The False ADHD Controversy
More kids are being diagnosed with attention deficit hyperactivity disorder (ADHD) than ever before, according to the Centers for Disease Control. 8.8% of children were diagnosed in 2011, compared with 7.0% in 2007.
An uptick was also witnessed in the number of parents choosing to medicate their children with stimulants such as Ritalin. That proportion now sits at two-thirds.
ADHD is perhaps childhood's most common neurobehavioral disorder. It's characterized by an array of symptoms, including squirming, excessive daydreaming, forgetfulness, and hyperactivity. Scientists still can't precisely pinpoint what's going on in the brain to trigger ADHD, but it's evident that something is amiss. Children with ADHD generally have reduced brain volume in the left pre-frontal cortex.
But the lack of a conclusive causal mechanism in the brain leads many onlookers to conclude that ADHD is a manufactured condition. Its symptoms are merely side effects of childhood, they argue. But this is not in agreement with evidence stemming from genetics. Thanks to large twin studies, a number of genes have been implicated, particularly those that affect dopamine transporters. The dopamine system of the brain regulates a whole heap of processes, but it's most commonly linked with reward seeking. As far as ADHD goes, we know that when dopamine levels are driven up within the brain, ADHD symptoms lessen in severity.
ADHD certainly exists, says Russell Barkley, a professor of psychiatry and neurology at the University of Massachusetts.
"No scientific meetings mention any controversies about the disorder, about its validity as a disorder, about the usefulness of using stimulant medications like Ritalin for it. There simply is no controversy. The science speaks for itself. And the science is overwhelming that the answer to these questions is in the affirmative: it's a real disorder; it's valid; and it can be managed, in many cases, by using stimulant medication in combination with other treatments."
There are legitimate realms of disagreement over ADHD, however. The fact that kids in North Carolina are twice as likely to be diagnosed with the disorder than kids in California shows that there must be more at work than genetics. Environmental factors like parenting, economic status, diet, and exposure to cigarette smoking may also play minor roles. Moreover, the fact that Britain has rates of ADHD less than half that of the United States likely shows that Americans are more apt to diagnose -- or over diagnose -- it.
Even more contentious is the question of when to use medications like Ritalin or Adderall, which -- like cocaine, amphetamines, and opium -- are classified by the Drug Enforcement Agency as schedule II controlled substances. Is it really wise to be placing children on such drug regimens, especially when their brains are still in the sensitive process of developing?
That's for parents to decide, but general scientific consensus seems to point to "yes." In cases of ADHD where dietary and behavioral modifications don't seem to cut it, medication can be a life-changer.
"The judicious use of medication... is a good idea," Max Wiznitizer a pediatric neurologist at Case Western Reserve University, told ABC News. "The goal of the medication is to help kids focus, to reduce their impulsivity, and also to allow them to function adequately in their social environment."
Those who blatantly deny the existence of ADHD or blindly oppose the drugs to treat it often don't consider the consequences for children who don't receive appropriate care. One study found that they're more likely to drop out of school and be unsuccessful later in life.
When Harold Kopelwicz, the vice chairman of psychiatry at New York University hears comments insinuating that ADHD is no more than a subjective fabrication of psychiatrists and drug makers, he gets a bit riled.
"To suggest that this is a fraud, that somehow children are being abused by these treatments, is really an outrage, because for these kids, to not get treated is really the greatest abuse and neglect..."
(Image: Associated Press)