so hyper and impulsive he'll run
into traffic without stopping to look first. Hallucinations are an
extremely rare side-effect of methylphenidate, and their occurrence
has nothing to do with the presence or absence of medication
holidays. Individuals with ADHD who are properly treated with
stimulant medication such as Ritalin have a lower risk of developing
problems with alcohol and other drugs than the general population.
More importantly, fifty years of research has repeatedly shown that
children, adolescents, and adults with ADHD safely benefit from
treatment with methylphenidate.
Myth #3:
No study has ever demonstrated that
taking stimulant
medications can cause any lasting behavioural or educational benefit
to ADHD children.
FACT:
Research
has repeatedly shown that children, adolescents, and adults with ADHD
benefit from therapeutic treatment with stimulant medications, which
has been used safely and studied for more than 50 years. For example,
The New York Times reviewed a recent study from Sweden showing
positive long- term effects of stimulant medication therapy on
children with ADHD. Readers interested in more studies on the
effectiveness of medication with ADHD should consult the professional
writings of Dr. Russell Barkley, Drs. Gabrielle Weiss and Lily
Hechtman, and Dr. Joseph Biederman.
Myth #4:
ADHD kids are learning to make excuses, rather than take
responsibility for their actions.
FACT:
Therapists,
educators, and physicians routinely teach children that ADHD is a
challenge, not an excuse. Medication corrects their underlying
chemical imbalance, giving them a fair chance of facing the challenges
of growing up to become productive citizens. Accommodations for the
disabled, as mandated by federal and state laws, are not ways of
excusing them from meeting society's responsibilities, but rather make
it possible for them to compete on a levelled playing field.
Myth #5:
ADHD is basically due to bad parenting and lack of
discipline, and all that ADHD children really need is old-fashioned
discipline, not any of these phoney therapies.
FACT:
There are
still some parent-bashers around who believe the century-old
anachronism that child misbehaviour is always a moral problem of the
"bad child." Under this model, the treatment has been to "beat the
Devil out of the child." Fortunately, most of us are more enlightened
today. A body of family interaction research
conducted by Dr. Russell Barkley and others has unequivocally
demonstrated that simply providing more discipline without any other
interventions worsens rather than improves the behaviour of children
with ADHD. One can't make a paraplegic walk by applying discipline.
Similarly, one can't make a child with a biologically-based lack of
self-control act better by simply applying discipline alone.
Myth #6:
Ritalin is unsafe, causing serious
weight loss, mood swings,
Tourette's syndrome, and sudden, unexplained deaths.
FACT:
Research has repeatedly shown that children, adolescents, and adults
with ADHD benefit from treatment with Ritalin (also known as
methylphenidate), which has been safely used for approximately 50
years. There are NO published cases of deaths from overdoses of
Ritalin; if you take too much Ritalin, you will feel terrible and act
strange for a few hours, but you will not die. This cannot be said
about many other medications. The unexplained deaths cited in some
articles are from a combination of Ritalin and other drugs, not from
Ritalin alone. Further investigation of those cases has revealed that
most of the children had unusual medical problems which contributed to
their deaths. It is true that many children experience appetite loss,
and some moodiness or "rebound effect" when Ritalin wears off. A very
small number of children may show some temporary tics, but these do
not become permanent. Ritalin does not permanently alter growth, and
usually does not result in weight loss. Ritalin does not cause
Tourette's syndrome, rather many youngsters with Tourette's also have
ADHD. In some cases, Ritalin even leads to an improvement of the of
tics in children who have ADHD and Tourette's.
Myth #7:
Teachers around the country routinely push pills on any
students who are even a little inattentive or overactive.
FACT:
Teachers
are well-meaning individuals who have the best interests of their
students in mind. When they see students who are struggling to pay
attention and concentrate, it is their responsibility to bring this to
parents' attention, so parents can take appropriate action. The
majority of teachers do not simply push pills- they provide
information so that parents can seek out appropriate diagnostic help.
We do agree with the position that teachers should not diagnose ADHD.
However, being on the front lines with children, they collect
information, raise the suspicion of ADHD, and bring the information to
the attention of parents, who then need to have a full evaluation
conducted outside the school. The symptoms of ADHD must be present in
school and at home before a diagnosis is made; teachers do not have
access to sufficient information about the child's functioning to make
a diagnosis of ADHD or for that matter to make any kind of medical
diagnosis.
Myth #8:
Efforts by teachers to help children who have attentional
problems can make more of a difference than medications such as
Ritalin.
FACT:
It would be nice if this were true, but recent scientific evidence
from the multi-modal treatment trials sponsored by the National
Institute of Mental Health suggests it is a myth. In these studies,
stimulant medication alone was compared to stimulant medication plus a
multi-modal psychological and educational treatment, as treatments for
children with ADHD. The scientists found that the multi-modal
treatment plus the medication was not much better than the medication
alone. Teachers and therapists need to continue to do everything they
can to help individuals with ADHD, but we need to realize that if we
don't also alter the biological factors that affect ADHD, we won't see
much change.
Myth #9:
C.H.A.D.D. is supported by drug companies, and along with many
professionals, are simply in this field to make a quick buck on ADHD.
FACT:
Thousands of parents and professionals volunteer
countless hours daily to over 600 chapters of CHADD. around the U.S.
and Canada on behalf of individuals with ADHD. CHADD. is very open
about disclosing any contributions from drug companies. These
contributions only support the organization's national conference,
which consists of a series of educational presentations, 95% of which
are on topics other than medications. None of the local chapters
receive any of this money. It is a disgrace to impugn the honesty and
efforts of all of these dedicated volunteers. CHADD. supports all
known effective treatments for ADHD, including medication, and takes
positions against unproven and costly remedies.
Myth #10:
It is not possible to accurately diagnose ADD or ADHD in
children or adults.
FACT:
Although scientists have not yet developed a single medical test for
diagnosing ADHD, clear-cut clinical diagnostic criteria have been
developed, researched, and refined over several decades. The current
generally accepted diagnostic criteria for ADHD are listed in the
Diagnostic and Statistical Manual of Mental Disorders (DSM-IV)
published by the American Psychiatric Association (1995). Using these
criteria and multiple methods to collect comprehensive information
from multiple informants, ADHD can be reliably diagnosed in children
and adults.
Myth #11:
Children outgrow ADD or ADHD.
FACT:
ADHD is not
found just in children. We have learned from a number of excellent
follow-up studies conducted over the past few decades that ADHD often
lasts a lifetime. Over 70% of children diagnosed as having ADHD will
continue to manifest the full clinical syndrome in adolescence, and
15-50% will continue to manifest the full clinical syndrome in
adulthood. If untreated, individuals with ADHD may develop a variety
of secondary problems as they move through life, including depression,
anxiety, substance abuse, academic failure, vocational problems,
marital discord, and emotional distress. If properly treated, most
individuals with ADHD live productive lives and cope reasonably well
with their symptoms.
Myth #12:
Methylphenidate prescriptions in
the U.S. have increased 600%.
FACT:
The
production quotas for methylphenidate increased 6-fold; however that
DEA production quota is a gross estimate based on a number of factors,
including FDA estimates of need, drug inventories at hand, EXPORTS,
and industry sales expectations. One cannot conclude that a 6-fold
increase in production quotas translates to a 6-fold increase in the
use of methylphenidate among U.S. children any more than one should
conclude that Americans eat 6 times more bread because U.S. wheat
production increased 6-fold even though much of the grain is stored
for future use and export to countries that have no wheat production.
Further, of the approximately 3.5 million children who meet the
criteria for ADHD, only about 50% of them are diagnosed and have
stimulant medication included in their treatment plan. The estimated
number of children taking methylphenidate for ADD suggested in some
media stories fails to note that methylphenidate is also prescribed
for adults who have ADHD, people with narcolepsy, and geriatric
patients who receive considerable benefit from it for certain
conditions associated with old age such as memory functioning. (see Pediatrics, December 1996, Vol. 98, No. 6)
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